Majority Of Pharmacists Research Articles

Pharmacist-Prescribed Hormonal Contraception: A Survey of Perceptions of Georgia Community Pharmacists and Non-Community Pharmacists.

Pharmacist-prescribed hormonal contraception (HC) is supported by a majority of pharmacists and pharmacy students; however, few studies have evaluated perceptions of non-community pharmacists, or differences in geographic areas. The primary objective of this study is to assess differences between community and non-community pharmacists in perceptions of pharmacist-prescribing HC in Georgia, a state that does not currently permit this practice. Secondary objectives include assessment of community pharmacist interest in prescribing HC, and differences in perceptions between pharmacists in metropolitan and nonmetropolitan areas. A survey was emailed in early 2022 to 2592 Georgia pharmacists, with Likert questions assessing interest, perceptions, comfort, and perceived barriers regarding pharmacist-prescribed HC. Chi square testing identified differences between groups. The completed survey response rate was 11.8%. Regardless of practice site, a majority agreed that pharmacists are well trained to prescribe HC (community 61.8% vs. non-community 68.1%, p = 0.25) and provision of HC services is within pharmacists' scope (community 73.6% vs. non-community 74.2%, p = 0.90). Overall, metropolitan and nonmetropolitan community pharmacist perceptions were similar; however, more metropolitan pharmacists believed pharmacists are well trained to prescribe HC (66.7% vs. 48.7%, p = 0.049) and that it is within their scope of practice (78.1% vs. 61.5%, p = 0.045). In summary, the majority of pharmacists, regardless of practice type, believe that pharmacists are prepared to prescribe HC and that it is a part of pharmacists' professional scope of practice.

The role of pharmaceutical care in the use of rifaximin for the treatment of diarrhea

the management of diarrhea represents a prevalent issue within the realm of healthcare. Rifaximin is recommended to treat traveler's diarrhea and irritable bowel syndrome. At the same time, it is important to rationally use an antimicrobial drug to prevent the development of antimicrobial resistance. Aim: to evaluate the role of pharmaceutical care in using rifaximin to treat diarrhea, based on a questionnaire. A questionnaire survey was done among 55 pharmacy professionals and 42 pharmacy visitors regarding the dispensing and use of rifaximin for diarrhea treatment. The survey of pharmacy visitors revealed that rifaximin was used for the treatment of small intestinal bacterial overgrowth syndrome (32 cases), traveler's diarrhea (7 cases), and irritable bowel syndrome with diarrhea (3 cases). Patients did not undergo stool culture before rifaximin prescription, which could have prevented antimicrobial resistance and ruled out other causes of diarrhea. It was found that 14% of respondents reported improvement the next day, while 83.3% reported improvement within three days. Pharmacists can educate visitors about the importance of completing the treatment course. Five percent of respondents reported nausea as an adverse reaction. Pharmacists dispensed rifaximin for the treatment of diarrhea in adults almost three times more often than in children. The tablet form of the drug was used in 94.5% of cases, while the oral suspension was used in 5.5% of cases. The majority of pharmacy visitors (89.0%) received rifaximin with a doctor's prescription, and 10.9% without a prescription, which emphasizes the importance of pharmaceutical care to prevent irrational use of the drug. The results of the study show that 92.7% of pharmacists provide recommendations on the safety of rifaximin use, and 78.2% recommend abstaining from alcohol during treatment. Only 21.8% of pharmacists warn about the possible staining of urine, which can cause concern for patients. The majority of pharmacists (89.1%) systematically ask women about possible pregnancy, which indicates their awareness of safe pharmacotherapy. Pharmacists also clarify the simultaneous use of rifaximin with other drugs: 32.7% ask about taking oral contraceptives, 7.3% – antiarrhythmic drugs, and 3.6% – warfarin. mailto:https://meshb.nlm.nih.gov/record/ui?ui=D002648Pharmacists can enhance the effectiveness of rifaximin treatment by preventing its uncontrolled use, emphasizing the importance of completing the treatment course and informing about possible adverse reactions. When providing pharmaceutical care to visitors taking rifaximin, pharmacists should educate them about potential changes in urine color. Additionally, pharmaceutical workers advise women taking oral contraceptives to use additional contraceptive methods while taking rifaximin.

Empowering pharmacy professionals to enhance public health nutrition: a mixed methods study

