Regulation Of Pharmacies Research Articles

Cannabis dispensary staff approaches to counseling on potential contraindications to cannabis use: insights from a national self-report survey

BackgroundLegal cannabis is available in more than half of the United States. Health care professionals (HCPs) rarely give recommendations on dosing or safety of cannabis due to limits imposed by policy and lack of knowledge. Customer-facing cannabis dispensary staff, including clinicians (pharmacists, nurses, physician’s assistants), communicate these recommendations in the absence of HCP recommendations. Little is known about how dispensary staff approach individuals with complex medical and psychiatric comorbidities. Using responses from a national survey, we describe how cannabis dispensary staff counsel customers with medical and psychiatric comorbidities on cannabis use and examine whether state-specific cannabis policy is associated with advice given to customers.MethodsNational, cross-sectional online survey study from February 13, 2020 to October 2, 2020 of dispensary staff at dispensaries that sell delta-9-tetrahydrocannabinol containing products. Measures include responses to survey questions about how they approach customers with medical and psychiatric comorbidities; state medicalization score (scale 0-100; higher score indicates more similarity to regulation of traditional pharmacies); legalized adult-use cannabis (yes/no). We conducted multiple mixed effects multivariable logistic regression analyses to understand relationships between state medicalization and dispensary employees’ perspectives.ResultsOf 434 eligible respondents, most were budtenders (40%) or managers (32%), and a minority were clinicians (18%). State medicalization score was not associated with responses to most survey questions. It was associated with increased odds of encouraging customers with medical comorbidities to inform their traditional HCP of cannabis use (Odds ratio [OR]=1.2, 95% confidence interval [CI] 1.0-1.4, p=0.03) and reduced odds of recommending cannabis for individuals with cannabis use disorder (CUD) (OR=0.8, 95% CI 0.7-1.0, p=0.04). Working in a state with legalized adult-use cannabis was associated with recommending traditional health care instead of cannabis in those with serious mental illness (OR 2.2, 95% CI 1.1-4.7, p=0.04). Less than half of respondents believed they had encountered CUD (49%), and over a quarter did not believe cannabis is addictive (26%).ConclusionsWhen managing cannabis dosing and safety in customers with medical and psychiatric comorbidity, dispensary staff preferred involving individuals’ traditional HCPs. Dispensary staff were skeptical of cannabis being addictive. While state regulations of dispensaries may impact the products individuals have access to, they were not associated with recommendations that dispensary staff gave to customers. Alternative explanations for dispensary recommendations may include regional or store-level variation not captured in this analysis.

Prevalence of Self-medication Practices and Their Associated Factors in Puducherry, India: A Cross-sectional Study

Background: Self-medication is the most important health issue in developing countries like India. Even though there is abundant healthcare access, self-medication is still chosen by the patients. The purpose of this study was to estimate the prevalence of self-medication and the factors associated with self-medication practices among the urban fisherman population in Puducherry. Methods: This cross-sectional study was conducted from July 2021 to December 2021 (6 months) among 18-60 years fisherman population residing in the urban practice areas. The sample was selected by simple random sampling technique using a semi-structured questionnaire after obtaining informed consent from the participants. Data analysis was carried out by chi-square test and proportions. Results: The majority of participants about 77.8% belonged to the 30-60 years age group; and, 57% were male and 43% were female. The prevalence of self-medication was 67%. Socioeconomic status had a statistically significant relationship with self-medication among other sociodemographic factors including age, gender, education, and occupation. It was found that 82.05% of participants practiced self-medication for their previous similar complaints. The source of information regarding self-medication obtained from the pharmacists is 55.8%. Among the various types of self-medication, allopathy drugs were among the most important reasons because of their easy access. Most self-medication was taken for the symptoms such as cough, cold, flu, headache, and myalgia, and the side effects were found to be 12.1% for self-medication. Conclusion: The majority of the participants used self-medication for cough, cold, flu, headache, myalgia, etc. in case of emergency to hospitals. Awareness about health hazards, drug resistance in prolonged self-medication practice, and regulation of pharmacies limit self-medication.

