Portuguese Pharmacies Research Articles

Legibility of USP pictograms by clients of community pharmacies in Portugal

Effective and safe use of medicines depends on patients' good understanding of the pharmacotherapy. Pictograms are a communication tool, as complement of verbal/written information, to facilitate drug use and, avoiding errors, being useful for drug effectiveness and safety. To assess the ability of pharmacy's clients, in understanding USP pictograms, establishing the relationship with their socio demographic profiles. The study was developed in community pharmacies, in Lisbon region. Cross sectional study, carried out in pharmacies in Lisbon. A structured questionnaire was used in pharmacies clients of 18 years old and above. Legibility of fifteen USP pictograms was studied using ISO and ANSI criteria. Correlation between the legibility of pictograms and pharmacies clients' demographic profile (age, gender, scholarship, frequency of medicines use) was evaluated. SPSS data base version 18 was used for descriptive analysis. Legibility of fifteen United States Pharmacopeia (USP) pictograms and, its relationship with clients' demographic data (scholarship degree, age, frequency of medicines use and, gender) was studied. From 751 responders, ten pictograms were legible by ISO and seven by ANSI. More than 30 % of the responders weren't able to understand five of the pictograms. It was found statistically significant relationships between some the understanding of some pictograms and clients' scholarships degree, age and frequency of medicines use. It was found that not all the fifteen tested USP pictograms were correctly comprehended by Portuguese pharmacies' clients, having found correlations with scholarship degree, daily use of medicines and age group, for some pictograms. To ensure the effectiveness of USP pictograms it is advisable to test patients' comprehension, before their use in general practice.

Pharmacists’ counseling protocols for minor ailments: A structure-based analysis

Background Self-medication is an important component of health care. To optimize pharmacists’ over-the-counter counseling, there are several guidelines and protocols used in practice. In a self-care environment, protocols should comprise items related to patients’ autonomy. The structure of self-medication protocols, among other elements, should present steps to facilitate patients’ participation. Objective To analyze structural differences between existing community pharmacy minor ailment protocols, including those related to patient autonomy and empowerment in self-medication conditions. Methods The study design followed a cross-sectional descriptive approach. Self-medication protocols were systematically collected from 3 different professional sources (Pharmaceutical Society [OF], National Pharmacies Association [ANF], and Grupo Holon [GH]). A structural-based analysis, by comparison with the general self-medication OF standard protocol, produced outcome measures such as frequencies of flowchart critical steps, active pharmaceutical substances, dosage forms, and posologies. Simple scores were computed to assess protocols’ structural quality, as well as differences between protocols, produced by each professional organization. Results Forty-four protocols presented on average 8 counseling steps toward 10 different active substances, 7 dosages forms, and 14 posologic schemes. From a maximum of 30 critical items, 1 protocol scored 24, 7 scored 23, and 5 scored less than 15 items. Significant differences were found between protocols’ structural components from different sources, particularly between GHs’ protocols compared with those produced by OF and ANF. Conclusions In general, all protocols matched the OF standard for ailment characterization but fell short on steps related to medicine information and selection. Steps for patient participation and agreement were absent, as was pharmacists’ expected role of outcomes monitoring. It might be appropriate to redesign self-medication protocols, preferably through a consensus process that includes not only professionals’ but also patients’ preferences, starting from the prevalent conditions in Portuguese pharmacy practice.

Syringe exchange in community pharmacies—The Portuguese experience

Background Since 1993 the participation of Portuguese pharmacies to the national Syringe Exchange Programme (SEP) has remained high. However, no national guidelines or standard procedures are available regarding the provision of this service. We aimed to describe practices and attitudes toward syringe dispensing and other harm reduction strategies in Portuguese pharmacies. Methods A cross-sectional survey was conducted using an anonymous self-administered questionnaire. All pharmacies in Portugal ( n = 2775) were invited to participate. The questionnaire addressed SEP ever involvement and discontinuation; injection equipment policies; problems and needs in service provision. Results Participation rates were 69.6% among pharmacies involved in SEP and 42.7% in those not involved in the programme. Among current providers, 64.3% followed a strict “one-for-one” policy and 21.6% established limits on the number of syringes distributed. Syringe selling was reported by 76.2%. One-tenth of pharmacies supervised methadone consumption Problems in service provision were experienced by 12.8% of respondents. Need for increased training and improvement of referral pathways were frequently reported. Conclusions Pharmacy-based harm reduction interventions in Portugal have tended to follow strict policies favouring conservative approaches. Training and feedback adaptation seem indispensable to avoid service discontinuation and boost an activity with an essential humanitarian dimension.

Contribuição para o estudo da leitura de folhetos informativos nas farmácias Portuguesas