Unhealthy dietary patterns stand as the foremost risk factor for noncommunicable disease- associated morbidity and mortality(1). As widely accessible healthcare providers, pharmacy professionals’ potential to catalyze improvements in public health nutrition is substantial, offering a means to combat the escalating epidemic of obesity and NCDs through tailored interventions, services, and education(2,3).Our study employed a mixed-methods approach to assess the role of pharmacy professionals in promoting nutrition advice and healthy dietary practices.An online questionnaire (N=200) was designed and conducted to evaluate pharmacy professionals’ nutrition knowledge, the advice given in various diet-related conditions (e.g. obesity, type 2 diabetes, cardiovascular disease risk factors, malnutrition, sustainable diets), practices in delivering diet- related guidance within their routine practice and perceived roles and future ambitions of pharmacy professionals towards nutrition counselling, yielding both quantitative and qualitative insights.Subsequently, qualitative interviews and focus group discussions (N=19) were conducted, engaging pharmacists, nutritionists and dietitians to gather insights essential for the development of a comprehensive nutrition toolkit tailored for pharmacy practice.These interviews delved deeper into the subject, with the goal of designing a nutrition toolkit that empowers pharmacists with the knowledge, tools, and resources needed to play a more active and impactful role in promoting nutrition and healthy lifestyle practices among their patients. Thematic analysis was conducted, and emerging themes and subthemes were identified.Our findings indicate that a significant portion of participants in our study are involved in providing nutrition and diet advice for various health conditions. The majority of pharmacists considered diabetes programmes having a high level of importance (84%), followed by weight management services (78%), hypertension management (86%), and healthy diet campaigns (63.5%). However, our knowledge and confidence rating questions revealed a significant gap in training and a clear need for educational materials tailored for pharmacists to enhance their ability to provide nutrition advice effectively. Key themes identified in open-text questions were referrals and collaboration, training and education needs, wider needs (changes in the public health system, materials/resources, integration and implementation of nutrition in pharmacy practice) and perceived roles as pharmacists in providing nutrition advice (patient support, feeling responsible, specialised focus areas).Qualitative findings underscore the pressing demand for nutrition training and education to deliver comprehensive services, as well as the necessity for collaborative efforts with dietitians and nutritionists to ensure effective care and the improvement of referral pathways in pharmacy practice.This research contributes to the advancement of public health nutrition by recognizing the potential role of pharmacy professionals as key players in the dissemination of nutrition knowledge and fostering healthy behaviours within the community. The results will guide us in the collaborative development of a nutrition toolkit tailored for pharmacy practice, employing a co-design approach.

Toward inclusive health care: Pharmacists’ perceptions on academic preparedness and health care provision for the LGBTQIA+ community

BackgroundThe community of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities (LGBTQIA+), comprising sexual and gender minorities, frequently encounters violence, discrimination, and numerous obstacles in accessing health care services. Pharmacists have the potential to significantly contribute to the health care provision for this community. ObjectiveTo assess pharmacists’ perceptions regarding academic preparedness and health care provision for the LGBTQIA+ community in Brazil. MethodsAn online cross-sectional survey was conducted from August 2022 to February 2023, focusing on the academic training of pharmacists and the provision of health care to the LGBTQIA+ community in Brazil. Data collection was achieved through a 28-question online questionnaire, comprising both closed-ended questions, and Likert-type items. The study variables were subjected to an exploratory descriptive analysis. ResultsWe received 261 complete and valid responses. A majority of pharmacists indicated that they provided health care to the LGBTQIA+ community (n = 161, 61.7%); however, they lacked formal education on LGBTQIA+ health care during their pharmacy program (n = 256, 98.1%). Most participants strongly agreed that pharmacists play a crucial role in promoting health care for this community (n = 213, 81.6%). However, only a small percentage felt confident in addressing issues related to the effectiveness and safety of hormone use for transgender patients (n = 38, 14.6%). Furthermore, less than a third believed that the health care provided by pharmacists should be differentiated for patients within and outside of the LGBTQIA+ community (n = 76, 29.1%). ConclusionThe results of this study underscore the necessity and significance of incorporating this topic both in pharmacy training and continuing education. This approach is crucial to enhance and bolster the clinical practice of pharmacists.

Pharmacists' Attitudes Towards Long-Term Use of Nasal Decongestants: A Cross-Sectional Study.

Rhinitis medicamentosa is a nonallergic inflammation of the nasal mucosa caused by topical decongestants overuse. It mainly affects young and middle-aged adults. Therefore, the aim of this study was to investigate the attitudes of pharmacists regarding the utilization of over-the-counter intranasal decongestants. An online cross-sectional study was conducted from November 2021 to January 2022. The target population of the study included pharmacists who work in community pharmacies in Saudi Arabia. Binary logistic regression analysis was used to identify predictors of having positive attitude towards controlling the use of decongestant. A total of 220 participants were included in this study. Around 15.0% of them reported that ND come with a physician prescription. The majority of the participants (87.3%) reported that the less than 5 days is the maximum safe duration for the use of NDs. Overall, the study participants demonstrated moderately positive attitude towards controlling the use of decongestant with a mean attitude score of 2.5 (standard deviation: 1.2) out of 5; which represents 50.0% of the maximum score. Binary logistic regression analysis identified that pharmacists aged 31-40 years were two-folds more likely to have positive attitude towards controlling the use of decongestant compared to others (p<0.05). Around 45.9% of them reported that they recommend other over-the-counter treatments like nasal irrigation, nasal steroids, or antihistamine if they see a patient with RM asking for ND with or without prescription. The majority of pharmacists in Saudi Arabia demonstrated sufficient awareness and understanding on the adverse effects associated with the excessive use of NDs. Rhinitis medicamentosacan be avoided by appropriate measures, highlighting the importance of raising awareness about the excessive use of decongestants among healthcare professionals and patients alike.

An Assessment of Knowledge, Attitude, and Practice (KAP) of Colorectal Cancer among Community Pharmacists in the Qassim Region of Saudi Arabia.