Digital Marketing: Problems of Internet Pharmacies Legal Regulation

Digitalisation of pharmaceutical activities is creating a new type of pharmaceutical market, a more flexible and less costly; yet it has become more dangerous for patients and the economic stability. The reason is the imperfection of the legal regulation and online sales of pharmaceutical products, in particular. It is necessary to clarify that digitalisation of pharmaceutical activities is not only about online sales of pharmaceutical products. It is also digital marketing, which includes promoting pharmaceutical products via the Internet, including advertising such products. Research shows that prescription drugs are sold to such patients by both illegal online pharmacies and legal ones. Most counterfeit medicines are sold through illegal online pharmacies. The purpose of the article is to draw attention to the need for legal support for the activities of Internet pharmacies using more efficient technologies, including limiting their activities. Carrying out the research, several scientific methods were used. The methods of system-structural analysis, induction and deduction were used at all stages of the research in the study of the legal regulation of the sale of medicines in various countries through Internet pharmacies, the practice of its use, the state of illegal behavior in this area, analytical materials and scientific sources. The formal-logical method was used to study regulatory acts and international documents, the comparative-legal method was used to perform comparative analysis of the legal regulation of Internet pharmacies’ activity, as well as the practice of its application in the countries of the European Union, the USA, Turkey, Ukraine, and some Arab states. It should be noted that in the EU member countries, due to single European economic and customs area and general regulation, the problems of Internet pharmacies are of the same nature. The content analysis method was implemented for studying journalistic materials and researching websites that offer distance selling, online ordering, and delivery of pharmaceutical products to a consumer in various ways. Keywords: online pharmacies, digital marketing, digitalisation of pharmacy.

Prevalence of self-medication practices in urban area of Kanchipuram district, Tamil Nadu

Background: Self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. Self-medication is one element of self-care. The World Self-medication Industry defines self-medication as the treatment of common health problems with medicines especially designed, labelled and approved for use without medical supervision. It is also defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. This study was carried out to investigate the problem and factors responsible for self medication.Methods: A community based cross sectional descriptive study was conducted in Anakaputhur, an urban field practice area of Sree Balaji Medical College. A pre-tested structured questionnaire was used as a study tool to interview the study participants, conducted by face to face interview.Results: There is an association present between age groups and self-medication were the p value was 0.035. There is an association present between occupation and subjects on self-medication p=0.001. An association present between education and self-medication, per capita income and self-medication and marital status and self-medication with a p=0.000. No statistically significant association was found between other factors like tobacco use and alcohol use with self-medication.Conclusions: Self-medication is an important health issues in India. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

Self-medication practice and associated factors among adults in Gorgan, north of Iran

Background and Purpose: Self-medication is an important concern in every part of the world. The aim of this study was to estimate the prevalence and to investigate the associate factors of self-medication among adults in Gorgan, north of Iran. 
 Materials and Methods: This descriptive cross-sectional study was carried out among adults aged 12 years and above who were residents in Gorgan city. The participants were selected using the multi-stage cluster sampling method. SPSS Software and Pearson's chi-squared test were used for data analysis.
 Results: A total of 592 households with 2050 respondents were visited. The prevalence of self-medication was 67.9%. A larger number of females were self-medicating (71.3%) than males (63.5%). The majority of the respondents self-medicated because of the previous use experience (59.3%). The main indication for self-medication use was headache (60.8%). Analgesics were the most commonly self-medicated by the respondents (83.9%). Also, 88.6% of the respondents prepared their drug from drugstores. Furthermore, there were significant differences between self-medication and demographics characteristics including gender, age group, marital status, occupation, education level and income (p<0.05).
 Conclusion: The prevalence of self-medication especially with analgesics is relatively high among adult city-dwellers in Gorgan. So, preventive measures, such as strengthening of the communities awareness on the side effects of self-medication practice and regulation of pharmacies are very important mechanisms to decrease the practice.

Government looking at closing loopholes in regulation of online pharmacies, says GPhC

Government looking at closing loopholes in regulation of online pharmacies, says GPhC

Prevalence & Practice of Self-Medication in Ernakulum District, southern India

Introduction
 Self-medication can lead to many problems and has many concerns associated with it including development of drug resistance. The objectives of the current study were to assess the prevalence of self-medication practices among people residing in selected urban and rural areas of Ernakulam district, to assess the pattern of use of self-medications and to determine the differences, if any, between the rural, urban and slum population in the prevalence and pattern of use of self-medications
 Methods
 A community based cross-sectional study was conducted and 539 individuals from urban, rural and urban slums of Ernakulam district, Kerala were interviewed using a structured questionnaire. Data was tabulated in MS Excel and analysed using IBM Statistical Package for Social Science (SPSS) version 15. Descriptive statistics such as frequency and percentage was used to summarize the data. Univariate and multivariate analysis was done to assess the factors associated with self-medication
 Results
 In the study, 21.5% (114/539) reported that they practised self-medication within last three months. Major indications for self-medication were aches and pain (28.9%), fever (22.8%) and chronic diseases (13.7%). Among those who practised self-medication, 6.1% (7/114) used antibiotics. In the final logistic regression model, being in urban area [urban areas (OR 5.8, 95% CI 3.2-10.4), urban slums (OR 2.9, 95% CI 1.5-5.4)] and increasing age groups [18-59 years (OR 2.1 95% CI 1.1-3.8) and more than 60 years (OR 3.2 95% CI 1.6-6.5)] were associated with self-medication practices.
 Conclusion
 Holistic approach should be taken to prevent the problem of self-medications, which includes proper awareness and education to public, improving access to care and regulation of pharmacies regarding sale of drugs.

