Pharmacist In Charge Research Articles

Drug dispensing in public community pharmacies: evidence from the MedMinas project

BackgroundDrug dispensing is a service provided by pharmacists to ensure the supply of medications and other health-related products. However, despite the importance of dispensing services, Public Community Pharmacies (PCP) in Brazil still focus on the control and distribution of medicines and supplies. Thus, this paper aims to evaluate how the pharmacists in charge conduct and the challenges they encounter in dispensing services in PCP.MethodsThis is a mixed methods study, with a representative sample of 26 municipalities (whose populations vary between 37,784 and 409,341 inhabitants) in the state of Minas Gerais, Brazil. Data collection took place between April and October 2019 and included interviews and documentary research. Quantitative data analysis was carried out using descriptive statistics and qualitative data was subjected to thematic content analysis.Results24 dispensing services were analyzed. The PCP had, on average, two active pharmacists and operated full-time (40 h per week). In relation to dispensing services, the most frequently mentioned steps were checking the adequacy of the prescription received, followed by providing counseling to the user about the medicines, mainly regarding administration, storage and disposal. The results highlighted a need for improvements in terms of infrastructure, workforce and the pharmacist’s work process.ConclusionIt is necessary to invest and to design improvement strategies in dispensing services, especially regarding physical infrastructure, human resources and work processes.

Empowering precision medicine: Insights from a national survey on pharmacogenomics knowledge, attitudes, and perceptions among community pharmacists in the UAE

BackgroundCommunity pharmacists are essential to pharmacogenomics implementation because they can help trainers, clinical advisors, and other medical professionals understand the importance of pharmacogenomics and encourage them to use it in their practice. This study is to evaluate the community pharmacists' understanding, attitudes, and perceptions of pharmacogenomics in the United Arab Emirates (UAE). MethodsProfessionals employed at community pharmacies in Abu Dhabi, Dubai, and the Northern Emirates participated in a cross-sectional study design. From July 2023 to February 2024, five pharmacy students in their last year conducted the survey. The study team employed a structured questionnaire to collect data in addition to conducting in-person interviews. The study questionnaire comprised three distinct sections namely, demographic information, knowledge of pharmacogenomics concepts, and perceptions regarding pharmacogenomics. ResultsA total of 586 pharmacists enrolled in the study. The average knowledge score regarding pharmacogenomics was 75.1 % with a 95 % confidence interval (CI) of [72.4 %, 77.7 %]. The average attitude score toward pharmacogenomics was 67.5 % with a 95 % CI of [66.3 %, 68.7 %]. Better pharmacogenomics knowledge among several groups: independent pharmacies (OR 1.7; 95 % CI 1.2–2.4), Pharmacists in Charge (OR 1.4; 95 % CI 1.3–2.02), pharmacists with 11–15 years of experience (OR 2.1; 95 % CI 1.4–4.2), graduates from international universities (OR 4.6; 95 % CI 1.6–12.9), and those who received training on pharmacogenomics (OR 11.9; 95 % CI 3.3–14.5). Similarly, better attitude scores were observed among independent pharmacies (OR 1.5; 95 % CI 1.1–2.1), Pharmacists in Charge (OR 1.5; 95 % CI 1.07–2.1), pharmacists with 16–20 years of experience (OR 2.1; 95 % CI 1.16–3.7), graduates regional universities (OR 1.47; 95 % CI 1.05–2.1), and those who received training on pharmacogenomics (OR 4.8; 95 % CI 3.2–7.3). ConclusionThe positive attitudes toward pharmacogenomics that we found in our research indicate that community pharmacists in the United Arab Emirates are beginning to realize the potential advantages of pharmacogenomics in terms of improving patient care. Policies ensuring the privacy and confidentiality of genetic information are also necessary in considering concerns about the availability of genetic test results to insurance companies and potential employers.