Background: The global burden of colorectal cancer remains a major public health issue and one of the leading causes of death worldwide. In Saudi Arabia, it continues to be a health concern. Any delays in diagnosis for any reason may contribute to advanced complications; therefore, pharmacists' knowledge and awareness of colorectal cancer are crucial for the welfare of society. Studies of colon cancer-related knowledge, attitude, and practice (KAP) among community pharmacists have not previously been conducted in the Al-Qassim region of Saudi Arabia. In the present study, therefore, we sought to investigate the KAP on colon cancer among pharmacists in Al-Qassim. Methods: This was a prospective, cross-sectional, observational study. A sample of 150 community pharmacists was recruited using a convenience sampling method. A self-administered questionnaire was used to evaluate levels of knowledge and practice. Results: Out of a total of 150 pharmacists, the majority of respondents (60.7%) possessed an adequate level of knowledge. About 50% of participants had heard of the early screening test, and 68.7% knew that colonoscopy is necessary in such scenarios. On the basis of their attitudes, 41.3% of study participants were aware of colon cancer symptoms and risk factors. In practice, however, the majority of pharmacists (81%) did not perform early cancer screenings, while 19% did screen when advised to do so by a physician. Conclusions: Our results indicate that pharmacists in Qassim have an adequate level of knowledge of colon cancer in terms of awareness, assessment, and screening. Since community pharmacists are among the most reliable members of the medical community, a greater awareness of colon cancer among pharmacists may improve public knowledge of the disease.

Community pharmacists’ knowledge, attitudes toward epilepsy and availability of antiepileptic drugs in Ouagadougou (Burkina Faso)

BackgroundThe community pharmacists educate patients and their families concerning the development of adherence to their therapy, and then improving health-related quality of life for those patients. Our study aims to describe the management of epilepsy in pharmaceutical pharmacies in a low income country.MethodsThis was a cross-sectional study carried out in the pharmaceutical pharmacies of the city of Ouagadougou during a period of 2 months, from November 15 to December 15, 2020.ResultsFifty six pharmacists with a mean age of 41 ± 12.73 years were included in the study. Of them, 7.14% received specific training on epilepsy. Respondents with good knowledge about epilepsy were 48.21%. The level of “good knowledge” was significantly higher among respondents who had received specific training in epilepsy and among those with more than 15 years of experience as a dispensary pharmacist. The experience of more than 15 years was the factor significantly associated with a level of good knowledge about epilepsy. Regarding the seizure first aid management, the majority of pharmacists knew the attitudes of seizure first aid management by citing the lateral security position (83.9%). Phenobarbital was the most widely used antiepileptic drug in 96.43%. In 47.17% (n = 53) of pharmacies, demand exceeded supply.ConclusionsEffort must be put on the supply of antiepileptic drugs and the training of health personnel.

Evaluating the Benefits of Using Mobile Application (diarrhea management step by step) in the Management of Diarrhea by Community Pharmacists

Diarrhea is one of the most commonly encountered minor ailments in the community pharmacies. It is associated with significant morbidity and mortality. However, the majority of pharmacists in Iraq did not manage diarrheal cases in a proper way. Therefore, the current study aimed to evaluate the benefit of a new mobile application (diarrhea management step by step) to improve the pharmacist's role in the management of diarrhea. The study was conducted from 21th September to 21th October 2021 using a pre-post design via a simulated patient (SP) technique. A validated diarrhea scenario was presented to each pharmacist by the SP twice, once before and the other after giving the mobile application to the pharmacist. Furthermore, pharmacists were asked to rate the application in regard to its ease of use, reducing the time needed for management of diarrhea cases, reducing diagnostic errors, reducing medication errors, and applicability in daily clinical practice. The study sample involved 50 community pharmacists. However, only 47 completed the study. After using the application, all questions necessary to assess diarrhea were significantly improved. Moreover, the average number of questions asked to the SP was significantly increased. On the other hand, providing the SP with an appropriate non-pharmacological and pharmacological treatment was also significantly improved. Additionally, counseling the SP with the necessary information about dispensed medication was improved; however, significant improvement was detected only in regard to information about the drug dose and dosing frequency. Most participated pharmacists strongly agreed with the application ease of use, its ability to reduce diagnosis and medication errors, and its applicability for use in daily clinical practice. In conclusion the tested application is an effective method to improve the pharmacist's role in the assessment and management of diarrhea.

Current Practices and Perceived Role of Community Pharmacists in Type 2 Diabetes Services in Pakistan.

