Chain Pharmacies Research Articles

Диуретики: возможен ли безрецептурный отпуск?

Relevance. Diuretics currently play an important role in modern clinical practice. However, at present, diuretics are increasingly used and not “for medical purposes”: to reduce excess weight for cosmetic purposes or by people involved in sports, in those forms where weight categories are provided, or to reduce the concentration of a prohibited substance in urine. In this case, diuretic therapy is associated with the development of a large number of undesirable drug reactions, the likelihood of which increases with the “over-the-counter” dispensing of drugs and, accordingly, with their uncontrolled consumption. Aim. Using an anonymous questionnaire to reveal the demand for diuretics among the visitors of Tyumen pharmacies and the readiness of pharmacists for their over-the-counter dispensing. Materials and methods: analysis of the results of an anonymous survey, visitors and employees of the pharmacy chain (n = 70) in Tyumen. Results. In 42.9% of cases, respondents applied for “over-the-counter” purchase of diuretics (no hard copy). All non-prescription consumers were of working age: 70% were between the ages of 30 and 60, and 30% were under 30. In 20% of cases, over-the-counter dispensing of diuretic drugs was denied by pharmacy staff. 12.5% of non-prescription consumers reported adverse drug reactions to diuretics. An anonymous survey of “non-prescription respondents” under 30 revealed that in 50% of cases, diuretics were used to eliminate edema, in 25% of cases – for weight loss for cosmetic purposes, and in 25% – for weight loss by people involved in sports. In 37.5% of cases, respondents noted the development of unwanted drug reactions in the form of arterial hypotension, seizures, and decreased performance. Conclusion. Non-prescription leave dispensing of diuretics is noted in 42.9% of cases. The main consumers of non-prescription leave diuretics are people of working age. There is a low awareness of consumers about adverse drug reactions of diuretics, which requires not only to limit the over-the-counter dispensing of this group of drugs, but also to educate the population about the dangers of self-medication.

Prescription Filling Patterns of Evidence-Based Medical Therapies for Heart Failure During the COVID-19 Pandemic in the United States

BackgroundMaintaining a steady medication supply during a public health crisis is a major health priority. We leveraged a large U.S. pharmacy-claims database to understand the use of evidence-based therapies in heart failure (HF) care during the coronavirus disease-2019 (COVID-19) pandemic.MethodsWe analyzed 27,027,650 individual claims from an all-payer pharmacy-claims database across 56,155 chain, independent and mail-order pharmacies in 14,164 zip codes in 50 states. Prescriptions dispensed (in 2-week intervals) of evidence-based HF therapies in 2020 were indexed to comparable timeframes in 2019. We normalized these year-to-year changes in HF medical therapies relative to those observed with a stable basket of drugs.ResultsFills of losartan, lisinopril, carvedilol, and metoprolol all peaked in the weeks of March 2020 and demonstrated trajectories thereafter that were relatively consistent with the reference set of drugs. Fills of spironolactone (+4%) and eplerenone (+18%) showed modest trends toward increased relative use during 2020. Fills of empagliflozin (+75%), dapagliflozin (+65%) and sacubitril/valsartan (+61%) showed striking longitudinal increases throughout 2020 that deviated substantially from year-to-year trends of the overall basket of drugs. For all 3 therapies, fills of all quantity sizes increased relatively throughout 2020. For both generic and brand-name therapies, prescription fill patterns from mail-order pharmacies increased substantially over expected trends beginning in March 2020ConclusionPrescription fills of most established generic therapies used in HF care were maintained, whereas those of sacubitril/valsartan and the sodium-glucose cotransporter-2 inhibitors steeply increased during the COVID-19 pandemic. These nationwide pharmacy claims data provide reassurance about therapeutic access, during a public health crisis, to evidence-based medications used in HF care.

A baseline survey of community pharmacies' workforce, premises, services and satisfaction with medical practitioners in Jordan.