Analysis Of The Effectiveness And Efficiency Of The Internal Control System For The Supply Of Medicines In Public Hospitals Sinar Husni

The internal control system will help hospitals minimize risks arising from medicine supplies, such as damage, loss, theft and shortages of supplies which can disrupt hospital service activities in terms of medicine availability. The aim of this research is to analyze the internal control system for medicine supplies at the Sinar Husni General Hospital. This research approach is descriptive using qualitative data types. Data collection methods were carried out by interviews and literature studies. The research subjects were the pharmacist in charge and pharmacy warehouse assistant at Sinar Husni General Hospital. The results of the research show that the internal control system for medicine supplies at Sinar Husni General Hospital has not been implemented effectively and efficiently so it is not in accordance with the objectives of internal control. This is proven by the existence of control elements that have not been implemented optimally, namely the risk assessment element, control activities, and information and communication.

Performance of Jazia Prime Vendor System in ensuring availability of health commodities in Singida Region, Tanzania: a pre- and post-evaluation study

BackgroundAvailability of the health commodities in public health facilities in Tanzania remains a challenge, and has been reported to be below 70%. Moreover, Medical Stores Department’s capacity to supply health commodities has been only 40%. Therefore, Jazia Prime Vendor System (Jazia PVS) was outsourced to complement the Medical Stores Department. In 2017 Jazia PVS was introduced in Singida Region after being piloted in three other Regions. This study therefore, was conducted to assess the performance of Jazia PVS in enhancing the availability of the health commodities in the public health facilities between 2017 and 2019 in Singida Region, Tanzania.MethodsA mixed method pre- and post-evaluation analytical study design was used in all the selected public health facilities in the Municipal and District Councils of Singida Region, Tanzania. These included 138 public health facilities: One Regional Referral Hospital, four District Hospitals, 19 Health Centres and 114 Dispensaries. Percent availability of health commodities was abstracted from electronic logistics management information system. Documentary review involved quarterly orders, Jazia PVS delivery notes, and payment vouchers; while all the 138 pharmacists incharge were interviewed.ResultsThe mean availability of health commodities was modestly higher after adoption of Jazia PVS (mean = 59.17%, SD = 6.12%) than before Jazia PVS (mean = 54.39%, SD = 5.36%); and the difference between means was 4.78% (t = -9.49, df = 136, p < 0.001). Furthermore, 20.3% (109/421) of orders were fulfilled, while 58% (312/421) were not, (χ2 = 10.46, df = 6, p = 0.1067). About 73.7% of orders (320/434) were delivered on time, while 26.3% (114/434) delayed, (χ2 = 121, df = 6, p < 0,001). Prompt payment to Jazia PVS was 43.0% (164/381) deliveries, while 57.0% (217/382) were not punctual, (χ2 = 26, df = 6, p < 0.001). Satisfaction level of the pharmacists incharge for Jazia PVS was 11.8%, (χ2 = 78.04, df = 3, p < 0.001).ConclusionWith Jazia PVS, availability of health commodities improved by 4.78% in 2 years. Prompt payment of Jazia PVS will enhance performance of the vendor.

PAUSATE Study: Prevalence and appropriateness of the use of antimicrobials in Spanish hospitals

ObjectiveTo determine the prevalence and appropriateness of antimicrobial use in Spanish hospitals through a pharmacist-led systematic cross-sectional review. MethodA nationwide multicenter cross-sectional study was conducted on 10% of the patients admitted to the participating hospitals on one day in April 2021. Hospital participation was voluntary, and the population was randomly selected. The study sample was made up of patients who, on the day of the study, received at least one antimicrobial belonging to groups J01, J02, J04, J05AB, J05AD or J05AH in the Anatomical Therapeutic Chemical Classification System. The pharmacist in charge made a record and carried out an evaluation of the appropriateness of antimicrobial use following a method proposed and validated by the Pharmaceutical Care of Patients with Infectious Diseases Working Group of the Spanish Society of Hospital Pharmacy. The evaluation method considered each of the items comprising antimicrobial prescriptions. An algorithm was used to assess prescriptions as appropriate, suboptimal, inappropriate and unevaluable. ResultsOne-hundred three hospitals participated in the study and the treatment of 3,568 patients was reviewed. A total of 1,498 (42.0%) patients received antimicrobial therapy, 424 (28.3%) of them in combination therapy. The most commonly prescribed antimicrobials were amoxicillin-clavulanic acid (7.2%), ceftriaxone (6.4%), piperacillin-tazobactam (5.8%), and meropenem 4.0%. As regards appropriateness, prescriptions were considered appropriate in 34% of cases, suboptimal in 45%, inappropriate in 19% and unevaluable in 2%. The items that most influenced the assessment of a prescription as suboptimal were completeness of medical record entries, choice of agent, duration of treatment and monitoring of efficacy and safety. The item that most influences the assessment of a prescription as inappropriate was the indication of antimicrobial agent. ConclusionsThe method used provided information on the prevalence and appropriateness of the use of antimicrobials, a preliminary step in the design and implementation of actions aimed at measuring the impact of the use of antimicrobials within the antimicrobial stewardship programs.

