Pharmacy Assistants Research Articles

P02 Novel pharmacy roles strengthen the multidisciplinary hospital infection team

Abstract Background Pharmacists have an essential role to play in the NHS Long Term Plan. Hospital pharmacy departments need to develop novel roles to strengthen teams and improve patient care. In September 2017, Mid Yorkshire Hospitals NHS Trust appointed a consultant antimicrobial pharmacist along with an administrative apprentice to strengthen pharmacy and infection leadership and support the delivery of the antimicrobial resistance national targets. From January 2018 to June 2020, the infection team worked with locums but no substantive consultant microbiologists. Objectives To describe the benefits of developing novel pharmacy roles to strengthen an infection multidisciplinary team Methods A shortage of consultant microbiologists provided opportunities to develop and enhance other infection roles. These included one year of funding from Pathology for a Band 6 Specialist Pharmacy Technician. The role was subsequently funded by the Adult Community Services team to support the home intravenous antibiotic service. Senior support was provided by the Pathology Group Manager, Head of Infection Prevention and Control and Director of Pharmacy. The apprenticeship levy supported a Level 4 Data analyst qualification to develop the pharmacy administrator role. Two other infection roles were developed: Advanced Clinical Practitioner and Trainee Clinical Scientist, both of which could not be sustained for lack of adequate consultant microbiologist resources for clinical supervision within the team. Results The Specialist Pharmacy Technician coordinates the home intravenous antibiotic service. Clinical responsibility remains with the discharging consultant medical officer. The antimicrobial pharmacy team led the introduction of antibiotic elastomeric pumps for home use, saving 2500 inpatient bed days. Patient and staff feedback on the novel pharmacy roles has been positive. Band 5 Pharmacy Data Analyst – Antimicrobials responsibilities include clinical trial participation, data collection and analysis including ward level working, reporting and coordination of the audit programme. The role has enabled contribution to national research studies, including Antibiotic Review Kit (ARK-Hospital) and Procalcitonin: Evaluation of Antibiotic Use in COVID-19 Hospitalised Patients (PEACH). Through a new strategy, consultant microbiologist workforce has progressively grown back to three full time equivalents and a 4th post advertised, enabling an increase in participation in ward rounds, multidisciplinary team meetings, antimicrobial stewardship, infection prevention & control, Director of Infection Prevention and Control role and leading NIHR research trials. The consultant pharmacist remains in post as a senior leader, and also has a Trust role as Director of Innovation. This change provided funding for an increase from Band 3 to Band 5 data analyst, promotion of a senior Band 7 pharmacist to a Band 8a advanced clinical pharmacist, and conversion of a part time Band 7 pharmacist to a full-time role. Discussion An innovative approach to development of pharmacy, data, nurse and scientist roles has strengthened the infection service in a regional hospital and community services Trust. Pharmacy-led team meetings are now routine in the Trust allowing for more efficient use of consultant microbiologist time. Conclusions Potential future roles are further administrative support, pharmacy assistant, clinical nurse specialist – antimicrobials, and antimicrobial pharmacy team leader.

How to Provide Tailored Medication Counselling to Hematology Patients? A Pilot Project

Hematological diseases are characterized by ample variance in disease trajectories requiring the delivery of tailored medication counselling. However, the one size fits all approach to providing medication counselling still seems pervasive in hospitals. Therefore, the outpatient pharmacy of the Albert Schweitzer hospital in the Netherlands implemented a pilot project concerning tailored allocation of medication counselling among hematology patients through structural assessment of their needs. The 124 included hematology patients were provided with tailored medication counselling by trained pharmacy assistants for 12 months. The tailored medication counselling provided to the hematology patients was based on the assessments of their needs using the Bloem & Stalpers segmentation model. This model constitutes four segments each describing a medication counselling profile based on the perceived acceptance and control of patients. The evaluation of this pilot project shows that subjective health experience, satisfaction with medication information and medication compliance among included patients improved