The aim of the present study was to describe the local situation in community pharmacies in Jordan by assessing the baseline resources available in terms of workforce, premises and services provided. A survey was developed and administered to community pharmacists from Amman, the capital of Jordan, and Irbid, a large city in North Jordan. Three hundred sixty-seven community pharmacists, 167 from Amman and 200 from Irbid, completed the surveys. The community pharmacists were mostly females (66.6%) and predominantly (about three quarters) younger than 30years old. The community pharmacists were in independent (69.2%) and chain (30.8%) pharmacies. Respondent pharmacists reported delivering medication review services (93.1% of the respondents delivered the service), smoking-cessation services (86.7%), nutrition services (71.5%), blood pressure testing (86.7%), diabetes screening (86.9%) and home delivery (18.8%). Patient counselling is carried out by 94.5% of respondents. Community pharmacists spend most of their time dispensing prescriptions and counselling patients on prescription and non-prescription medicines and chronic diseases. The study also shed the light on a related aspect of practice which was the relationship with local doctors. Only 9.9% of the respondents indicated high satisfaction with their professional relationship with local medical practitioners, 81.6% had a mid-level of satisfaction and 8.5% had the lowest level of satisfaction. The present study identified baseline characteristics of the local situation in community pharmacies. The majority of pharmacists dispensed medications, provided counselling, reviewed medications and provided smoking cessation service.

Perceptions of working conditions and safety concerns in community pharmacy

Background/ObjectiveWorking conditions within community pharmacy can impact pharmacists and their ability to provide safe patient care. The objective of this study was to determine pharmacists’ perceptions of working conditions while controlling for respondent (years of experience, degree, work status) and workplace variables (prescription volume, type of community setting). MethodsThis mixed-methods study used a cross-sectional survey to investigate community pharmacists’ perceptions of company climate (at the store level, corporate level, as well as fear of discipline), workflow issues, and career satisfaction. Items utilized a seven-point Likert-type response format (1 = strongly disagree to 7 = strongly agree). Linear regression was used to assess relationships between perceptions and years of experience, degree, work status, prescription volume, and type of community setting. A free-response question captured perceptions of safety concerns. An adapted version of the Agency for Healthcare Research and Quality integrative model of health care working conditions on organizational climate and safety was used as a framework for this analysis. ResultsRespondents working in national chains had significantly more fear of being disciplined for following policies to promote safety and addressing patient safety concerns than respondents in independent (P < 0.001) and grocery and big box stores (P < 0.001), when controlling for years of experience in community pharmacy, degree, and prescription volume. Most participants (n = 805, 96.9%) indicated organizational or company level factors were the most substantial threat to safety, with work design and quality emphasis being the second most frequently mentioned hazards. ConclusionCompany climate and workflow were perceived negatively in all community settings but were perceived the most negatively by those working in chain pharmacies. A majority of pharmacists feared being disciplined for addressing safety concerns with management, which may be detrimental to patient safety. Further research on how to improve working conditions is warranted.

Community pharmacists in Virginia dispensing naloxone under a standing order: A qualitative study

BackgroundIn 2016, the Virginia Health Commissioner signed a standing order into law allowing licensed pharmacists to dispense opioid receptor antagonists (ORAs) for overdose reversal. ObjectivesUsing the theory of planned behavior as an initial guide to study development, the aim of this qualitative study was to explore community pharmacists’ attitudes, subjective norm, perceived behavioral control, and behavioral intention toward dispensing ORAs under a standing order in Virginia. MethodsSemi-structured interviews were conducted with community pharmacists across the Commonwealth between June 2018 and October 2019. Interviews were recorded, transcribed verbatim, and thematically analyzed. ResultsTwenty-one community pharmacists were interviewed. Pharmacists were confused about the specifics and the processes involved with dispensing naloxone under the standing order. Furthermore, many recognized the underuse of the standing order. Positive attitudes focused on the life-saving action of ORAs. Negative attitudes included encouraging risky behaviors by patients, negatively affecting the patient-pharmacist relationship, offending or contributing to stigmatizing patrons, and having liability issues to the pharmacy. Subjective norms regarding dispensing of ORAs under the standing order were perceived to be favorable among peer pharmacists and primary care and emergency department physicians but may be seen as profit-seeking by patients. Barriers to service provision included lack of guidance from corporate offices (in chain pharmacies), inadequate training, patient out-of-pocket costs, reimbursement issues, inadequate staffing and time, and stigma. Facilitators comprised the existence of practice site-specific protocols, the REVIVE! training, technician support, increased community awareness, physician collaboration, pharmacist training, and employer guidance. Whereas some pharmacists intended to become more familiarized with the standing order, others did not intend to actively identify patients who were at risk of an opioid overdose. ConclusionPharmacists expressed mixed behavioral intention toward dispensing ORAs under the standing order. Future research should focus on quantifying the uptake of the standing order at the state level.