Introduction Health and its promotion are closely related to the level of education or literacy of individuals. In community pharmacies, it is expected in patient education to make use of written information through patient leaflets. This tool gives autonomy to its users, based on the individual literacy skills. Health literacy is one's ability to obtain, process and interpret information about health and health services in order to make informed decisions. How to measure the level of difficulty in reading and understanding texts written in English has been studied since 1920, when the first formula to rank the minimum level of schooling that is required by a text to be read and understood were proposed and designated by readability formulas. Material and methods The main objective of this study was to experiment readability formulas, for analyzing the complexity of reading and interpreting information leaflets commonly used in Portuguese pharmacies. Two formulas, the SMOG and the Flesh-Kincaid Index, were applied to a sample of 4 patient leaflets, estimating the number of years of schooling required for the proper understanding of these texts. Two independent accredited translators translated the brochures into English, resulting in a consensus version for each leaflet. The Portuguese retroversions were evaluated to confirm the proximity of the translations with the original texts. The simultaneous use of two formulas informed the degree of concurrent validity and reliability of the results. Results The average value for the SMOG was 11.13 (SD = 0.81), while the average Flesch-Kincaid was equal to 8.32 (SD = 0.90). These results correspond to a minimum level of education in Portugal around 10 years. The correlation coefficient between scales was 0.948 ( p = 0.51), convergence that supports results validity. For this set of patient leaflets, the minimum formal education required to read and understand its content was 9 complete years of schooling. A significant proportion of the population using pharmacies as a credible and accessible source of health information, particularly the chronically ill and elderly, present levels of education usually lower than the 9th grade. This way, the current patient leaflets might not be fully understood by its recipients. The current leaflets, as a tool for health related decisions, may not have the utility that one would initially anticipate. Conclusions Readability formulas are important tools for the evaluation and adjustment of written information to the potential users, working as feasible alternatives to classical tests of literacy in the population, and contributing to the success of health education strategies. It would be desirable to develop and validate readability tools in our own language.

Pattern of use of emergency oral contraception among Portuguese women

This study describes the purchasers' profile and characterizes the pattern of use of emergency oral contraception among pharmacy users. The study was carried out in 455 Portuguese pharmacies. A cross-sectional study was undertaken in which pharmacists selected the first six purchasers of emergency oral contraception between May and June of 2006. Only user-purchasers were eligible to answer the questions about emergency oral contraception use. Participants completed a questionnaire on sociodemographic data and variables concerning contraceptive methods (including the emergency oral contraceptive acquired, the source of information about the availability of this emergency contraceptive method, prior use of emergency oral contraception, the frequency of use in the current cycle, the frequency of use in the preceding year, the time elapsed between unprotected sexual intercourse and the acquisition of emergency oral contraception, the reason for use and the regular method of contraception used). Although these drugs are available outside pharmacies--in some shops and supermarkets--their pattern of use was only assessed among pharmacy users. Descriptive statistics were used to characterize data. Prevalence of correct use, which was defined as the proportion of user-purchasers who acquired emergency oral contraception up to 72 h after unprotected sexual intercourse and had never used it in the current cycle. The sample comprised 1466 user-purchasers (72.6%) and 552 purchasers for another person's use (27.4%). Levonorgestrel-only contraceptives represented 96.1% of the emergency oral contraception acquired. User-purchasers aged between 18 and 30 represented 65.2% and 42.3% had attended secondary school. The majority of them (79.5%) were using a regular method of contraception and 62.6% were first-time users of emergency oral contraception. In 59.0% of the situations the reason for use was failure of the contraceptive used. Emergency oral contraception was used correctly by 96.9% of user-purchasers.

Preemptive Modernization and the Politics of Sectoral Defense: Adjustment to Globalization in the Portuguese Pharmacy Sector

Preemptive Modernization and the Politics of Sectoral Defense: Adjustment to Globalization in the Portuguese Pharmacy Sector

Community Pharmacy Services in Portugal

To describe the status and outline the trends of community pharmacy services in the Portuguese healthcare system. The legal framework for Portuguese pharmacies includes geographic and demographic criteria for opening pharmacies and restricting ownership to pharmacists. Since 1975, pharmacy owners have been organized under one association, the Portuguese National Pharmacy Association, which has dealt with pharmacy development over the past 20 years. Securing the economic sustainability of pharmacies was the first milestone. Investing in information software and communication technologies and modernizing the architecture of pharmacies was the next step. Then, professional services such as point-of-care measurements, drug waste management, and needle exchange services were developed. The methadone substitution program was introduced at a later date. Finally, major comprehensive services, including disease management/pharmaceutical care programs, were implemented. All Portuguese pharmacies are independent, which means that the decision to provide different services and the extent to which they are attained vary from pharmacy to pharmacy. Recent political changes seem to reinforce the need to pursue the strategies already defined-to expand the traditional scope of pharmacy business to a wider range of health services. Achievements that have been accomplished and strategies that are in place reflect a high level of organization and unity among Portuguese pharmacies. From a global perspective, pharmacies are reorganizing to be able to compete against other possible agents and are preparing to expand their scope of intervention.

Comparative Analysis of Over-the-Counter Tablet Preparations of Isoflavones Extracted from Soy Available in Portugal

The results of a survey of 28 over-the-counter tablet preparations of isoflavones extracted from soy and 2 with black cohosh that are available in Portuguese pharmacies are presented. All were remedies for hot flushes and post-menopause related problems. Their isoflavone content was analysed by HPLC/DAD and LC/MS-MS. The results show that the isoflavonoids in soy extracts sold by the pharmaceutical companies in Portugal are mainly daidzin, glycitin and genistin.

Achievement Motivation and Self-efficacy Perception Amongst Portuguese Pharmacy Students

Portuguese pharmacy education is undergoing a process of change and the present curriculum of the Lisbon Faculty of Pharmacy (FFUL) is under active discussion. Programs can be better developed to simultaneously achieve learning objectives and students’ success. Previous research has found students’ goal orientation to be consistent with their beliefs about how success is achieved. This work aimed at measuring dimensions of Achievement Motivation (Task Orientation, Ego Orientation and Work Avoidance) and Self-efficacy Perception amongst a sample of 1st and 5th year Portuguese pharmacy students, including those from a private college (ISCS). Both scales, previously used for educational research in Portugal, confirmed the three motivational dimensions and the self-efficacy construct, through Principal Component Analysis and internal consistency testing. Preliminary analysis showed behavioural differences between first and final year students within FFUL and ISCS. These results suggest that a curriculum reform needs to entail not only the update of subject content but also the customisation of teaching and learning methods according to years of academic experience.