Pharmacists In Community Pharmacies Research Articles

Pharmacy student driven detection of adverse drug reactions in the community pharmacy setting

Post-marketing safety studies of adverse drug reactions (ADRs) form an important part of pharmacovigilance. Countries having a formal pharmacovigilance system to a large extent rely on voluntary ADR reporting from health professionals through spontaneous report systems. The contribution of pharmacists in ADR reporting, although varies significantly among countries. Pharmacists in community pharmacies are in a unique position for detection of experienced ADRs by the drug users. The study reports from a study on community pharmacy internship students' proactive role in ADR detection through direct encountering and questioning with drug users. Pharmacy students undertaking internship in a community pharmacy were approached. Thirteen students from nine community pharmacies participated in the project as data collectors. Prior to the study students attended an educational seminar focusing on ADR detection and reporting in general. Ibuprofen was chosen as the drug of study. Pharmacy students approached recurrent drug users purchasing the drug. Participating users were asked about experienced ADRs linked to ibuprofen use. Reported ADRs were collected and analysed. Hundred and twenty eight ibuprofen users participated in the study out of who thirty three reported forty five ADRs possibly linked to ibuprofen use. The reported ADRs followed earlier reported patterns of distribution with gastric pain showing up as the most commonly reported symptom followed by heartburn, nausea, diarrhoea and constipation. Through adequate training community pharmacy internship students get competencies and are capable of detecting and reporting ADRs through direct questions to drug users.

Pharmacists’ perception of pharmaceutical care in community pharmacy: a questionnaire survey in Northwest China

The aim of this study was to explore the perceptions of community pharmacists towards the concept of pharmaceutical care, implementing frequencies of pharmaceutical care, and barriers to implementation of pharmaceutical care in China. A 38-item self-completion pre-tested questionnaire was administered to a quota sample of 130 pharmacists in community pharmacies in Xi'an, Shaanxi Province, northwest China in April 2008. Main outcome measures included understanding of pharmaceutical care; perceived frequency of pharmaceutical care activities; attitude towards pharmaceutical care; barriers to implementation of pharmaceutical care. A response rate of 77.7% (101/130) was achieved. The data were analysed descriptively. Factor analysis was used to explore potential barriers to the provision of pharmaceutical care. Respondents' understanding of the definition of pharmaceutical care was not entirely satisfactory: it was widely but incorrectly seen as a medication counselling service and many pharmacists appeared to misunderstand their role in the process. Respondents spent most of their work time performing prescription checks and providing patients with directions for drug administration, dosage, and precautions, but they tended to ignore health promotion within and outside of pharmacy settings. Factor analysis suggested four factors influencing the implementation of pharmaceutical care in the surveyed community pharmacies: lack of external conditions for developing or providing pharmaceutical care, lack of time and skills, absence of information and economic incentive, and lack of full support from other health professionals, with a cumulative variance of 64.7%. Cronbach's alpha for the four factors was 0.71, 0.72, 0.69 and 0.74, respectively. Although the respondent pharmacists had a certain degree of understanding of the definition, aim, function and use of pharmaceutical care, and carried out some activities currently, a range of barriers need to be overcome before comprehensive pharmaceutical care becomes a reality in China. These barriers could be overcome through participation in effective continuing educational programmes, availability of more resources, effective collaboration with other health professionals.

Knowledge, Perception and Attitude of Community Pharmacists towards Generic Medicines in Karachi, Pakistan: A Qualitative Insight

Purpose: In an era of escalating healthcare costs and ageing population, there is a need for costeffective measures. This study was aimed to investigate the knowledge, perception and attitude of community pharmacists towards generic medicines. Methods: A qualitative methodology was adopted. Snowball sampling technique was used to identify eight community pharmacists. Semi-structured interviews were conducted with the pharmacists until the point of saturation was obtained. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and further verified by other authors’ analyses. Results: Thematic content analysis identified three major themes: knowledge of generic medicines, perception towards generic medicines, and attitude towards generic medicines. All the pharmacist showed good understanding and positive perception towards generic medicines. Mixed responses were observed regarding dispensing of locally manufactured medicines. Low cost was cited as the major determinant in dispensing locally manufactured generics. Conclusion: The current study showed good knowledge and perception towards generic medicines among community pharmacists in Karachi, Pakistan. It also highlighted mixed attitudes towards generic medicine dispensing. A 24-hour mandatory presence of professionally qualified pharmacists in community pharmacies can boost the confidence of doctors in pharmacists and enhance generic substitution. Keywords: Community pharmacist, Generic Medicine, Pakistan, Qualitative methodology

Is a Migraine Screener Useful for Pharmacists in Community Pharmacy to Distinguish Patients with Migraine?

In this study, to clarify the characteristics of a migraine screener that would be useful to pharmacists in community pharmacies, we used the migraine screener to investigate patients with migraine. Diagnosis of migraine was made according to the internal classification of headache disorders 2nd edition (ICHD-II). Eighty patients with migraine (with aura: n=21, without aura: n=59) were divided into a positive group (n=51, 64%) and a negative group (n=29, 36%) based on the results of the migraine screener, which included a 4-item (headache exacerbation in daily performance, nausea, light-sensitivity and hypersensitivity to odors). The positive rate of the migraine screener was 64%. In the positive group, patients had moderate-to-severe migraine attacks in the past 3 months. Moreover, 82% of patients in the positive group reported disturbances in their daily of life due to headache. In the negative group, 41% of patients also reported disturbances in their daily of life. Therefore, pharmacists have to check the influence of headache on daily of life not only in the positive group but also in the negative group. These findings provide useful information to guide pharmacists in community pharmacies when using the screener for migraine to distinguish patients with headache from those with migraine.