Self medication practice and associated factors at the regional hospital Bamenda, Cameroon: a prospective study

Background: Due to paucity of studies on the prevalence and pattern of self medication among Cameroonians and particularly dwellers of Bamenda City, in this research was undertaken to study the practice of self-drug administration among adult out patients at the Regional Hospital Bamenda; identify potential factors influencing self-medication practices; sources of drugs and/or information about medications and finally the reasons for self-drug administration.Methods: Participants (200) of age 18 years and above who came for external consultation during the study period were sampled conveniently after giving their consent. They were administered questionnaires on self-medication practices. Data was analyzed using SPSS version 19.0.Results: The prevalence of self-medication in this study was 86.50% (173/200). The females were more involved in the practice of self-medication (88.18%) than males (85.54%). Participants from deferent occupations had used various classes of drugs through self initiative. Analgesics were most commonly used (84.39%). This was followed by antimalarials (52.60%) and antibiotics (41.62%). While the least represented was the class of laxatives (1.73%). The factors promoting self medication practices were mainly due to mild nature of illness (36.50%) and longtime spent to see the doctor (22.50%). The leading source of information on self-medication prescription and administration came from doctors (78.61%) and pharmacists (34.42%). Over the counter drugs were the most commonly purchased from private pharmacies (76.88%).Conclusions: Self-medication is an important health issue in this area. This study shows the necessity to educate the public on health education and make regulation of pharmacies in limiting self-medication practices.

Regulation of Pharmaceuticals in Developing Nations: A Case from Nepal

Department of Drug Administration (DDA), medicine regulatory authority of Nepal, is aligned towards achieving Universal Health Coverage through the regulation of medicines, pharmacies, manufacturing facilities and medicine testing laboratories from its offices located in Kathmandu, Birgunj, Biratnagar and Nepalgunj and takes legal or administrative actions as appropriate. It has its own regulatory laboratory, National Medicines Laboratory for testing and analysis of medicines. Besides, DDA reports suspected ADR to Upshala Monitoring Centre, Sweden, provides drug information and conducts regulatory trainings. Unlike in the developed world, DDA may not be able to fulfill all of its objectives. But then, a mechanism of regulation of pharmaceuticals is functional and is dynamic as per national need.https://doi.org/10.21423/jrs-v04n04p018 (DOI assigned 5/14/2019)

Study on self-medication practice among consumers in parts of East Bengaluru

Background: Self medication is defined as the use of medication by a patient on his own initiative or on the advice of a pharmacist or a lay person instead of seeking advice a medical practitioner. Objectives: To assess the self medication practices for allopathic drugs in East Bengaluru and also identify the association between self-medication practice and socio demographic characteristics in the study population. Methodology: A community based cross sectional study was conducted in East Bengaluru area over the period of 6 months using pre tested semi structured questionnaire. Result: The data on practice of self medication were collected from 427 study participants. A significant correlation was observed for younger age group, while a moderate correlation for education, economic status of the survey respondents. Fever, pain and cough (20.60%), pain (17.09%), and fever & pain (16.85%) were the most common illnesses where self-medication is being used. Pain killers (68.85%) and antipyretic drug (50.58%) were the most commonly used self medicating drugs. Telling the symptoms to pharmacist (89.69%) was the commonest method adopted to procure drugs by the users. The major reason for practicing self medication was lack of time to visit doctor (32.31). Conclusion : Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

Prevalence of self-medication practices and its associated factors in rural Bengaluru, Karnataka, India