Community pharmacists' perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis.

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care. Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care. Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%-74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%-79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1-1.019), postgraduates (OR 1.77; 95% CI 1.66-1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11-1.39), pharmacists in charge (OR 1.22; 95% CI 1.01-1.47), pharmacists with >10years of experience (OR 11.3; 95% CI 6.01-15.62), pharmacists with 6-10years of experience (OR 4.42; 95% CI 3.90-5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15-1.46). Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients' weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care.

Adoption of electronic patient medication records in community pharmacies in the United Arab Emirates: A cross-sectional survey.

Access to accurate and relevant patient health information is crucial for community pharmacists to deliver high-quality care. The use of electronic patient medication records (e-PMR) in the United Arab Emirates (UAE) is currently limited to hospital settings, and community pharmacists do not have access to patient records. To evaluate the perceptions of community pharmacists regarding the potential benefits, barriers, and concerns associated with the implementation of the e-PMR system in community pharmacies in the UAE. A validated questionnaire was administered to a sample of licensed community pharmacists using proportionate random sampling. The survey was structured and consisted of 40 questions in four sections: characteristics of community pharmacists and pharmacies; perceived usefulness of e-PMR; perceived barriers; and concerns about the use of e-PMR. In total, 552 pharmacists filled out the questionnaire (82.1% response rate). The majority of participants somewhat or strongly agreed that e-PMR would reduce drug abuse (71.6%), dispensing errors (64.4%) and prescribing errors (69.0%), and believed that e-PMR would enhance pharmacists' ability to perform medication reviews (76.0%). Pharmacists in charge (adjusted odds ratio (AOR) = 2.5; 95% confidence interval (CI): 1.6-3.6), facing difficulty tracking the medical history of patients (AOR = 3.2; 95% CI: 2.8-3.9) and working in pharmacies providing telepharmacy services (AOR = 3.4; 95% CI: 2.7-3.8) were more likely to consider e-PMR useful. The implementation of the e-PMR system in community pharmacies has potential benefits for patient safety and medication therapy management in the UAE.

Are pharmacists' knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes.

Deprescribing is a novel strategy whereby medical professionals aim to optimize a patient's prescription program by removing redundant medications. Few studies have looked at the viewpoints of community pharmacists and other healthcare professionals on deprescribing in daily practice. This study's objectives included evaluating community pharmacists' deprescribing knowledge, attitudes and practices, as well as identifying the obstacles to and enablers of deprescribing in daily practice. Five pharmacy students in the last year of their studies polled employees of neighbourhood pharmacies in Abu Dhabi, Dubai, and the Northern Emirates from April 2022 to July 2022. The study's questionnaire was divided into two sections: questions that inquired about the respondents' demographic data and questions that evaluated the respondents' understanding and usage of the deprescribing of potentially harmful medications for patients. The original Bloom's cutoff points were revised and modified to assess the general knowledge and deprescribing practices of United Arab Emirates (UAE) community pharmacists. Multivariate logistic regression identified the variables influencing respondents' deprescribing knowledge and practice. The average age of the participants was 30.8 ± 6.4 SD. Of the total, 255 (37.7%) were male and 422 (62.3%) were female. Pharmacists from independent pharmacies constituted 52.9% of the study sample and 47.1% were from Chain pharmacies. Among the participants, 58.8% (n = 398) had 1-5 years of experience and 41.2% (n = 279) had more than 5 years. Nearly three-quarters of the pharmacists (72.1%, 488) graduated from local universities and 27.9% (n = 189) graduated from regional/international universities. The vast majority of the study sample (84.8%, 574) were bachelor's degree holders and 88.3% (n = 598) were pharmacists in charge. Of the total, 69.3% (n = 469) received deprescribing training to treat patients with multimorbid diseases. The knowledge and practice score was 71.3% with a 95% confidence interval [70.2%, 72.4%]. Of the total participants, 113 (16.7%) had poor knowledge and practice about deprescribing, 393 (58.1%) had moderate knowledge and practice and 171 (25.3%) had good knowledge and practice. This study highlights the level of understanding of community pharmacists about deprescribing in the UAE. Although most of the respondents in this study received training on deprescribing, less than half of the community pharmacists were unaware of certain classes (long-acting sulfonylureas, anti-diabetic, antihyperlipidemic and psychotropic drugs) of drugs that are candidates for potential deprescribing. This finding indicates that their knowledge about deprescribing was insufficient. Several barriers community pharmacists face in deprescribing were also identified, with patients' resistance and insufficience being the most prevalent. Therefore, there is a need for improved deprescribing practices to ensure drug safety.