Background Diabetes mellitus is a chronic illness which is becoming more prevalent in developing countries, and it is being managed mostly in hospitals or clinics in underdeveloped nations. Other strategies for treatment delivery in emerging nations must be considered as the number of diabetic patients grows.Community pharmacists are a valuable choice for diabetes care. However, only developed countries have data on community pharmacists' diabetes treatment practices. Methodology A non-probability consecutive sampling strategy was used to gather a self-administered questionnaire from 289 community pharmacists. Six points Likert scale was employed to score current practices and pharmacists' perceived role. A response rate of 55% was attained. Characteristics associated with present behaviors and perceived roles were analyzed using Chi-square and logistic regression. Results The majority of the respondents were males, 234 (81.0%). Out of 289, 229 (79.2%) were of 25-30 years of age and were pharmacists as well as qualified persons (QP) 189 (65.4%).A QPis one who has the legal authority to sell drugs to customers. The majority had <5 years of working experience as a community pharmacist, 268 (92.7%), and did not have diabetes training, 237 (82.0%). Most community pharmacies were stand-alone, 110 (38.1%), and had a single or a group of proprietors, 248 (85.8%). Openhours of most of the pharmacies were 16-20 hours per day, 202 (69.8%), and most had one pharmacist, 243 (84.1%), i.e., working as a pharmacist as well as a qualified person. Approximately 203 (70.2%) of the pharmacies had customers >2000 in a month and >100 customers purchased anti-diabetes medications per month. Only 44 (15.2%) community pharmacies had a designated roomor spacefor patient counselling. The majority of pharmacists were also in favor of providing services other than dispensing such as counselling the patients about prescribed medicines, direction of use, use of devices for insulin administration, training on self-monitoring of glucose, and healthy lifestyle and diet practices. Pharmacy setting, ownership, patient counseling area, and the number of customers per month were key factors in the provision of diabetes services. The main obstacles identified were a lack of pharmacist availability and academic competency. Conclusion In Rawalpindi and Islamabad, most community pharmacies only provide a basic dispensing service for diabetes patients. Most of the community pharmacists agreed to extend their duties. The expansion of pharmacist professional responsibilities would help control the rising diabetes burden. The facilitators and hurdles identified would serve as a foundation for the introduction of diabetic care in community pharmacies.

Adaptive Changes in the Working Environment of Community Pharmacists during the Covid-19 Pandemic in the Kano Metropolis, North-Western Nigeria.

Background: Rapid spread of COVID-19 and the resultant strict access to conventional hospitals forced the public to turn to community pharmacies being the most accessible points of primary healthcare, thus overloading the pharmacy services. This study aims to assess the coping strategies and adaptive changes in the work environment of community pharmacists in Kano Metropolis, NorthWestern Nigeria during the lockdown periods due to the COVID-19 pandemic Methods: A questionnaire-based cross-sectional study was carried out across selected community pharmacies within Kano Metropolis, North-Western Nigeria. A non-probability (convenience) sampling was used in this study. Convenience sampling also known as availability sampling, here units are selected for inclusion in the sample because they are easiest for the researcher to access. The survey retrieved relevant data from the participants, including socio-demographic data and changes in the work environment during the COVID-19 pandemic lockdown periods. Data were analysed using IBM SPSS version 23.0. Results: A total of 97 licensed pharmacists responded to the survey. Majority of the pharmacists (73.2%) reported increased workload, caused mostly by more prescriptions, and higher demand for safety equipment, antiseptics, and disinfectants. Moreso, 79.4%, reported higher stress levels during the pandemic as compared to the pre-pandemic era. About 89.9% of participants reported adjusting their working conditions to include the use of facemasks as protective equipment which is available in sufficient quantities as reported by 61.9% of pharmacists. The pandemic and subsequent lockdowns aroused concerns in the majority of participants (90.7%) for their health and that of their families. This prompted majority of the community pharmacists (92.7%) to suggest that pharmacists should be authorized to independently renew prescriptions of patients with stable chronic conditions during the COVID-19 pandemic. Likewise, 91.8% supported the idea that pharmacists should be authorized to participate in the COVID-19 immunization process to widen coverage. Conclusions: The COVID-19 pandemic resulted in an increased workload and altered working conditions of community pharmacists in Kano metropolis of North-Western Nigeria. This prompted pharmacists to professionally re-strategize to accommodate such an increased workload despite being frontline healthcare providers in the healthcare system.

Feasibility of Community Pharmacist-Initiated and Point-of-Care CYP2C19 Genotype-Guided De-Escalation of Oral P2Y12 Inhibitors.

Tailoring antiplatelet therapy based on CYP2C19 pharmacogenetic (PGx) testing can improve cardiovascular outcomes and potentially reduce healthcare costs in patients on a P2Y12-inhibitor regime with prasugrel or ticagrelor. However, ubiquitous adoption-particularly in an outpatient setting-remains limited. We conducted a proof-of-concept study to evaluate the feasibility of CYP2C19-guided de-escalation of prasugrel/ticagrelor to clopidogrel through point-of-care (POC) PGx testing in the community pharmacy. Multiple feasibility outcomes were assessed. Overall, 144 patients underwent CYP2C19 PGx testing in 27 community pharmacies. Successful test results were obtained in 142 patients (98.6%). De-escalation to clopidogrel occurred in 19 patients (20%) out of 95 (67%) eligible for therapy de-escalation, which was mainly due to PGx testing not being included in cardiology guidelines. Out of the 119 patients (84%) and 14 pharmacists (100%) surveyed, 109 patients (92%) found the community pharmacy a suitable location for PGx testing, and the majority of pharmacists (86%) thought it has added value. Net costs due to PGx testing were estimated at €43 per patient, which could be reduced by earlier testing and could turn into savings if de-escalation would double to 40%. Although the observed de-escalation rate was low, POC CYP2C19-guided de-escalation to clopidogrel appears feasible in a community pharmacy setting.