Pharmaceutical regulations in Chad: assessment of drug dispensing practices in private pharmacies in N'Djamena

the purpose of this study was to evaluate drug dispensing practices in private pharmacies in the city of N'Djamena and, specifically, (I) to describe the characteristics of dispensaries, (ii) describe dispensing practices and (iii) assess regulatory compliance when dispensing on the basis of a prescription and an advice. we conducted a cross-sectional survey from June to December 2020. Data were collected in two stages, through interviews with pharmacists and participant observation in drug delivery practices in pharmacies. in total, 26 pharmacies, or 50% of pharmacies in N'Djamena, were surveyed. The main survey findings were: private pharmacies in the city of N'Djamena employed two categories of staff, namely pharmacists and auxiliary staff (pharmacy technicians, nurses and salespeople or staff with "no health qualifications". These had not been trained in a health school recognised by the Ministry of Health) to dispense medicines. Very few pharmacies (8%) had a customer confidentiality area and a order book. The three modes of delivery were observed in more or less equal proportions (30 to 40% of dispensations). Dispensing at the patient's request was slightly predominant (40%) and the majority of medicines dispensed at the patient's request and based on dispenser's advice belonged to the different tables of toxic substances (over 70%). The noted absence of the pharmacist from the pharmacy justified why 84% of patients' requests were addressed to the pharmacy assistants. this study shows low compliance of pharmacies with pharmaceutical regulations for proper dispensing of medicines in the city of N'Djamena. Factors related to pharmaceutical sector governance and human resources management as well as therapeutic patient education could explain this gap.

Exploring the Influence of an Interprofessional Student-Run Clinic on Matriculation to Health Professional School: A Retrospective Cross-Sectional Study

Background: Projected demographic trends in the United States suggest increasing racial and ethnic diversity. It is important that the healthcare workforce reflects these trends to reduce healthcare disparities among underserved populations. For example, concordant backgrounds between patients and providers improve communication and increase probability that patients seek and receive healthcare among marginalized populations. Building in curricular opportunities to connect with the underserved community is one way to recruit students from diverse backgrounds into this pipeline that will lead to a diverse workforce in healthcare. The objective of this study was to assess the influence of an interdisciplinary student-run clinic (SRC), which focuses on caring for underserved and vulnerable populations, on students’ decisions to matriculate in four health professional programs (medical, occupational therapy, pharmacy, and physician assistant) at a single institution.
 Methods: In this retrospective cross-sectional survey study, we examined factors influencing first-year students’ decisions to attend a private university in a large metropolitan area. The primary outcome was students’ self-reported ratings of the university’s SRC as a factor in their matriculation decisions. Two-tailed Mann-Whitney-U tests was applied to compare the relative importance of SRC on matriculation. Free response data were evaluated by a qualitative content approach.
 Results: A total of 419 students completed the survey (73% completion rate) across the 4 programs. We found that underrepresented minorities in medicine (URM) (p < 0.05) and first-generation (p < 0.01) students rated the importance of an SRC on their matriculation decision significantly higher than non-URM and non-first-generation students.
 Conclusions: Our findings suggest that the presence of an SRC may positively impact matriculation decisions and diversification of the student body across certain health professional disciplines.

Knowledge, Attitude and Practice of Pharmacy Professionals Against Dispensing Antibiotics Without Prescription in Ethiopia.

Antibiotic resistance is a global public health threat that warrants immediate intervention. Dispensing of antibiotics without prescription (DAWP), is an inappropriate practice that contributes significantly to the emergence and spread of antibiotic resistance. The current study aimed to assess the knowledge, attitude and practice of community pharmacists and pharmacy assistants towards DAWP. A cross-sectional study was conducted, and data was collected from community pharmacists and pharmacy assistants during the eighth national pharmacist's day, which was held on December 4, 2021, in Addis Ababa, Ethiopia. A pre-tested self-administered questionnaire comprise of four sections (socio-demographic characteristics, and knowledge, attitude and practice towards DAWP) was used. The data was analyzed using SPSS version 26 and descriptive statistics (mean, percentage, standard deviation) were computed. Binary logistic regression was used to predict determinates of DAWP. A total of 175 community pharmacy professional were invited in the study, with 158 (111 pharmacists and 47 pharmacy assistants) completing the survey for 90.3% response rate. Most of the participants (86.7%) were aware that DAWP is illegal in Ethiopia. Despite their knowledge, the extent of DAWP was found to be 67.7%. The most common reason given by study participants for DAWP was that most patients do not want to consult prescribers unless the infection appears serious (53.2%). Pharmacy professionals with educational background of masters and above (AOR= 0.354, 95% CI: 0.013-0.744, P= 0.045), and with two to five years of working in community pharmacy (AOR= 0.745, 95% CI: 0.595-0.933, P= 0.010) had a lower tendency to DAWP, respectively. Despite majority of pharmacy professional are aware that DAWP is illegal and contributes to antibiotic resistance, they commonly DAWP for common cold and diarrheal diseases. Strict enforcement of existing antibiotic supply policies, and ongoing educational support for community pharmacy professionals on the judicious use of antibiotics is recommended.