Evaluation of clinical pharmacist interventions for adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy.

Due to the increasing complexity of cancer chemotherapy and its associated supportive care, the role of clinical pharmacists in cancer chemotherapy is becoming increasingly more important. The present study evaluated the clinical interventions of a single pharmacist on the adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy. A single-center, retrospective study was conducted at the 614-bed, tertiary care Gifu University Hospital. Hospitalized patients with thoracic cancer who received cancer chemotherapy in the respiratory medicine ward between April 2013 and May 2014 were enrolled. One of the two clinical pharmacists in charge was based in the respiratory medicine ward and implemented pharmaceutical care for the patients, including management of adverse events. Patient data were recorded in the electronic medical chart and retrospectively analyzed. A total of 445 patients with thoracic cancer received cancer chemotherapy in the respiratory medicine ward. A total of 152 interventions (101 patients) were performed by the clinical pharmacist prior to the administration of cancer chemotherapy, half of which comprised the addition of drugs to prevent adverse events. A total of 190 patients (39.4%) experienced grade ≥2 non-hematological or grade ≥3 hematological adverse events associated with cancer chemotherapy, and 223 medical interventions for relief of adverse events lowered the incidence of grade ≥2 non-hematological or grade ≥3 hematological adverse events to 17.8%. Of these, 45.3 and 7.5% of medical interventions for non-hematological and hematological adverse events, respectively, were implemented based on the pharmacist's recommendations. These findings revealed the marked contribution of a single clinical pharmacist in the respiratory medicine ward to the prevention and relief of adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy.