Physicians and pharmacists' clinical knowledge of statin therapy and monitoring parameters, and the barriers to guideline implementation in clinical practice.

Millions of individuals worldwide use statins, and their significant impact on cardiovascular disease (CVD) has been well-established. However, a lack of knowledge about the up-to-date guideline recommendations regarding statin therapy is a common barrier to implementation in clinical practice. Therefore, the present study aimed to assess the current clinical knowledge about statin therapy and its monitoring parameters. Also, we evaluated the barriers to cholesterol management guideline implementation in Yemen. This observational cross-sectional study was conducted over four months, from June/2021 to September/2021, in Sana'a, Yemen. A validated questionnaire was distributed face-to-face to 650 participants (350 physicians and 300 pharmacists). Physicians and pharmacists from governmental and private hospitals and those working in private clinics or community pharmacies were included in the study. A total of 496 participants filled out the survey, with 22 being excluded due to incomplete data. So, the study has an overall response rate of 72.9% (474). The majority of pharmacists (81.8%) and physicians (78.7%) could not identify the patient group that needed ASCVD risk assessment before statin therapy initiation. Although a significant proportion of respondents knew of the fact that high-intensity statins are recommended for patients with ASCVD (65.4%) and primary hypercholesterolemia (58.4%), the majority of physicians and pharmacists could not identify the high (61.6% and 66.7.3%, respectively) and moderate statin-intensity doses (72.2% and 68.6%, respectively). Only 21.9% of all respondents knew that atorvastatin and rosuvastatin can be administered at any time of the day. Similarly, a low overall rate of respondents (19.6%) knew that atorvastatin does not need dose adjustment in chronic kidney diseases, with a statistically significant difference in knowledge between physicians and pharmacists (12.5% vs. 25.6%, p <0.001, respectively). Notably, only 39.2% of participants were aware that statins are not safe to use during breastfeeding. Around half of respondents (52.3%) correctly identify the duration (4 to 12 weeks) at which LD-C measuring is recommended after therapy initiation or dose change. The lowest knowledge scores for respondents were related to statin-drug interactions. Age, experience, degree, and previous guideline exposure were all significantly associated with the knowledge scores (p <0.05). The four most perceived barriers to implementing cholesterol management guidelines were no audit on adherence to the guidelines in the workplace (73.4%), insufficient resources to adequately implement and follow up on the guideline's recommendations (73.6%), patient's financial status (75.7%), and lack of familiarity about the guideline's latest recommendations (63.3%). Physicians and pharmacists had suboptimal clinical knowledge regarding statin therapy, dose intensities, drug-drug interaction, contraindications, and monitoring parameters. Therefore, physicians' and pharmacists' educational interventions regarding the up-to-date recommendation about statins are recommended.

Knowledge of Pharmacists about Cardiopulmonary Resuscitation Medications in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2022,11,3,82-91.DOI:10.5530/ijpcs.2022.11.15Published:December 2022Type:Research Article Authors:Yousef Ahmed Alomi, Rola AL Kenani, Samah Mukhlef Alzaid, Wafa Hussain Alshehre, and Khawlah Ibrahim Alshahrani Author(s) affiliations:Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE, Critical care clinical pharmacists TPN clinical pharmacist Freelancer Business Planner, Content Editor, and Data Analyst,Riyadh, SAUDI ARABIA. Rola AL Kenani, BSc. Pharm, SSC-PhP, Nephrology Pharmacotherapy Specialist, Riyadh, SAUDI ARABIA Samah Mukhlef Alzaid, Bsc.Pharm, Clin. Pharm, Clinical Pharmacy Services, Gurayat General Hospital, Ministry of Health, Gurayat, SAUDI ARABIA Wafa Hussain Alshehre, Pharm.D, BCSP, Drug information clinical pharmacy specialist, Pharmacy Department, Aliman Hospital, Ministry of Health, Riyadh, SAUDI ARABIA. Khawlah Ibrahim Alshahrani, Pharm D, College of Pharmacy, Taif University, Taif, SAUDI ARABIA. Abstract:Objectives: To illustrate the knowledge of pharmacists about CPR medications services in Saudi Arabia. Materials and Methods: The study analyzed a cross-sectional survey that discussed pharmacist’s knowledge of Cardiopulmonary Resuscitation (CPR) medications in Saudi Arabia. The survey consisted of respondents’ demographic information about pharmacists and Cardiopulmonary Resuscitation (CPR) drugs, assessment of primary and advanced knowledge, and the resources used for Cardiopulmonary Resuscitation (CPR) medications. The 5-point Likert response scale system was used with closed-ended questions. The survey was validated through the revision of expert reviewers and pilot testing. Besides, various tests of the reliability of McDonald’s ω, Cronbach alpha, Gutmann’s λ2, and Gutmann’s λ6 were carried out with the study. The data analysis of the Pharmacist practice of Cardiopulmonary Resuscitation (CPR) medications is done through the survey monkey system. Besides, the statistical package of social sciences (SPSS), Jeffery’s Amazing Statistics Program (JASP), and Microsoft Excel sheet version 16 were implemented. Results: A total number of 439 pharmacists responded to the questionnaire. Of them, more than onethird responded from the Central region (122 (31.69%)), one Quarter responded from the Eastern region (91 (23.64%)), and one-fifth responded from the southern part (79 (20.52%)). Males responded more than females (203 (53.14%)) versus 179 (46.86%)), with statistically non-significant differences between all levels (p=0.219). Most of the responders were in the age group of 36-45 years (152 (39.48%)) and 46-55 years (134 (34.81%)), with statistically significant differences between all age groups (p=0.000). The majority of pharmacists had training courses in Basic Life Support (BLS) (293 ((77.11%)), Advance Cardiac Life Support (ACLS) (289 ((76.05%)), Pediatric Cardiac Life Support (PCLS) (287((75.53%)), and Neonatal Cardiac Life Support (NCLS) (203 ((53.42%)), with statistically significant differences between all levels (p=0.000). The average score of basic knowledge of pharmacists about Cardiopulmonary Resuscitation (CPR) medications was (1.67). The element “know how to prepare and dispense ACLS medications list” obtained the highest score (2.04). The aspect “there is an official standardized NCLS medications list” (1.94), and The element “there is an official standardized PCLS medications list” (1.93). The average score of advanced knowledge of pharmacists about Cardiopulmonary Resuscitation (CPR) medications was (1.86). The element “know the compatibility of ACLS medications” obtained the highest score (2.31). The aspect “know the drug - interactions with NCLS medications” (2.27), and The element “know the drug - interactions with PCLS medications” (2.17). The resources used most about the CPR medications were Medical association literature/guidelines/recommendations 307 (76.56%), Peer discussions 298 (74.31%), and Scientific literature 293 (73.07%). Conclusion: The pharmacists’ knowledge of CPR medication was inappropriate. Therefore, undergraduate education and training of CPR medication is high recommended. Besides, involvement training for postgraduate studies is required to improve pharmacy staff knowledge of CPR services and patient outcomes in Saudi Arabia. Keywords:Cardiopulmonary Resuscitation, Knowledge, Medications, PharmacistsView:PDF (346.17 KB) PDFClick here to download the PDF file. Images Knowledge of Pharmacists about Cardiopulmonary Resuscitation Medications in Saudi Arabia