Importance of Pharmacy Partnerships in Effective COVID-19 Vaccine Distribution.

The goal of vaccinating the majority of Americans against coronavirus disease 2019 (COVID-19) in a timely manner requires a robust federal vaccine distribution plan involving pharmacy partnerships. Previously, the 2009 Centers for Disease Control and Prevention (CDC) H1N1 Vaccine Pharmacy Initiative resulted in approximately 10% of adults who received a vaccine during the 2009 pandemic reporting they were vaccinated at a pharmacy. This proportion has already largely increased for COVID-19 vaccinations, with the US Department of Health and Human Services (HHS) using similar channels for vaccination as existing partnerships with national pharmacy and grocery retail chains for the COVID-19 Community-Based Testing Program. It continues to prove crucial that the Biden administration's national COVID-19 vaccine distribution plan, including the Federal Retail Pharmacy Program, focus on ensuring equitable vaccine distribution and access in medically underserved areas and to vulnerable populations, enabling maximum uptake of COVID-19 vaccines.

Research of ethics and deontological aspects in pharmacies

The aim of the study was to study the ethical and deontological aspects related to the professional activities of pharmacists. Materials and methods. To achieve the goal of the study, an analysis of scientific sources on ethical and deontological issues related to the professional activities of pharmacists (pharmacists) was carried. During the research, the methods of information search, systematization, comparison, and generalization, as well as sociological research methods were used. The object of the study was the results of questionnaires and interviews of visitors and employees of pharmacy chains of KP “Prymula”; pharmacy chains that are part of the company “Apteka-Mahnoliia”: Pharmacy ANC, Kopiika and pharmacies of the social project “Blahodiia”; pharmacy chains that are part of the company Med-service. Descriptive statistics methods were used to present the obtained data. To determine the significance of individual factors (Wij), obtained because of the questionnaire are listed to the corresponding specific weight of the component. Results. The systematization of the following factors: which determine the quality of service; related to the purchase of drugs (medicines); which determine the priority of qualities of pharmacies; determining the relationship between a pharmacist and a doctor. It was found that the most negative impact on pharmacy visitors, from the point of view of consumers, was the inattention of the pharmacist, his mistakes, irritability, rudeness, incompetence, as well as the high price of drugs, queues, and slow service. From the point of view of pharmacists, pharmacy visitors were most negatively affected by rudeness, incompetence of pharmacy employees, irritability, the price of drugs, the range of drugs, the presence of queues, and slow service. The results of the assessment of the parameters that determine the relationship between the pharmacist and the doctor showed that, in general, pharmacists maintain the authority of the doctor in the eyes of visitors and, along with the latter, carry out educational work among the population. However, a fifth of respondents assume the functions of a doctor, which is completely unacceptable. Using the technology of sociological survey, the analysis was carried out and, based on ranking, the leading rational and emotional factors that form loyalty for certain segments of the professional activity of pharmacies using ethical and deontological principles were identified. Conclusions. The systematization of the following factors: which determine the quality of service; related to the purchase of drugs that cause dissatisfaction; which determine the dissatisfaction of visitors to pharmacies; which determine the priority of qualities of pharmacies; determining the relationship between pharmacist and doctor. Using the technology of sociological survey, the analysis was carried out and, based on ranking, the leading rational and emotional factors that form loyalty for certain segments of the professional activity of pharmacies using ethical and deontological principles were identified. It is established that the views on consumer dissatisfaction with visiting pharmacies differ insignificantly from the views of pharmacists. Pharmacist visitors are most negatively affected by the inattention and rudeness of the pharmacist, the high price of drugs, the presence of queues and slow service. It is established that, in general, pharmacists maintain the authority of the doctor in the eyes of visitors and, along with the latter, conduct educational work among the population.