Pharmacist's whistleblower claim for wrongful termination is rejected

Most pharmacists are “at will” employees, meaning that without an employment contract stating to the contrary, they can be discharged at the employer's will for any or no reason. Many state laws contain an exception to the “discharge at will” doctrine, providing that an employee may not be discharged from employment for refusing to participate in an illegal act or for reporting illegal acts by the employer. This provision encourages “whistleblowers” to report and put an end to illegal conduct they detect. A Mississippi pharmacist recently attempted to assert the whistleblower provision following her discharge from employment. The plaintiff, who had been designated as the pharmacy's Pharmacist-in-Charge (PIC), had what the court called a “rocky” relationship with the pharmacy owners. She thought that the owners “infringed on her authority as the PIC.” She wanted “full reign” over a pharmacy technician and the relief pharmacist, and she felt that she had not been given this needed authority. The event that led to termination of the plaintiff's employment occurred on the Saturday of a Labor Day weekend. At the end of that day, the relief pharmacist processed a verbal order for four diazepam tablets for a patient. On Tuesday morning, the plaintiff opened the pharmacy and discovered a new prescription for a larger quantity of the drug, with the notation to “take four tablets out” of the quantity dispensed. The prescription was dated with Tuesday's date. The plaintiff concluded that the relief pharmacist had unlawfully dispensed the four diazepam tablets on Saturday. She reported this allegedly illegal act to the pharmacy owners. The report apparently led to a series of “heated” discussions over a period of days, eventually resulting in the plaintiff being fired. The plaintiff's wrongful discharge lawsuit against her former employer was dismissed, and from the dismissal the pharmacist appealed. The court evaluated the evidence, which was somewhat contradictory. The court concluded that the relief pharmacist had received a verbal authorization to dispense a Schedule IV controlled substance, and that verbal prescriptions are allowed for these medications. The plaintiff contended that the prescription was not lawful because the prescription had not been “reduced promptly to writing,” as is required by law. In support of this argument, the plaintiff cited the delay between the Saturday when the order was received and the Tuesday date on the written prescription. The court noted that the word “promptly” is not defined in the relevant laws. The court examined the purpose of controlled substance regulations, concluding that they are “designed to ensure that the doctor examines the patient before delivering the prescription and to ensure that there is a legitimate medical reason for delivering the prescription.” The court ruled that the plaintiff had failed to provide any evidence “that a delay of such duration is a crime.” Dismissal of the plaintiff's wrongful discharge lawsuit was affirmed. All pharmacists, and particularly those designated as a pharmacy's PIC, have a significant responsibility to ensure that violations of pharmacy laws are avoided. When regulatory violations occur, they must be reported to appropriate pharmacy authorities. Whistleblower laws in many states protect a reporting pharmacist from retaliation based on the submission of such a report. Whistleblower laws apply when a clear violation of regulatory requirements has occurred or is reasonably suspected to have occurred. Unique interpretations of the law that support allegations of minor regulatory violations cannot be used as a smokescreen to avoid the consequences of major disagreements with management. The diversion of controlled substances is a very serious matter. Any activity related to controlled substance diversion must be reported to and taken seriously by management. Disagreements over the definition of a word like “promptly” may lead to interesting discussions, but it is unlikely that a clear violation of regulatory requirements will be identified by these discussions.

Eliminating the Board of Pharmacy's Role in Designating a Pharmacist-in-Charge.

Nearly all states require that each licensed pharmacy designate a pharmacist-in-charge (PIC). By law, the PIC typically has responsibility for all professional practice laws and facility standards laws and can be held accountable for such. However, the extent to which the PIC has actual authority over many facility standards varies by organization. This can seemingly put a target on the back of the PIC for decisions they wield little authority over. Idaho recently removed the legal references to the PIC, signaling that facilities are responsible for facility standards and insulating pharmacists from discipline for matters that are outside their control.

For a smooth pharmacy inspection, think ahead and ask questions

For a smooth pharmacy inspection, think ahead and ask questions

Tanggungjawab Hukum Apoteker dalam Pemusnahan Obat Narkotika di Rumah Sakit

The availability of health service facilities is a constitutional mandate that must be provided by the state. The peoples need for affordable and quality pharmaceutical preparations is a basic requirement in the context of protecting peoples and patients safety using pharmaceutical preparations in hospitals. One of guarantee from the hospital with the availability of pharmacy is quality pharmacists and quality pharmaceutical preparations and safe medicine. Pharmaceutical preparations in the form of narcotic drugs have properties that can change if the storage or temperature does not comply with the provisions other than that the effective period of the drug has been determined by the pharmaceutical industry. Pharmacists have an obligation to be thorough and careful to drug narcotics damaged or expired before being handed over to patients. This research is a normative legal research using normative juridical methods or library law research. The results of this study conclude that the pharmacist responsible for the pharmaceutical installation of the hospital is responsible for destroying narcotic drugs that have been damaged or expired for solid drugs by means of removing the contents, then incinerating them, and for liquid drugs being removed first, then the contents are diluted or mixed with water and then discarded. at a special place witnessed by representatives from the Ministry of Health, the Food and Drug Supervisory Agency, the Health Service of the local Drug and Food Control Agency with the hospital. If the responsible pharmacist fails to destroy the pharmaceutical preparations, especially narcotics drug that are damaged or expired, then the legal liability can be held, namely the pharmacist in charge and the hospital .