Assessment of Community Pharmacists’ Response to Patients with PCOS with Adverse Drug Events in Qatar: Simulated Client Approach

The public considers community pharmacists the most accessible healthcare providers. Services provided by pharmacists such as dispensing, counseling, and monitoring of adverse drug reactions have positive effects on patient health. The aim of this study was to evaluate the Qatari community pharmacists' data gathering, labeling, dispensing, and counseling practices in response to patients with adverse drug events (ADE). This study is a simulated client (SC) observational descriptive study. Thirty community pharmacies were chosen at random and placed in one of the two groups with 15 interactions over the phone and 15 interactions in person. The case is about a patient with PCOS taking metformin who presented with bothersome diarrhea and sought assistance from a pharmacist. Simulated clients used the Data Collection Tool to gather data. Each simulated client completed forty interactions with community pharmacists. Ninety percent of pharmacists dispensed medication, mostly antibiotics (37.5%) and antidiarrheal (67.5%). A total of 7 pharmacists (17.5%) made referrals. The majority of pharmacists (87.5% and 82.5%, respectively) failed to obtain crucial patient information, such as the frequency and duration of diarrhea. The SC had to remind all the pharmacists that this is an ADE from metformin. More than one-third of pharmacists (43.75%) who dispensed medication did not label any of it. No significant difference was found between groups in data gathering and dispensing (P-value &gt;0.05). Current community pharmacy consultation, labeling, and counseling practices on ADEs are inconsistent with evidence-based practice and need to be improved. Such a study is scarce, and it is the first simulated client approach assessing the community pharmacy responses to ADE in the State of Qatar. This topic is important for minimizing the practice gap and to develop professional training programs that are desperately needed to advance the profession. Keywords: patient, pharmacies, adverse drug events, Poly Cystic Ovarian Syndrome, Qatar. https://doi.org/10.55463/issn.1674-2974.50.3.6

Exploring the appearance of and messaging on antibiotics to address inappropriate antibiotic use - public and pharmacists views