Sustaining rural pharmacy workforce understanding key attributes for enhanced retention and recruitment.

To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Twelve rural communities across Tasmania and Western Victoria, Australia. Participants (n=24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community.

Implementing the pharmacy technician role in existing pharmacy settings: Stakeholders views of barriers and facilitators.

The field of pharmacy will benefit from pharmacy technicians, a higher educated mid-level support workforce. They support pharmacists in providing pharmaceutical patient care through delegated roles and responsibilities. Empirical research on pharmacy technicians within pharmacy practice community and hospital pharmacy practices tends to focus on the practical outcomes of this workforce addition. It mostly addresses the 'WHAT' of service delivered by pharmacy technicians. Literature on the 'HOW' of their role development in practice is scarce. Furthermore, it seems difficult for most pharmacy technicians to effectively fulfil this professional role. This qualitative study explored factors influencing role development of pharmacy technicians in community and hospital pharmacies. On site, individual and small-group interviews were conducted with pharmacy technicians (n=10), and two colleagues: pharmacists (n=7) and pharmacy assistants (n=6). Interviews were based on a semi-structured interview guide. Participants were asked to describe specific incidents and organisational, relational and pharmaceutical care perspectives, illustrative of the process of developing and implementing the pharmacy technician role. Template analysis was used to develop a list of codes representing themes identified in the data. Five interrelated themes influenced development and implementation of the pharmacy technician role. Two of them were at a more contextual level: (a) experiencing a lack of vision on added value of the new role within the field of pharmacy and (b) learning climate. The other three were related to personal interactions between staff members: (c) role expectations and organisational fit, (d) personal traits of pharmacy technicians and (e) support of pharmacy technicians through task delegation and role enhancement. The data showed that development and implementation of pharmacy technician roles is a complicated process. A detailed plan for addressing and remediating the five identified themes is important to promote role development of pharmacy technicians.

Evaluating UK Pharmacy Workers' Knowledge, Attitudes and Behaviour towards Antimicrobial Stewardship and Assessing the Impact of Training in Community Pharmacy.

The Antibiotic Guardian (AG) campaign, developed in 2014 is an online ‘pledge’ approach to engage health workers and the public about antimicrobial resistance. It is underpinned by models of science communication and behaviour change. Since its launch until the end of 2021, more than 140,000 individuals pledged. A service evaluation was conducted to determine the impact of the campaign upon UK pharmacy workers, in response to national training introduced in 2020. Pledged pharmacy workers were sent an online questionnaire collating demographics, self-reported behaviour and opportunity to support prudent antibiotic use. It also investigated respondents’ daily practice and antimicrobial stewardship (AMS) efforts, and motivations for pledging. Capability was measured with a set of knowledge questions. Awareness of changes to the Community Pharmacy Quality Scheme in England to include incentivized training on antimicrobial resistance (AMR) was explored. Of the 5344 pharmacy workers invited to participate, 783 (14.6%) responded to the survey. There was a statistically significant difference between job roles and capability score. Pharmacists, including Academic and Hospital Pharmacists and Pharmacy Technicians reported higher confidence and capability scores than Dispensers and Pharmacy Assistants (F = 13.776, p = 0.0002). Respondents reported strong knowledge on antimicrobial resistance and high confidence in fulfilling their AG stewardship pledge within daily practices (92.7% of all respondents answered all capability questions, as measured by knowledge, correctly). Two thirds of respondents (61.6% (423/693)) agreed or strongly agreed that they had access to and were able to utilise local antibiotic prescribing guidance and a similar proportion of responding community pharmacists (60%) were aware of the content of their workplace AMS plans. No statistically significant relationships were found between motivations for pledging and subsequent behaviour; pledging due to mandatory requirements of work-place training was the most common answer in both 2019 (42%) and 2020 (54%) cohorts. This evaluation supports the value of the AG pledge-based approach to engage and educate pharmacy workers. Reflections show its impact on increasing evidence-based stewardship for pharmacy workers and their response to mandatory training requirement by employers highlights the effectiveness of the AG campaign to promote AMS within pharmacy teams.