Background: Self-medication is an important concern for health authorities at global level. In developing countries like India most episodes of illnesses are treated by self-medication because of easy availability of a wide range of drugs commercially. Inadequate health services results in increased proportions of drugs used as self-medication compared to prescribed drug. Methods: Study design of it is a community based cross-sectional study. Study area of the study is rural field practice area, of Vydehi institute of medical sciences and research centre, Bengaluru. Study population is above the age group of 15 years. A total of 269 subjects in the rural area of Vydehi institute of medical sciences and research centre were selected by systematic random sampling method. Subjects were interviewed by using a pre-tested and semi-structured questionnaire after obtaining informed oral consent. Information regarding socio-demographic details, self-medication in the past one year and associated factors were collected. Results: 26.8% of study population were aged between 26-35 years, out of which 49.4% were males and 50.6% were females, 39.8% had high school level of education, 44.2% were house wives,72.1% belonged to class I socio-economic status, 97% belonged to Hindu community. Out of the total population, 109 (40.5%) were practicing self-medication. 38.2% were taking medication five or more times in a year. Conclusions: Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices. There may be a larger role for a training programme to empower people about safety and side effects of SM use, to achieve a greater sense of self control.

Trends in pharmacy staff's perception of patient safety in Swedish community pharmacies after re-regulation of conditions.

All changes in the regulation of pharmacies have an impact on the work carried out in pharmacies and also on patient safety, regardless of whether this is the intention or not. To compare staff apprehension regarding some aspects of patient safety and quality in community pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market. Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects possible. All four items demonstrated a significant decrease in the first survey after the changes as compared to before. In the second survey significant differences were found on the two items representing safety climate whereas the items representing team climate and management showed no significant differences. The comparison carried out in this study indicates a negative effect in Swedish community pharmacies on safety and quality issues, as experienced by pharmacy staff. It is recommended that the possible effects of healthcare reforms are assessed before implementation, in order to counteract conceivable decline in factors including patient safety and working conditions.

Urinary antibiotic activity in paediatric patients attending an outpatient department in north-western Cambodia.

ObjectiveAntibiotic resistance is a prominent public and global health concern. We investigated antibiotic use in children by determining the proportion of unselected children with antibacterial activity in their urine attending a paediatric outpatient department in Siem Reap, Cambodia.MethodsCaregiver reports of medication history and presence of possible infection symptoms were collected in addition to urine samples. Urine antibiotic activity was estimated by exposing bacteria to urine specimens, including assessment against multiresistant bacteria previously isolated from patients in the hospital (a methicillin-resistant Staphylococcus aureus (MRSA), a multiresistant Salmonella typhi and an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolate).ResultsMedication information and urine were collected from 775 children. Caregivers reported medication use in 69.0% of children in the preceding 48 h. 31.7% samples showed antibacterial activity; 16.3% showed activity against a local multiresistant organism. No specimens demonstrated activity against an ESBL-producing E. coli.ConclusionsAntibiotics are widely used in the community setting in Cambodia. Parents are often ill-informed about drugs given to treat their children. Increasing the regulation and training of private pharmacies in Cambodia may be necessary. Regional surveillance of antibiotic use and resistance is also essential in devising preventive strategies against further development of antibiotic resistance, which would have both local and global consequences.

Prevalence of self-medication practices and its associated factors in Urban Puducherry, India

Background and Objectives:Self medication is an important concern for health authorities at global level. This study was aimed to find the prevalence of self medication for allopathic drugs and associated factors among households of urban community. This study was also aimed at assessing the attitude of respondents who had experienced self-medication.Materials and Methods:This cross-sectional study was done in field practice area attached to a medical institution in urban Puducherry. A total of 352 subjects from 124 households were selected by random sampling. With pretested interview schedule, information regarding self-medication use in the past three months and associated sociodemographic factors, purpose, source of drug procurement, attitude toward self-medication use were collected.Results:Prevalence of self-medication was found to be 11.9%. Males, age >40 years and involving in moderate level activity of occupation, were found to be significantly associated with higher self-medication usage (P < 0.05). Fever (31%), headache (19%), and abdominal pain (16.7%) are most common illnesses where self-medication is being used. Telling the symptoms to pharmacist (38.1%) was the commonest method adopted to procure drugs by the users. Majority of the self-medication users expressed that self-medication is harmless (66.6%) and they are going to use (90%) and advice others also (73.8%) to use self-medication drugs.Conclusion:Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