DEVELOPMENT STRATEGY OF PHARMACY DEPARTEMENT BASED ACCREDITATION EVALUATION IN RSUD Dr MOEWARDI SURAKARTA BY HANLON METHOD

Getting excellent service is the dream of all society, especially recipients of health services in the hospital including in pharmacy departement. Many problems obtained by the patient, because services do not meet the standards. To meet the needs of the patient, pharmacy departement must be accredited. The purpose this study was to determine the suitability of pharmacy departement service to accreditation standards in RSUD Dr Moewardi Hospital Surakarta and development strategy based on Hanlon method. The research was a non experimental research plan. The data collected by using a self-assessment questionnaire of pharmacy care standards. The respondents consisted of key informant was the Hospital Director, Sub Division Head of Human Resources and Training, Head of Organization and Personnel, and the pharmacist in charge, and key informants that pharmacists and pharmaceutical technical employee in pharmacy installation hospital, and the main informant were all pharmacists and pharmacy technical staff of pharmacy installation hospital in Dr Moewardi Hospital Surakarta. From the results count of respondent of pharmacy installation officers, equalled with observation result. The processing of research data conducted with Hanlon method. The results showed that was difference in accreditation standard assessment between self-assessment of pharmacy installation hospital staff (97,5%) with the observation results (93,75%). From this result, the pharmacy installation of Dr Moewardi Surakarta had to meet KARS accreditation standards but still need to be maximized again to lead to JCI accreditation standard. Therefore, it was needed the commitment of Director, Accreditation Committee, Stakeholders and pharmacy installation hospital staffs in improving services in accordance with standards. Strategy and plan development efforts could be done through the addition of pharmacy staff, provision of space/place which meet the standards, complete SOP, optimal pharmaceutical care and evaluated and followed up

Stockouts of HIV commodities in public health facilities in Kinshasa: Barriers to end HIV.

Stockouts of HIV commodities increase the risk of treatment interruption, antiretroviral resistance, treatment failure, morbidity and mortality. The study objective was to assess the magnitude and duration of stockouts of HIV medicines and diagnostic tests in public facilities in Kinshasa, Democratic Republic of the Congo. This was a cross-sectional survey involving visits to facilities and warehouses in April and May 2015. All zonal warehouses, all public facilities with more than 200 patients on antiretroviral treatment (ART) (high-burden facilities) and a purposive sample of facilities with 200 or fewer patients (low-burden facilities) in Kinshasa were selected. We focused on three adult ART formulations, cotrimoxazole tablets, and HIV diagnostic tests. Availability of items was determined by physical check, while stockout duration until the day of the survey visit was verified with stock cards. In case of ART stockouts, we asked the pharmacist in charge what the facility coping strategy was for patients needing those medicines. The study included 28 high-burden facilities and 64 low-burden facilities, together serving around 22000 ART patients. During the study period, a national shortage of the newly introduced first-line regimen Tenofovir-Lamivudine-Efavirenz resulted in stockouts of this regimen in 56% of high-burden and 43% of low-burden facilities, lasting a median of 36 (interquartile range 29–90) and 44 days (interquartile range 24–90) until the day of the survey visit, respectively. Each of the other investigated commodities were found out of stock in at least two low-burden and two high-burden facilities. In 30/41 (73%) of stockout cases, the commodity was absent at the facility but present at the upstream warehouse. In 30/57 (54%) of ART stockout cases, patients did not receive any medicines. In some cases, patients were switched to different ART formulations or regimens. Stockouts of HIV commodities were common in the visited facilities. Introduction of new ART regimens needs additional planning.

Practice of community pharmacists related to multivitamin supplements: a simulated patient study in Iran.