Eczane Personellerinin Akılcı İlaç Kullanımı ile İlgili Bilgi, Tutum ve Davranışlarının Değerlendirilmesi

Introduction: Irrational drug use is a severe problem affecting public health, increasing morbidity, mortality rates, and treatment costs. Healthcare personnel has important responsibilities in this regard. In this study, we aimed to evaluate the knowledge, attitudes, and behaviors of pharmacists, assistant pharmacists, and pharmacy technicians.Materials and Methods: Pharmacists, assistant pharmacists, and technicians working in pharmacies registered in an urban area were reached. Volunteers with the support extended to literature Turkey Pharmaceuticals and Medical Devices Agency, Department of Rational Drug Use ‘Survey of Hospital Pharmacists were required to be filled out online.Results: 156 pharmacy personnel voluntarily participated in the study. Of the volunteers, 48.1% were pharmacists, 4.5% pharmacy assistants, and 47.4% pharmacy technicians. 59% of the participants declared that they did not receive training on rational drug use. Among pharmacy technicians, this rate is 73%. All pharmacies monitor the drug monitoring with electronic devices or instant measurements by the responsible persons; 99.4% of the participants stated that they informed the patient about the storage conditions of the drug, and 84% informed the health personnel about the drug with a special preparation condition. 18.6% of the participants reported one or more adverse events in the last two years. It has been determined that there is no complete standardization in the disposal of residual/waste drugs for drugs from patients.Conclusion: In order to organize rational drug use training for pharmacy technicians, implement a standard method for waste residual medicine management, and increase feedback on pharmacovigilance practices, it is necessary to encourage the staff.

Advancing a global pharmacy support workforce through a global strategic platform.

The pharmacy support workforce (PSW) is the mid-level cadre of the global pharmacy profession, referring to pharmacy technicians, assistants and other cadres that assist in the delivery of pharmaceutical services in a variety of practice contexts. The PSW undertake technical tasks delegated under the supervision of a pharmacist or performed collaboratively. The PSW are not intended to replace pharmacists, but rather work side-by-side with the pharmacist to achieve a shared goal. However, extensive variation in the PSW exists globally, ranging from an educated, regulated, and highly effective workforce in some countries to unrecognized or non-existent in others. Vast differences in education requirements, specific roles, regulatory oversight, and need for pharmacist supervision, inhibit the development and advancement of a global PSW. As clinical care providers, pharmacists worldwide need for a competent support workforce. Without the confidence to delegate technical responsibilities to a well-trained and capable PSW, pharmacists will be unable to fully deliver advanced clinical roles. A clear vision for the role of the PSW in the expanding scope of pharmacy practice is needed. One organization working to unite global efforts in this area is the International Pharmaceutical Federation (FIP). The FIP Workforce Development Hub Pharmacy Technicians & Support Workforce Strategic Platform was established to address the pharmacy workforce shortage in low and middle-income countries. Further developments were made in 2019, with the creation of a representative global PSW advisory panel, to provide guidance towards the development of the global PSW. Provision of frameworks and strategic input to support quality in education, development of legislative frameworks, guidelines for registration and licensure, and advice on appropriate role advancement are critical to move the PSW forward. In order to produce substantial advancement of roles and recognition of the PSW and advancement of pharmacists as patient care providers, global collaborative work is needed.