Nutrition and Packaging Characteristics of Toddler Foods in Australia

Abstract Objectives To analyse nutritional and packaging characteristics of toddler specific foods in the Australian retail food environment. Methods A cross-sectional audit of the current Australian toddler (12–36 months) food environment was undertaken by visiting major supermarket and pharmacy chains, and online searching. All toddler foods within the store were included. Details on product label attributes were collected via photographs using a smartphone for data entry and analysis. Products were categorised as a (i) snack food or meal, and (ii) snacks sub-categorised dependent on main ingredients. Products were classified as a discretionary or core food as per the Australian Dietary Guidelines (ADG) and level of processing according to NOVA classification. Results 154 toddler specific foods were identified. Snack foods accounted for 81% of all foods. 40% of all foods were classified as discretionary and 85% of all foods were ultra-processed. Close to half (47%) of all products were both core and ultra-processed. Per 100g, discretionary foods provided significantly more energy, protein, total and saturated fat, carbohydrate, total sugar and sodium (p &amp;lt; 0.001) than core foods. Total sugars were significantly higher (p &amp;lt; 0.001) and sodium significantly lower (p &amp;lt; 0.001) in minimally processed foods than in ultra-processed foods. Conclusions The retail food environment for toddlers in Australia consists of many food products which do not align with best practise feeding guidelines or dietary recommendations, as the majority of toddler foods available in Australia are UP snack foods, and do not align with the ADG. Funding Sources None.

Enhancing point-of-care testing through standardized training and redeployment of pharmacy technicians in the community setting

ObjectivesThe primary objective of this study was to assess the impact of a standardized training model for technician-supported point-of-care testing (POCT) on the number of health screenings performed across two states in a large community chain pharmacy. Secondary objectives included the assessment of pharmacist and technician perceptions of advanced roles of the pharmacy technician in POCT service delivery. Practice descriptionCertified pharmacy technicians (CPhTs) across six regional divisions of a large community chain pharmacy in Tennessee and Ohio participated in a standardized training program prior to implementation of technician-supported POCT. Practice innovationStandardized training consisted of pre-training assessments, online training modules, post-training assessments, followed by in-person skills-based assessments. CPhT participation was limited to technical tasks of POCT (e.g. sample collections, quality assurance). Evaluation methodsThe study addressed its primary objective by comparing total number of health screenings for included pharmacies in 2019 as compared to 2020. Descriptive and inferential statistics were used. Perceptions were assessed using an electronic, Likert-type scale questionnaire. ResultsPharmacies with technician-supported POCT showed a 46% increase in the total number of health screenings performed vs. 2019. The survey found that 74% (106/144) of pharmacists and 83% (34/41) of CPhTs agreed or strongly agreed that technician-supported POCT is acceptable for their practice site. Most pharmacy personnel agreed or strongly agreed that the service was appropriate and feasible for their respective practice sites. ConclusionThis study provided supporting evidence that technician-supported POCT may positively impact the number of health screenings conducted in a community pharmacy setting. Standardization of training may allow for expansion of this service across additional states. Furthermore, pharmacy personnel perceptions were overall positive.

PPM6 Evaluating an Artificial Intelligence Powered Medication Adherence Program's Targeting by Patients' Socially Vulnerability

The CDC’s Social Vulnerability Index (SVI) scores census tracts based on socioeconomic status, household composition & disability, minority status & language, and housing type & transportation. In 2020, a national retail pharmacy chain used an Artificial Intelligence (AI) powered program to target in-person, telephonic, SMS and email interventions to patients with the goal of improving the population’s adherence rate to Diabetes, Hypertension, and Statin medications. The AI program did not explicitly attempt to provide more or less support to patients based on their SVI score.

Analysis of consumer behaviour in a retail drugstore chain in Russia based on the type of consumer loyalty

Purpose: To identify the consumer loyalty types in a retail segment of the Russian pharmaceutical market.&#x0D; Methods: A sociological study was conducted in pharmaceutical organisations of various forms of ownership, located in different administrative districts of Moscow (Russian Federation). This was done using a questionnaire developed in advance, and based on literature review. The survey involved 480 respondents selected in a simple random sampling.&#x0D; Results: All questionnaire filled out by the respondents were considered valid. Analysis of the loyalty parameters obtained during the study are as follows: (1) behavioural (repeated purchases), (2) emotional (subjective opinions and experience, sympathy, respect for the brand, etc) and (3) rational (utility assessment) components (4) consumer satisfaction, (5) the desire to buy again, (6) the ability to switch to competitors. They were allocated to four consumer segments. In the course of the study, one consumer segment identified a type of loyalty that had not been previously reviewed by other authors; therefore, a modified classification of the loyalty types was created. Under this classification, constancy, constancy imaginary, inconstancy, and migratory loyalties can be some types of loyalty. The identified socio-demographic characteristics of the respondents influenced the categorization of the loyalty type.&#x0D; Conclusion: A modified classification of loyalty types was created which serves as a parameter for segmentation of the respondents into four groups, with well-readable characteristics and the primary trends in making purchases.