Abstract Introduction The purpose of medicines labelling and packaging is to provide clear unambiguous identification of the medicine and the conditions for its safe use, allowing patients to understand and act on the information.1 Inappropriate antibiotic usage, (deviation from directions provided to the patients by the prescriber, resulting in sub-optimal treatment) may result in exposing bacteria to sub-therapeutic plasma concentrations and/or environment, which are one of the main drivers of Antibiotic Resistance.2 A recent comprehensive analysis showed the global burden associated with drug-resistant infections in 2019 was an estimated 4.95 million deaths.3 Aim To ascertain the support from pharmacists and the public and their perceptions on the likely barriers to harmonising or standardising physical appearance and/or messaging on antibiotic packaging to reduce inappropriate antibiotic usage. Methods This study received ethics approval from the University of Huddersfield. In partnership with NHS England Antimicrobial Stewardship lead for North-East and Yorkshire, two questionnaires (public and pharmacist) were piloted. The final version was transferred to Qualtrics (online questionnaire format). During a 5-week period public questionnaires were distributed via posters with QR codes and social media. Pharmacist questionnaires were emailed to consenting pharmacists (community, hospital, GP practice, industry) around Huddersfield, Doncaster, Rochdale, Dewsbury and Leeds. The data underwent descriptive statistical analysis. Results Inappropriate antibiotic usage (saving for future use) was admitted by 23.5% of the 174 public participants, sharing with others (2.5%), throwing their antibiotics in the bin (32.7%) and other inappropriate usage was reported. This compared to 22.2% returning antibiotics to the pharmacy for disposal. 100% of pharmacists (40) think inappropriate antibiotic use needs to be addressed; the majority of pharmacists (55.5%) and the public (61.4%) think a harmonised antibiotic appearance would reduce inappropriate use. ‘Putting the word “ANTIBIOTICS” on the packaging would improve antibiotic packaging appearance’ was the top improvement selected by pharmacists (38.3%) and public (35.3%). Pharmacists (38.9%) thought antibiotic manufacturers would be the greatest obstacle to harmonised packaging. The majority of public (70.5%) and pharmacists (85.3%) think a standardised messaging system would help reduce inappropriate antibiotic use. Both pharmacists (41.1%) and public (47%) highlighted that a standard leaflet for appropriate use could improve antibiotic use. Pharmacists (47.8%) thought that multiple stakeholders (e.g., MHRA, manufacturers, etc) would be the barriers to a standardised messaging. Discussion/Conclusion Inappropriate antibiotic use by individuals who re-use leftovers or share their antibiotics may result in a treatment failure and could to increase AMR. Improvements in antibiotic packaging and patient information leaflets with appropriate disposal instructions could help minimise AMR. Limitations of this study include the low number of practice and industrial pharmacist respondents compared to community and hospital pharmacists. Public and pharmacist respondents supported the wording “ANTIBIOTIC” on antibiotic packaging and a standardised leaflet covering increasing adherence and appropriate disposal of leftovers. This study warrants further evaluation with regulators, manufacturers and other key stakeholders.

Community pharmacists’ perception and attitudes toward independent prescribing in the United Arab Emirates: an exploratory study

Abstract Objectives To evaluate and investigate the perception and attitudes of community pharmacists (CPs) toward community pharmacist independent prescribing (CPIP) and their perceived ability to diagnose and manage common health problems. Methods A cross-sectional study was conducted on licensed CPs in Al-Ain City, United Arab Emirates (UAE) from September to December 2019. A sample of 220 participants was randomly selected from the database of 980 licensed pharmacists working in Al-Ain. Pharmacists were asked to complete a questionnaire that includes five sections: demographic characteristics, pharmacists’ confidence, perceived requirements and barriers for the CPIP process and perceived competence to manage common medical conditions. Key findings Two hundred CPs were enrolled (response rate 91%) in this study (mean age 30.7 ± 7.2 years old); majority were females 60.3% (n = 121) and 90.0% (n = 190) had minimum bachelor’s degree in pharmacy. Most of the participants had long-standing experience in the community pharmacy field (10 years). The majority of the pharmacists were confident in their ability to practice (CPIP) (70.0%, n = 140). However, they were least confident in their current knowledge and skills for practicing CPIP (58%, n = 116). More than 70.0% (n = 140) of the respondents were required to have a well-prepared consultation area, get proper access to patients’ records and provide recommendations. The main perceived barrier to CPIP was physicians’ acceptance (57.0%, n = 114). Around 75.0% (n = 140) of the CPs believed they are skilful in managing minor ailments such as acute back pain and acne, however, they reported lower perceived competence for the management of chronic diseases such as hypertension and asthma. Conclusions Most CPs have a positive attitude toward implementing CPIP, especially on minor ailments. The main perceived barrier was physicians’ acceptance and the majority of pharmacists were required to have access to patients’ medical records and a well-prepared consultation area.

An assessment of the current practice of community pharmacists for the disposal of medication waste in the United Arab Emirates: A deep analysis at a glance

ObjectiveThe study aimed to identify the current practice carried out by community pharmacists to dispose of expired medications in their workplace and assess any practical steps utilized to reduce medication waste. MethodA cross-sectional study was conducted among community pharmacists in the United Arab Emirates (UAE). The participants were asked about their routine practice in disposing of different expired medications and the current actions taken to reduce the number of disposed medicines. ResultsThe study included (n = 418) community pharmacists. More than a third of expired liquid, solid, and semi-solid dosage forms were collected by licensed contractors. In addition, more than a third of the pharmacists disposed of different dosage forms via unauthorized methods (general garbage, sink and toilet). Most expired drugs were skin and hair products, antibiotics and analgesics. The majority of pharmacists (68.4 %, n = 286) agreed that expired pharmaceutical and non-pharmaceutical products, other than those disposed of via contractor, should be done through a specialized centre. This opinion was found to be strongly associated with years of practice as community pharmacists (P < 0.05). ConclusionPart of the existing disposal practices for expired pharmaceutical products in the UAE is carried out by contractors licensed by health authorities. However, concern remains regarding some pharmaceutical and non-pharmaceutical products that have not been disposed of correctly. Additionally, there is a need for a specialized center for medication disposal (p < 0.05). A stock limitation is the best practice for managing medication quantities in stock (p < 0.05).