The COVID-19 Pandemic and Patient Safety Culture: A Cross-Sectional Study among Community Pharmacies in Jordan.

The COVID-19 pandemic has dramatically imposed stressful conditions that may impact the ability of healthcare staff to provide safe and effective care. Research on patient safety culture among community pharmacies during the pandemic is limited. This study aimed to assess the patient safety culture among community pharmacies in Jordan during the COVID-19 pandemic. Pharmacists and pharmacy assistants from 450 community pharmacies were approached through online means, with 378 answering the questionnaire written in Arabic that had been adapted from the Community Pharmacy Survey on Patient Safety Culture (PSOPSC). This study showed that various patient safety standards were addressed to a high degree during the COVID-19 pandemic, as represented by the high positive response rate (PRR) measures that were mainly observed in the dimensions “Teamwork” (90.1%), “Patient Counseling” (85.2%), and “Staff Training and Skills” (82.7%). Furthermore, significantly higher PRR scores for the “Teamwork”, “Staffing, Work Pressure, and Pace”, “Response to Mistakes”, “Organizational Learning—Continuous Improvement”, and “Overall Perceptions of Patient Safety” dimensions were observed among participants who worked in independent pharmacies than those who worked in chain pharmacies. Despite an overall positive patient safety culture in the current context of community pharmacies in Jordan during the COVID-19 pandemic, pitfalls were observed in the “Staffing, Work Pressure, and Pace” dimension.

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study.

Background Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from hospital. Hospital pharmacists play an important role in preparing these lists although this process is time consuming.Aim To measure the time required by hospital pharmacists to complete the various tasks involved in discharge medicine handover.Method Time-and-motion study design was used to (1) determine the time involved for pharmacists to produce discharge medicine lists, (2) explore how pharmacists utilise various software programs to prepare lists, and (3) compare the time involved in discharge medicine handover processes considering confounding factors. An independent observer shadowed 16 pharmacists between 22 February and 12 March 2021 and recorded tasks involved in 50 discharge medicine handovers. Relevant information about each discharge was also collected.Results Pharmacists observed represented a range of practice experiences and inpatient units. Mean time to complete discharges was 26.2 min (SD 13.6), with over half of this time used to check documentation and prepare discharge medicine lists. A mean of 4.0 min was spent on manually retyping and reconciling medicine lists in different software systems. Medical inpatient unit discharges took 4.6 min longer to prepare compared to surgical ones. None of the 50 discharges involved support from pharmacy assistants; all 50 discharges had changed or ceased medicines.Conclusion There is a need to streamline current discharge processes through optimisation of electronic health software systems and better delegation of technical tasks to trained pharmacy assistants.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11096-022-01436-1.

Avaliação de custos para implementação de uma central de misturas intravenosas em um hospital da fronteira sudoeste do Brasil

Objective: The objective of this study was to evaluate the cost for the implementation of an intravenous medication mixing center (CMI) in a philanthropic hospital on the southwestern border of Brazil. Methods: A survey of the costs of equipment, furniture, utensils and human resources required by the current legislation for the implementation of the CMI was carried out. In addition, an analysis of prescriptions was performed from hospitalized patients in Adult (UTI-AD) and Neonatal (UTI-NEO) Intensive Care Units (July to December/2020) who used injectable drugs. The costs of those medication and of losses for leftover medication were estimated. Seven drugs/mixtures were then selected as a proposal to carry out a pilot test for the implementation of the CMI. Results: The costs involving the physical area, furniture, equipment and materials were estimated at US$ 10,446.52. It is also estimated that it would be necessary to employ at least 2 pharmacists, 4 pharmacy assistants and 2 more students, with monthly costs calculated around US$ 2,267.80, excluding labor charges. The estimated total cost of intravenous drugs, solutions and materials to meet medical prescriptions for the 169 patients included in the study was US$ 24,748.13. Considering that the hospital does not have a CMI to centralize the preparation of unit doses of injectable drugs, a total loss of medication leftovers was estimated at approximately US$ 7,764.64. For pilot testing, the following preparations were suggested: omeprazole, heparin, midazolam and insulin (UTI-AD), electrolyte solutions, ampicillin and gentamicin (UTI-NEO). Conclusion: Although the implementation of a CMI requires significant resources, it would provide greater patient safety and an estimated savings of 31.4% with injectable drugs costs.