Scaling technician product verification: Contextual analysis for developing an implementation strategy for a large community pharmacy chain

ObjectiveTo identify facilitators and barriers of early implementation of a technician product verification (TPV) program in a large community pharmacy chain. MethodsA mixed-methods (surveys, semistructured interviews, and nondisguised direct observation) approach was used to ascertain facilitators and barriers to implementation and to subsequently develop a scalable implementation strategy with the aim to accelerate TPV scalability across a large community pharmacy chain in states where it is permitted. One-on-one staff interviews and observations provided qualitative data to identify facilitators and barriers to TPV. A Web-based survey was used to gather perceptions on a variety of implementation strategies that would make use of identified facilitators and work to overcome identified barriers. ResultsDuring the mixed-method study, 3 key themes emerged: TPV is a complex intervention whose implementation is facilitated by both adaptability and trialability and is highly dependent on state practice regulations; the implementation climate of the pharmacy organization serves as a facilitator to TPV; and individual beliefs about TPV change over time as implementation experience increases. ConclusionTPV is an expansion of the technician role that allows the profession of pharmacy to increase the provision of clinical activities by delegation of a nonclinical-based task. Early adopters of TPV recognize that verification is a task that is increasingly automated by mail-order pharmacies and that verification may no longer be considered a pharmacist task. Pharmacies in this study tended to revert to comfortable, traditional workflow at the first sign of distress. To be successful in the future, TPV should be thought of as the primary workflow procedure and not as an option. TPV is a service that will require staff buy-in, patience, and championship.

Over-the-counter access to levonorgestrel emergency contraception in South Texas: Does Over-the-counter mean ready to buy?

ObjectiveTo determine the percentage of pharmacies in Hidalgo County, Texas, with unrestricted over-the-counter access to levonorgestrel emergency contraceptive pills (ECPs). Unrestricted over-the-counter access means product is available directly to consumer on store shelf, in-stock the day of data collection, and with no security barriers present (such as locked cabinet or individual locked product container), and to compare this access to that of other reproductive health items. Study DesignWe conducted in-person secret shopper surveys from October 2018 to March 2019, recording in-stock over-the-counter availability of levonorgestrel ECPs, security barriers, and price. We collected the same information for condom multipacks, ovulation prediction test kits, and pregnancy tests. ResultsOut of the 76 pharmacies surveyed, 31 (40.8%) sold levonorgestrel ECPs over-the-counter, 23 (30.3%) had product in-stock over-the-counter and two (2.6%) had unrestricted over-the-counter access. Other reproductive health items such as condom multipacks, ovulation prediction test kits and pregnancy tests had unrestricted over-the-counter access in at least 33 (43.4%, p < 0.01) pharmacies. Of the chain pharmacies, 30 (73.2%) sold levonorgestrel ECPs over-the-counter with and without security barriers, while only one (2.9%) of the 35 independent pharmacies sold levonorgestrel ECPs over-the-counter with security barriers (p < 0.001). ConclusionsWhile previous research has noted high prevalence of levonorgestrel ECP availability in pharmacies, potential purchasers of over-the-counter levonorgestrel ECPs encounter access barriers not associated with other reproductive health products. These additional access barriers to levonorgestrel ECPs may increase consumer discomfort, decrease privacy, and delay access. ImplicationsAdvocacy efforts may be needed to promote unrestricted access to over-the-counter emergency contraceptives on par with other reproductive health items.