The changing roles of pharmacists in community pharmacies: perception of reality in India

To summarise the state of community pharmacy in India including: the provision of patient care, pharmacy education, the pharmaceutical market, healthcare delivery, community pharmacy services, the professional role of community pharmacists, and future developments. Medline, Scirus, and Google Scholar databases and the journals "Indian Journal of Pharmaceutical Sciences" and "Indian Journal of Hospital Pharmacy" were searched up to the end of December 2008. In addition to these, other available sources were used to identify relevant articles. India has a fast growing pharmaceutical industry sector and a need for well educated pharmacists. Domestic sale of medicines is estimated to be $5 billion during 2006 and increasing. The supply of medicines to the population is undertaken by privately owned community pharmacies and sometimes also by hospital pharmacies. Community pharmacists are involved only in dispensing medicines. Community pharmacists have an opportunity to improve healthcare of the population, particularly of the disadvantaged section of the society that does not have the resources to visit clinics (both the poor and rural population). However, important barriers to the provision of pharmaceutical care exists, including lack of proper education and training of pharmacists, weak implementation of existing laws, and lack of recognition of the pharmacy as a profession by the other healthcare professionals. The healthcare services in community pharmacies, currently insignificant, must undergo reforms to meet the changing needs of modern medicines users. The pharmacist's role in patient care is expected to grow as professional and educational standards develop. Although pharmacists' contributions to health care are not yet recognized, there is every reason to be optimistic toward making patient care in community pharmacy setting a success. For this, the educational system for pharmacists has to be adapted.

The Role of Pharmacists in a Community Pharmacy for Self-Medication of Patients with Headache

Pharmacists in a community pharmacy may recommend an over-the-counter (OTC) drug to patients with headache. However, it is not clear how pharmacists should distinguish the symptoms of patients and facilitate appropriate self-medication. Here, we investigated the role of pharmacists in a community pharmacy in recommending OTC drugs for self-medication by patients with headache and elucidated their future needs using a questionnaire intended for doctors and pharmacists. More than half of the pharmacists surveyed did not have any experience with recommending OTC drugs for patients with headache. To distinguish between patients for whom pharmacists should "recommend OTC drugs" and patients who should be encouraged "to consult a hospital or clinic," doctors thought that pharmacists should use an "assistance tool to diagnosis headache, such as a screener for migraine" and "guidelines for chronic headache." However, few pharmacists used these tools. About 68% of doctors indicated that it would be "meaningful" for pharmacists to distinguish patients with headache. Moreover, both doctors and pharmacists thought that pharmacists should provide patients not only with "instruction on the use of drugs" but also suggest "when to consult a hospital or clinic." However, 32% of doctors indicated that it is "meaningless" for pharmacists to attempt to distinguish patients with headache and expressed concern about the increase of patients who overuse headache medication. These findings provide useful information to guide pharmacists in community pharmacy when recommending OTC drugs for self-medication by patients with headache.

日本版処方-イベントモニタリング (J-PEM) で保険薬局の薬剤師からの情報を病院薬局の薬剤師からの情報で補う必要性について

Objective : To evaluate the necessity to complement the information obtained from pharmacists in the community pharmacy by that from the hospital pharmacy in Prescription-Event Monitoring in Japan (J-PEM) by using data in a J-PEM pilot study.Methods : For each patient, two questionnaires were sent to the prescribing doctor and the pharmacist who registered the patient ID code in the pilot study. If the patient ID code was registered by the pharmacist in the community pharmacy and if a pharmacist inside the hospital where the prescription was issued was willing to co-operate, a third questionnaire for the same patient was sent to the pharmacist in the hospital pharmacy. The information given by pharmacists was analyzed for 150 pairs of questionnaires (on 150 patients) sent back from pharmacists in both community and hospital pharmacies. The questions in the questionnaire were categorized into [1] those on drugs used by patients (concurrent drugs, daily dose of the drug monitored, and compliance), [2] those on events which the patient had experienced after the prescription of the drug monitored, [3] those on patients (the first date of prescription, reason of prescribing the drug monitored, initial date when the disease developed, underlying diseases or complications and whether and when the patient was lost to follow-up). The questionnaires were examined to determine whether the answer was given to each question. When the answer was given, its quality and quantity were then assessed. The answer to each question given by the pharmacist in the community pharmacy (C) and that by the pharmacist in the hospital pharmacy (H) were compared by the McNemar test after the pairs of answers were classified into the following categories : [1] C is better than H, [2] H is better than C, [3] C and H are similar to each other, and [4] impossible to classify. The difference was considered to be significant where p<0.05.Results and conclusion : For the initial date when the disease developed and 'underlying diseases or complications', H was significantly better than C. However, for concurrent drugs, compliance and events, C was significantly better than H. Otherwise, the difference was not statistically significant. Being compatible with the superiority of C over H in regard to concurrent drugs and events, the fraction of patients lost to follow-up during the observation period was small not only in H but also in C. This observation may be associated with the fact that almost all prescriptions were issued by a single hospital in more than 60% of community pharmacies in the pilot study, and most patients identified in the study were probably a regular visitor to one of such community pharmacies. The most important information to be provided by the pharmacists in J-PEM is that on events and drugs used by patients. It is thought to be not necessary to complement the information obtained from the community pharmacy by that from the hospital pharmacy.