Community drug retail outlet staff\u2019s knowledge, attitudes and practices towards non-prescription antibiotics use and antibiotic resistance in the Amhara region, Ethiopia with a focus on non-urban towns

IntroductionSome evidence suggests that knowledge and attitudes towards rational antibiotic use influences dispensing practice in community drug retail outlets. However, there is limited evidence in resource limited countries, including Ethiopia. We aimed to assess the knowledge and attitudes surrounding antibiotic use or supply and antibiotic resistance, and the non-prescribed antibiotic dispensing practices in community drug retail outlets in non-urban Ethiopia.MethodsWe conducted a cross-sectional survey of community drug retail outlet staff in the Amhara region, Ethiopia with a focus on non-urban towns. An expert validated self-administered questionnaire was used. Following exploratory factor analysis and best items selection, we summarised our findings and assessed factors associated with non-prescribed antibiotic dispensing. The data were analysed using Stata Statistical Software version 17. P-values < 0.05 were considered significant.ResultsA total of 276 participants from 270 drug outlets completed the questionnaire. The participants median age was 30 (Interquartile range (IQR) = 25–35) years and 79.7% were pharmacy assistants. The majority demonstrated good levels of knowledge about antibiotic use or supply and antibiotic resistance (77.9% and 76% of the participants responded correctly to more than half of the items, respectively). We identified four attitude domains: the role of antibiotics in recovering from diseases regardless of their cause (median score = 2 (IQR = 2–4), beliefs inconsistent with good practice); professional competency to supply non-prescribed antibiotics, and the non-prescribed antibiotics supply (median score for each domain = 4 (IQR = 4–5), attitudes consistent with good practice); and positive attitudes towards actions to prevent antibiotic resistance and promote appropriate antibiotic use (median score = 4 (IQR = 4–5). Fifty eight percent of the participants reported that they had dispensed antibiotics without a prescription. Participants who did not perceive that they were competent to supply non-prescribed antibiotics (adjusted odds ratio = 0.86, 95% confidence interval = 0.78–0.93) were less likely to report non-prescribed antibiotics dispensing.ConclusionWhile most of the participants had appropriate knowledge about and attitudes to antibiotic use and antibiotic resistance, basic knowledge and attitude gaps remain. Despite Ethiopia’s regulatory restrictions, the non-prescribed antibiotic provision continues to be a common practice. Our study highlights the need for multifaceted interventions that may include a strict regulatory system, staff training and public education.

Exploring career advancement of pharmacy support staff within two Queensland hospitals: a qualitative study

AbstractBackgroundInternationally, pharmacy assistants and technicians have expanded their roles to allow pharmacists to concentrate on more clinical duties. The Australian model of care is currently exploring avenues for strategic role expansion for these support staff.AimTo qualitatively explore pharmacist and support staff views on the training needs of Australian pharmacy support staff.MethodsEthics approval was obtained from both Metro South Human Research Ethics Committee and UnitingCare HREC prior to the commencement of the study. Semi‐structured interviews were conducted with personnel from the private and public settings to explore key issues identified in the literature. Interviews were conducted either face‐to‐face or via telephone between October 2017 and August 2018, with a mean duration of 39.85 min. NVivo® 11 qualitative software was used to consolidate the data. The general inductive approach was used for thematic data analysis, which allowed for the emergence of new themes and sub‐themes within the research topic.ResultsA total of 25 participants consisting of 10 pharmacists and 15 pharmacy support staff were recruited from a private (n = 13) and a public (n = 12) hospital in South‐East Queensland. Participants across both pharmacist and pharmacy support staff expressed inadequacy in current certification level, resulting in a need for further on‐the‐job training. The main reported facilitators to pursue further training were organisational support, career progression and remuneration. The main reported barriers were training cost and lack of time.ConclusionsThis exploratory study provides critical insights into the evolving needs of support staff that can inform innovative strategic role expansion for efficient and sustainable training.