Background Multivitamin supplements are a subset of dietary supplements sold in pharmacies as over-the-counter medicines. Community pharmacists are regarded as responsible professionals and relied on for their safe practice and efficacy. Objective The aim of this study was to evaluate the counselling practices of community pharmacists relating to typical use, interactions, contraindications, and side effects of multivitamin supplements using simulated patients. Setting Ninety-seven community pharmacies in Kerman, Iran. Method Two male students acted as simulated patients who role-played a scenario in the community pharmacies in two steps. In step 1, they spontaneously mentioned they were a student and did not eat properly through lack of time and requested a multivitamin supplement. In Step 2, if the pharmacists did not request a drug history, they would explain that they had severe acne and had been taking oral isotretinoin for a month. The counselling practice of the pharmacists was audio recorded. Main outcome measure The number of pharmacists who provided information about multivitamin use and identified isotretinoin-vitamin A interaction. Results Thirteen pharmacists in charge were absent at the time of the purchases. None of the pharmacists provided information about contraindications and side effects of multivitamin products. Twenty pharmacists provided instruction for multivitamin use, and two pharmacists took a drug history. In Step 1, only two pharmacists identified isotretinoin-vitamin A interaction, but in Step 2, this number increased to 15. Conclusion The counselling practice of pharmacists should be improved to promote effective and safe use of multivitamin supplements.

PHYSICIAN AND PHARMACIST OPINION ON DIABETES MELLITUS AND THE MOST COMMONLY PRESCRIBED ANTI-DIABETIC DRUG IN VARIOUS DISTRICTS OF U.P. (WEST), INDIA

Diabetes mellitus (DM) is a group of metabolic disorders characterized by a chronic hyperglycemic condition resulting from defects in insulin secretion, insulin action or both. The prevalence of diabetes is increasing rapidly worldwide and the World Health Organization indicates global prevalence of diabetes was estimated to be 9% among adults aged 18+ years and it will be the 7th leading cause of death in 2030. The aim of this paper is to gather latest information on the prevalence of Diabetes among the human society and also to investigate pharmaceutical marketing of Metformin and its combinations used for Diabetes Mellitus in various districts of U.P. (West) region. The survey was based on the questionnaire which was presented before the physicians and the pharmacist in-charge on medical store to get information about the patient having diabetes mellitus and commonly prescribed brands of Metformin alone and its combination with other anti-diabetic drugs. On the basis of physician’s opinion on the Diabetes (type 2), 65.78% of patients from total OPD patients was found to have diabetes, 49.76% patients are type-2 patients, 7.45% of teenagers was fall in the category of having type-1 diabetes and 8.57% were among the new patients of diabetes. There are 20 and 30 brands in Metformin (and its HCl salt), Metformin (and its HCl salt) with other anti-diabetic drug categories, respectively. The sale of Glyciphage of Franco Indian Remedies brand of the Metformin only, Diapride M 1 containing Glimepiride and Metformin 500 mg from Micro Labs Ltd., respective categories, were highest in the area of interest. KEYWORDS: Diabetes Mellitus, Metformin (and its HCl salt), Combination drugs, Marketing Investigation.

Track and trace: Is your pharmacy in compliance with the new law?

Is your pharmacy ready for the new track-and-trace law? Under the Drug Supply Chain Security Act (DSCSA), January 1 and July 1 are the key dates in 2015 for new requirements for pharmacies.

Pharmaceuticals, pharmacists and profits.

I am writing in response to the editorials on Pharmaceuticals, pharmacists and profits (Aust Prescr 2014;37:146-7 and 148-9). I enjoyed reading the Pharmacy Guild’s perspective on troubles facing the industry. However, the editorial failed to mention the financial troubles facing community pharmacists who are not pharmacy owners. Few people, including those studying to become pharmacists, are aware that the award rate for a full-time pharmacist in charge is $27.16/hour (equivalent to $53 674 annual salary).1 Note that pharmacist interns, pharmacists and experienced pharmacists are all paid less than this. To compare, an unqualified experienced retail employee may earn up to $44 787.2 Pharmacists’ wages are significantly below the average Australian wage of $76 804 before tax.3 From this wage, a pharmacist must pay to be registered for insurance and course fees for 40 hours of continuing professional development per year. Debt from university fees must also be paid. There is a current oversupply of pharmacists, and jobs for salaried pharmacists are not easy to obtain. I understand that some pharmacies are currently experiencing a period of hardship. But should salaried pharmacists be the ones to subsidise the industry by being forced to accept these low rates of pay?

CP-026 Implementation of quality prescribing indicators and compliance by a Rheumatology Team

BackgroundThe Andalusian Public Health Care Service have developed some indicators based on the selection of drugs for which there is better evidence of efficiency within several therapeutic groups, in areas...