Perceptions and Attitudes of Pharmacogenomics Through the Lens of Community Pharmacists and Patients

Background Pharmacists represent some of the most accessible healthcare workers and are in an opportune position to spearhead new clinical initiatives, such as pharmacogenomics (PGx) services. It is important that we understand the perceptions and attitudes both pharmacists and patients have regarding PGx and potential barriers of implementing it into routine clinical practice. Methods A cross-sectional survey study was conducted across one regional division of a large community pharmacy chain to assess the perceptions and attitudes of pharmacists and patients regarding PGx in California. A secondary aim was to determine perceived barriers to PGx implementation into community pharmacies. Results The majority (67%) of pharmacists agreed or strongly agreed to understanding PGx compared to 35% of patients being aware of PGx (p&lt;0.001). More patients (62%) preferred their pharmacist compared to pharmacists (43%) preferring themselves as a provider to manage patients' medications based on their PGx results (p&lt;0.01). Many patients (88%) expressed interest in participating in a PGx test; both pharmacists (84%) and patients (85%) were unlikely to have participated or know someone who has participated in PGx testing. Pharmacists and patients expressed similar concerns about privacy of their PGx data by employers (p=0.287) and insurers (p=0.953), a potential barrier to PGx implementation. Conclusion Pharmacists are well positioned to spearhead PGx consultations and patients are interested in pharmacists using PGx to help manage their medications; however, various barriers were identified that must be overcome for PGx to become incorporated in routine practice.

Newcomers' reaction to the abusive supervision toward peers during organizational socialization

This research examines how and when newcomers witnessing abusive supervision toward peers relate to newcomer organizational socialization outcomes. Drawing from social information processing theory, it is proposed that newcomers witnessing abusive supervision toward peers harms newcomer organizational socialization outcomes (i.e., social integration, role clarity, and task mastery) by discouraging them from engaging in proactive behaviors (i.e., information seeking from the supervisor, relationship building with the supervisor, and positive framing). It is further proposed that the strength of the negative association between newcomers witnessing abusive supervision toward peers, newcomer proactive behaviors, and newcomer organizational socialization outcomes is contingent on the salience of newcomer future work self. A time-lagged study of 164 newcomer–supervisor dyads from a large pharmacy chain company in Northern China supports the hypothesized moderated mediation model. Specifically, the indirect effect of newcomers witnessing abusive supervision toward peers on newcomer organizational socialization outcomes via proactive behaviors was negative and significant for newcomers with low future work self salience (FWSS), but not for newcomers with high FWSS. The research implications for theory and practice relating to newcomer organizational socialization and abusive supervision are also discussed.

Analyzing the Factors Affecting Purchase Intention of Drugstore Beauty Products

Objective – The objective of this study is to identify the key elements of buying beauty products in drugstore chains, discuss the reasons and factors behind why these drugstore chains had become the customers’ preference to visit and purchase beauty products, and to find out the relation of store convenience of drugstore chains to purchase intention of their beauty products.&#x0D; Methodology – The method used in this research is quantitative using an online survey started in November 2020. From 132 distributed questionnaires using Google Form link, only 106 responses are valid.&#x0D; Findings – The results reveal that shopping enjoyment and competitive price to have a significant influence on intention to purchase. However, the relationship between convenience and purchase intention was not supported.&#x0D; Novelty – Previous studies have predominantly examined the main effect of shopping convenience on purchase intention. This study extends our understanding of this relationship by highlighting the non-significant result in the convenience–intention linkage.

Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study

IntroductionFatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. ObjectivesThe objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes. MethodsThe interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1) a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period. ResultsBetween the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings. ConclusionThis small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.

Peculiarities of effective management of products assortment depending on different sizes of pharmacy chains