Implementation of a pharmacist-led transitional pharmaceutical care programme: Process evaluation of Medication Actions to Reduce hospital admissions through a collaboration between Community and Hospital pharmacists (MARCH).

What is known and objectiveThe recently conducted Medication Actions to Reduce hospital admissions through a collaboration between Community and Hospital pharmacists (MARCH) transitional care programme, which aimed to test the effectiveness of a transitional care programme on the occurrence of ADEs post‐discharge, did not show a significant effect. To clarify whether this non‐significant effect was due to poor implementation or due to ineffectiveness of the intervention as such, a process evaluation was conducted. The aim of the study was to gain more insight into the implementation fidelity of MARCH.MethodsA mixed methods design and the modified Conceptual Framework for Implementation Fidelity was used. For evaluation, the implementation fidelity and moderating factors of four key MARCH intervention components (teach‐back, the pharmaceutical discharge letter, the post‐discharge home‐visit and the transitional medication review) were assessed. Quantitative data were collected during and after the intervention. Qualitative data were collected using semi‐structured interviews with MARCH healthcare professionals (community pharmacists, clinical pharmacists, pharmacy assistants and pharmaceutical consultants) and analysed using thematic analysis.Results and DiscussionNot all key intervention components were implemented as intended. Teach‐back was not always performed. Moreover, 63% of the pharmaceutical discharge letters, 35% of the post‐discharge home‐visits and 44% of the transitional medication reviews were not conducted within their planned time frames. Training sessions, structured manuals and protocols with detailed descriptions facilitated implementation. Intervention complexity, time constraints and the multidisciplinary coordination were identified as barriers for the implementation.What is new and ConclusionOverall, the implementation fidelity was considered to be moderate. Not all key intervention components were carried out as planned. Therefore, the non‐significant results of the MARCH programme on ADEs may at least partly be explained by poor implementation of the programme. To successfully implement transitional care programmes, healthcare professionals require full integration of these programmes in the standard work‐flow including IT improvements as well as compensation for the time investment.

Tick ecology and Lyme borreliosis prevention: a regional survey of pharmacists’ knowledge in Auvergne-Rhône-Alpes, France

The most prevalent vector-borne diseases in Europe are caused by tick-borne pathogens, such as bacteria of the genus Borrelia that cause Lyme borreliosis.In this context, retail pharmacists are frequently the first medical source of information in the event of a tick bite. The objective of this study was to assess pharmacy professionals’ knowledge about both tick ecology and the appropriate measures for tick bites and Lyme borreliosis prevention. It was based on an online survey of 364 pharmacists and pharmacy assistants located in the Auvergne-Rhône-Alpes region of France. The results showed solid knowledge about preventive measures for tick bite and Lyme borreliosis, but weaker knowledge about tick biology (hosts, suitable habitats, favorable conditions for tick activity, etc.). In particular, several stereotypes were observed in the responses of the pharmacy professionals. These appear to result from a social construction of the knowledge on ticks and tick-borne diseases previously shown to the general population in the region. The results highlight the need for continuous training about ticks and tick-borne diseases for healthcare professionals serving local populations that live in endemic areas.

The state of pharmacy business in the Maykop department (1888-1920)

The relevance of the research is determined by the insufficient study of the issues of the history of the pharmacy business. They are often considered as part of the history of medicine, although in Tsarist Russia a lot of laws were issued regulating pharmacy activities. The purpose of the research is to analyze the development of the pharmacy business in the Maykop department at the time of its historical existence as a state unit. The research objectives: on the basis of legislative acts and charters to trace the legal regulation of the pharmacy business of the Maykop department; to explore existing types of pharmacies; to study the state of health of the population, the personalities of pharmacists and pharmacy assistants on the basis of the texts of archival documents. The research methods: source study, historical-typological, comparative, statistical ones. The formation of the pharmacies of the Maykop department occurred according to the laws of the Russian Empire. At the time of the formation of the department, there were only two free pharmacies in the city of Maykop. Later in more than 20 villages rural pharmacies and pharmacy stores were opened which provided the population with medicines. These pharmacies in most cases belonged to pharmacists or pharmacy assistants with a pharmaceutical education who own normal pharmacies in Maykop. The Soviet government, repealed the laws of the Russian Empire and expropriated pharmacies. With the liquidation of free pharmacies, the supply of medicines became an exclusively state affair.