Pharmacists' Knowledge and Perceptions of FDA Approval Standards and the Breakthrough Therapy Designation.

The “breakthrough therapy” designation (BTD) is a recent mechanism implemented by the United States Food and Drug Administration (FDA) to expedite access to drugs that address unmet needs. The purpose of this study is to describe pharmacists’ knowledge of FDA drug-approval standards and knowledge and perceptions of the BTD. Pharmacists engaged in advanced clinical practice were identified through membership profiles of a professional pharmacy organization. Eligible participants were then sent a questionnaire to assess knowledge of FDA approval standards and the BTD. A total of 226 pharmacists responded. The majority of respondents were women (70.2%) and had completed post-graduate training (85.8%). Over half correctly answered at least two of three questions on FDA approval standards (58.1%) and the BTD (78.1%). Only 24.1% of respondents identified as being familiar with the BTD. The majority of pharmacists (62.8%) were certain that FDA-approved “breakthrough” drugs represented a major advance over currently approved therapies and most (88.5%) preferred the drug designated as “breakthrough” in a hypothetical scenario. In conclusion, pharmacists were able to correctly answer questions about FDA approval standards and the BTD. However, they were unfamiliar with the implications of a BTD and may overestimate the benefit demonstrated by these drugs. Future research should identify knowledge gaps in pharmacist understanding of regulatory mechanisms designed to expedite drug approval.

Rethinking the gold standard - The feasibility of randomized controlled trials within health services effectiveness research.

An evidence-based randomized controlled trial for a novel Pharmacy Asthma Service was tested in 3 Australian states. Positive asthma outcomes were achieved after the 12-month intervention, albeit in both the intervention and comparator arms. The current investigation uses a mixed methods approach to 1) qualitatively explore how comparator arm pharmacists implemented the trial protocol and 2) quantitatively examine how this may have impacted patient outcomes in this trial. Post-intervention semi-structured qualitative interviews were conducted with 20 pharmacists, representing 21 of 37 (57%) comparator arm pharmacies that completed the trial. Based on these interviews, pharmacies were classified as 'adherent' to the trial protocol (reporting no interventions other than general practitioner referral) or 'non-adherent' (reporting at least one extra intervention to the trial protocol), or 'inconclusive'. These subgroups were compared descriptively in relation to patient outcomes. Overall, 33% (n=8/24) of the comparator pharmacies who were interviewed (n=21) or determined to have monitoring by a project officer to ensure adherence to the protocol (n=3) were classified as adherent), 58% (n=14/24) as non-adherent, 8% inconclusive (n=2/24). While all patients commenced with uncontrolled asthma (Asthma Control Questionnaire score (ACQ)>1.5), after 12 months the mean ACQ score for patients from adherent comparator pharmacies ('true control') was 1.8 (still uncontrolled asthma) compared to a score of 1.4 (controlled asthma) in the non-adherent comparator group. Quality of life significantly improved in the non-adherent comparator group over the 12 months of the trial. The majority of pharmacists in the comparator arm who were interviewed, introduced their own interventions, which may have influenced the outcomes of the trial. The naturalistic setting of the study was not protective against these confounders. These findings question the feasibility of comparator arms within primary care settings and that alternative study designs should be considered when designing future intervention studies in pharmacy practice.

The impact of cross-border e-prescriptions on access and safe use of medications – a survey of pharmacists in Finland and Estonia

An evidence-based randomized controlled trial for a novel Pharmacy Asthma Service was tested in 3 Australian states. Positive asthma outcomes were achieved after the 12-month intervention, albeit in both the intervention and comparator arms. The current investigation uses a mixed methods approach to 1) qualitatively explore how comparator arm pharmacists implemented the trial protocol and 2) quantitatively examine how this may have impacted patient outcomes in this trial.Post-intervention semi-structured qualitative interviews were conducted with 20 pharmacists, representing 21 of 37 (57%) comparator arm pharmacies that completed the trial. Based on these interviews, pharmacies were classified as ‘adherent’ to the trial protocol (reporting no interventions other than general practitioner referral) or ‘non-adherent’ (reporting at least one extra intervention to the trial protocol), or ‘inconclusive’. These subgroups were compared descriptively in relation to patient outcomes.Overall, 33% (n = 8/24) of the comparator pharmacies who were interviewed (n = 21) or determined to have monitoring by a project officer to ensure adherence to the protocol (n = 3) were classified as adherent), 58% (n = 14/24) as non-adherent, 8% inconclusive (n = 2/24). While all patients commenced with uncontrolled asthma (Asthma Control Questionnaire score (ACQ) > 1.5), after 12 months the mean ACQ score for patients from adherent comparator pharmacies (‘true control’) was 1.8 (still uncontrolled asthma) compared to a score of 1.4 (controlled asthma) in the non-adherent comparator group. Quality of life significantly improved in the non-adherent comparator group over the 12 months of the trial.The majority of pharmacists in the comparator arm who were interviewed, introduced their own interventions, which may have influenced the outcomes of the trial. The naturalistic setting of the study was not protective against these confounders. These findings question the feasibility of comparator arms within primary care settings and that alternative study designs should be considered when designing future intervention studies in pharmacy practice.