The aim of the work is to study the features of effective management of product's assortment in small, medium and large pharmacy chains.&#x0D; Materials and methods. The study of the features of the assortment policy of pharmacies that are part of pharmacy chains of different sizes was conducted using a questionnaire of 421 heads of pharmacies. The relationship between the size of the pharmacy chain and the approaches used to form the product's assortment is studied and the presence of the procedure of product's assortment formation in pharmacies is analyzed using Pearson's criteria c2 and c2 maximum likelihood (M-L c2). The importance of the influence of the size of the pharmacy network on the scores of the efficiency of the business process of forming the product range, as well as its width and intensity of updating using non-parametric analysis of variance Kraskal-Wallis; Manfer-Whitney test with Bonferroni correction for pairwise comparisons of pharmacy network clusters and correlation analysis. The presence of drugs in treatment protocols was analyzed using the Z-test to compare the frequency of drug administration. Peculiarities of introduction and withdrawal of drugs and medical products to the range of different size pharmacy chains criteria c2 Pearson's and maximum likelihood (M-L c2) are determined. System and logical analysis is used to systematize the existing approaches to product's assortment management in pharmacy chains of different sizes.&#x0D; Results. It is established that with the increase in the size of pharmacy chains the tendency to use a centralized approach to the analysis and formation of the range in chains increases, when the list of assortment items is fully created and approved at the head office of the chain. The importance of the relationship between the breadth of the assortment of pharmacies and the size of the chain, which includes a pharmacy. Thus, large and mega-chains support the assortment, which on average includes up to 8.5 thousand items of medicines and medical devices, medium - 4-5 thousand assortment's items, and in half of the establishments of small pharmacy chains the range may include from 2,5 to 3 thousand names of medicines and medical devices. It is established that regardless of the size of the pharmacy chain, the inclusion of medicines / medical products in the range of pharmacies most often takes into account the factor of seasonality of demand and taking into account the core range, i.e. the list of 100-150 most popular items in the pharmaceutical market. When withdrawing medicines or medical products from the assortment of pharmacies from all three clusters are often guided by indicators of low profitability of sales and lack of orders for goods for more than three months.&#x0D; Conclusions. The analysis of the assortment policy of pharmacy chains of different sizes showed that in most of the studied institutions it is quite effective. The obtained results allow us to conclude that the effectiveness of the formation and analysis of the assortment is achieved through the use of different approaches to the centralization of this business process depending on the size of the pharmacy chain

Facilitating pneumococcal vaccination among high-risk adults: Impact of an assertive communication training program for community pharmacists

BackgroundCommunity pharmacies are vital access points to provide a range of vaccines to adults, including pneumococcal vaccines; however, despite a growth in the number of vaccines given at these sites, the most recent rates of adults being immunized against pneumococcal disease remain below the goals set by Health People 2020. Low patient awareness is a leading reason for suboptimal vaccination rates, suggesting that a need exists to improve provider communication in recommending pneumococcal vaccination in high-risk adults. ObjectivesTo evaluate the impact of a communication training program to improve pharmacist promotion of the pneumococcal vaccine among high-risk adults in Tennessee. MethodsA multiphase training program was initiated in partnership with 2 regions of a nationwide community pharmacy chain (n = 100) focusing on improving evidence-based, presumptive recommendations related to pneumococcal vaccination. All locations were randomized to one of 3 arms on the basis of training intensity: (1) no training; (2) online training only; and (3) online and in-person simulation training. The program focused on improving evidence-based, pharmacist vaccine recommendations using health behavior theories, sales techniques, and improvisation provided through online and in-person simulation training. Changes in vaccinations (compared with the same 6-month period in the previous year) and provider self-efficacy were evaluated by Mann-Whitney U tests, chi-square tests, and general linear models. ResultsCompleting the full training program led to nominal changes in pharmacist self-efficacy across the 6 items measured (P > 0.05). Overall counts of all pneumococcal vaccines were lower (−11.3%) across all stores in the period after training; however, a small increase (2.1%) was observed in the stores that underwent the full training, versus changes of −22.0% (P = 0.084) and −9.4% (P = 0.199) in control and online-only training comparisons, respectively. ConclusionsPharmacists’ vaccine-related self-efficacy may be improved through an evidence-based communication training program, but a more holistic focus on all recommended adult vaccines may be necessary to realize meaningful improvements.

Potential drug interactions and profile of antimicrobials prescribed for outpatient use in the interior of Bahia

This study aimed to analyze the profile of antimicrobials and potential drug interactions, involving these drugs, prescribed for outpatient use in the interior of Bahia. This is a cross-sectional study, carried out based on the analysis of 404 antimicrobial prescriptions listed in the DRC no. 20/2011, made available by the store of a chain of pharmacies, referring to the period of May 2018. The analysis of drug interactions (IM) was made using the MICROMEDEX® version 2.0 database (2011). The most prescribed class of antimicrobials was that of β-lactams (27.7%), followed by macrolides (25.3%) and fluoroquinolones (18.3%). As for the drugs prescribed in combination, there was a predominance of non-steroidal anti-inflammatory drugs (23.3%) and analgesics (19.8%). A total of 20 different drug interactions were observed, involving antimicrobials, most frequently for ciprofloxacin. After analyzing the interactions, it was possible to verify the risks related to drug associations that can be minimized with the analysis of the prescription by a pharmaceutical professional and alert systems in electronic prescription.