A Qualitative Evaluation of the Use of Facial Recognition Technology for Opioid Substitution Treatment in Community Pharmacies

ABSTRACT Introduction: Opioids are used as analgesics and are available as prescription opioids, over-the-counter opioids or illicitly as heroin. Increasingly opioid addiction has become prevalent. Opioid addiction or dependence results in the addicts indulging in harmful or dangerous behaviour including unsafe opioid injecting. To address this issue, approved opioid substitution therapy (OST) has been introduced in Australia. It has been identified informally that community pharmacies have issues in dispensing OST because of less than robust patient verification processes. This has led to input errors, misidentification of patients, and refusal to dispense when the patient is not recognised in the records. Facial Recognition Technology (FRT), a form of artificial intelligence, has been used to recognise patients, dispense, and confirm medication ingestion. Some pharmacies in Victoria have commenced using FRT to address the mis-identification issues and help with better record keeping and auditing. Methods: A study to evaluate the pharmacy stakeholders’ (pharmacists, pharmacy assistants and pharmacy owners) experience of using FRT to dispense OST was conducted over 2019–2020. To evaluate the stakeholder’s views, an innovative evaluation approach termed ‘integrated model of evaluation (IMoE)’ was used. The stakeholders (pharmacies) views about use of FRT for OST and its impact on business practice (medication dispensing process and record keeping) improvement was evaluated. Semi-structured questionnaires were used to conduct interviews with individual stakeholders. To obtain a well-rounded perspective about the experiences with FRT, 11 key participants including three pharmacy owners, six pharmacists and two pharmacy assistants were interviewed. Interviews were transcribed and analysed using thematic analysis. Analysis compared and contrasted experiences and perspectives of OST dispensing prior to and after introduction of FRT. Results: The data was collated and analysed as per the IMoE framework. The framework focuses on five components including context, intervention, change, outcomes, and emergent program theory. As per the IMoE framework, the data is analysed inductively and used to formulate a theory explaining the changes because of the OST. As per this assessment process, the findings indicate a positive perception of the utility of FRT in OST program in specific and the pharmacy context in general. The employment of FRT was seen to be conducive to reducing time to pharmacy dispensing and time saving. Where there were issues, it was because of unfamiliarity with the technology or integration problems. Improvement in integration and scaling up of FRT in more pharmacies will yield efficiencies and economies of scale. Conclusions: This study presents an important view about the concerns and opportunities pharmacy stakeholders have in the use of FRT. This will help stakeholders better understand the way to implement facial recognition in the pharmacy sector and in what way they should disseminate information to better inform the public of its pros and cons.

Razvoj srpske medicine u XIX veku

With the fall of the medieval Serbian state under Turkish rule, every culture, including medicine, died out, and the people resorted to folk medicine and self-taught doctors, i.e. empiricists. Serbs began to get educated in Vienna and Pest, and there were Serbian doctors in Novi Sad already at the beginning of the 18th century. At that time, the first doctors with diplomas appeared in Serbia, but mostly as personal doctors of the Belgrade pasha or Knez Miloš, i.e. his brother Jevrem in Šabac. In the fourth decade of the 19th century, the first military doctors set out, and the newly created four military district commands got their doctors. The Serbian Medical Association started the first medical journal, "Serbian Archives" in 1874. Josif Pancic is writing the first textbook in natural sciences, and Dr. Acim Medovic is writing the first textbook on forensic medicine. Before the First Serbian-Turkish War, the civilian ambulance numbered 69 doctors, 10 medical assistants, 26 pharmacists, and five pharmacy assistants, while the military ambulance had 19 doctors, five medical assistants, one pharmacist, and four pharmacy assistants. Health was initiated but also the establishment of the Ministry of Health and the higher education institution of the Medical Faculty in Belgrade. Guided by the oath, expertise, and experience, the doctors of that time made a significant effort to improve and develop medicine in Serbia in the 19th century.