How to protect consumers against the risks posed by the online pharmacy market

Background: Regulation of the online pharmacy market is minimal. Attempts have been made to provide a framework but neither well-established hard laws nor soft laws exist in order to protect the consumer and the regular market from the risks posed by the online pharmacies. Objective: The objective of this research is to analyse how the online pharmacy market can be regulated in order to protect the consumer against the risks of ordering medication online. The question to be answered is thus: How should the online pharmacy market be regulated in order to diminish to the fullest extent possible of the risks faced by consumers when ordering medication online? Methods: In order to answer the research question, the risks of online pharmacies were identified first. Then, a comparative analysis of existing and evolving law in several (western) states was conducted. In addition, other initiatives, such as certification and accreditation methods were analysed. Results: For now, the expected outcome of the research will be that a combination of hard and soft law may be the most profitable one. State regulation should provide a clear legal framework imposing the legal boundaries, while verification mechanisms should provide assistance and give guidance to the online pharmacies in their quest for a reliable, trustworthy market share. In addition, it is of importance to harmonise the approach between states towards the regulation of online pharmacies as much as possible in order to provide a common framework for everyone, diminishing the issues arising from cross-border trade.

The availability, diversion and injection of pharmaceutical opioids in South Asia

To provide an overview of the availability of pharmaceutical opioids and the evidence on the extent of diversion and injection in South Asia. This paper reviews existing peer-reviewed and 'grey' literature on the extramedical use and injection of pharmaceutical opioids in Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. Reports indicate that prescribing for all types of pain is inadequate. There is a paucity of empirical data across South Asia regarding the mechanisms and extent of the diversion and misuse of pharmaceutical opioids, although the problem is widely acknowledged. India is believed to account for significant large-scale diversion within the region and further afield through poor regulation of licit opioid production and pharmacies. A recent decline in use of natural opiates has been accompanied by an increase in pharmaceutical opioid misuse and increasingly, injection, particularly in Bangladesh, India, Nepal and Pakistan. The medications are typically buprenorphine preparations and/or other lower potency opioids, such as codeine, nalbuphine and dextropropoxyphene. Opioid substitution treatment and needle-syringe programs are available in some countries, but better coverage is needed. Studies identify a lack of comprehensive knowledge regarding HIV and high prevalence of risk behaviours among at-risk populations in the region. It is imperative for the region to rapidly facilitate access to opioids for the treatment of pain and opioid dependence, ensuring effective systems that maintain quality care, regulate and monitor retail pharmacies, and minimise diversion. Prevention of HIV among people who inject pharmaceutical opioids is essential.

Quality safeguards and regulation of online pharmacies.

Using econometric evidence, this article confirms that distribution of medicines online is split into two market segments of very diverse quality, and identifies the factors that drive quality and quality assurance in this activity. Unlike fraudulent, 'rogue,' websites, which offer scant guarantees and usually sell just a few medicines without prescription, online pharmacies offering insurance coverage and linked to conventional pharmacies typically sell a whole range of drugs, require third-party medical prescriptions and provide abundant information to patients. It is shown that, where online pharmacies are allowed to act legally, market forces enhance quality, as private insurers require professional standards, and specialized third parties make a business of certifying them. Furthermore, older online pharmacies and those running conventional operations offer higher quality, probably because of reputational investments. Overall, this evidence supports licensing online pharmacies, especially considering that prohibiting them is ineffective against fraudulent sites.

Quality Safeguards and Regulation of Online Pharmacies

Using econometric evidence, this article confirms that distribution of medicines online is split into two market segments of very diverse quality, and identifies the factors that drive quality and quality assurance in this activity. Unlike fraudulent, 'rogue,' websites, which offer scant guarantees and usually sell just a few medicines without prescription, online pharmacies offering insurance coverage and linked to conventional pharmacies typically sell a whole range of drugs, require third-party medical prescriptions and provide abundant information to patients. It is shown that, where online pharmacies are allowed to act legally, market forces enhance quality, as private insurers require professional standards, and specialized third parties make a business of certifying them. Furthermore, older online pharmacies and those running conventional operations offer higher quality, probably because of reputational investments. Overall, this evidence supports licensing online pharmacies, especially considering that prohibiting them is ineffective against fraudulent sites.

PHARMACIES: THE SEM AND RETAIL HARMONIZATION

Assesses the likely impact of European legislation on the conduct of pharmacy business in Britian and Germany. Examines the range of (proposed) legislation and inferences drawn about its likely impact; compares the differing national systems for the regulation of pharmacies and considers the “fit” between these systems and the European framework; addresses the possibilities for internationalization of the operations of pharmacies by opening in the other country. Concludes that current proposals may impact on British practices more severely. An apparent opportunity for expansion by British firms in Germany is shown to be limited by the presence of major drugstore chains in the German market, which are seen to have domestic advantages over incoming firms. Summarizes the legislation connected with the SEM and pharmacy in a Table showing anticipated consequences in the two countries.