Retail Pharmacy Chain Research Articles

A program utilizing community pharmacists to improve diabetes education in the Kingdom of Saudi Arabia.

The aim of this program was to demonstrate that retail community pharmacists could successfully recruit, engage and counsel people with diabetes by serving as a trusted source of diabetes information. We evaluated the outcomes of this clinical program in preparation for a wider roll out. Joslin Diabetes Center collaborated with Nahdi Medical Company, a large retail pharmacy chain in Saudi Arabia, to offer a 'Let's Talk About Diabetes' (LTAD) program. LTAD consists of four 1: 1 counselling sessions, approximately 20 min each, scheduled over a 2-4 month period with a focus on medications, lab results, glucose monitoring and doctor visits. Twenty-five pharmacists completed diabetes education certification and intensive on-site training to deliver the LTAD program. The 25 program pharmacists in 11 locations enrolled 2639 individual customers into the program. Of these, 1582 participated in at least one session and 1137 (71.9%) participated in at least one LTAD session and completed follow-up surveys. There were 380 customers with paired HbA1C results which demonstrated a reduction from 8.50% (69 mmol/mol) to 7.32% (56 mmol/mol) (P < 0.001). There were improvements in diabetes awareness, attitudes towards diabetes and medication adherence. The evaluation of this community program suggests that a pharmacy-led diabetes education program is feasible in Saudi Arabia.

Pharmacist Provision of Hormonal Contraception in the Oregon Medicaid Population.

To describe early utilization of pharmacist prescription of contraception in Oregon's Medicaid program. Using Oregon Medicaid claims data, we conducted a retrospective analysis and quantified overall and monthly trends in pharmacist-prescribed contraceptives from January 1, 2016, to December 31, 2017. Our population was restricted to patients obtaining a new prescription for oral and transdermal methods and who had continuous Medicaid coverage during the study period. We summarized demographic and utilization characteristics, including whether patients were continuing or switching methods or initiating contraception. New prescriptions were those written to patients who did not have one for hormonal contraception in the prior 30 days. To assess program safety, we examined rates of prescriptions to patients with medical contraindications to contraceptive use. Among the 3,614 patients receiving a new prescription for oral or transdermal contraceptives in the Oregon Medicaid program from all health care providers, 367 (10%) received their prescription from a pharmacist. Five months after implementation, pharmacists filled an average of 61 prescriptions per month as the prescriber. Most claims originated from retail chain pharmacies (94%) in urban locations (71%). The majority of patients who were prescribed contraception by pharmacists (73.8%) had no history of contraceptive prescriptions in the preceding 30 days (n=252). Ages ranged from 13 to 49 years, fewer patients lived in a rural location (35.7%), most received a combined hormonal pill (90.5%), and the average day's supply dispensed was 65 (range of 21-364 days). Fewer than 5% (12) of patients had a diagnostic code indicating a possible contraindicating comorbidity. Among Medicaid enrollees, we found that 10% of all new oral and transdermal contraceptive prescriptions were written by pharmacists.

340-OR: Supports for Using Retail Pharmacists in Delivering Diabetes Education in Saudi Arabia

The aim of this program evaluation was to assess the effectiveness of retail pharmacists in providing diabetes education in Saudi Arabia. Following an earlier pilot showing feasibility, the program was expanded to 50 community pharmacies. Joslin Diabetes Center collaborated with Nahdi Medical Company that operates a large network of retail pharmacy chains in Saudi Arabia to offer a diabetes program called “Let’s Talk About Diabetes” (LTAD). Pharmacists identified potential participants as having diabetes by the medication and supplies they purchased and then invited them to join the LTAD program. LTAD consists of four 1:1 educational sessions on topics such as medications, lab results, glucose monitoring, and doctor visits. Each session lasts approximately 20 minutes each, scheduled over a 2-4 month period. The entire program spanned approximately a 4-year period including the pilot. Among the 2066 participants who had paired results at baseline and follow-up, HbA1c improved from 8.5 ±1.6 to 7.6 ±1.5%. This change remained significant (p&amp;lt;0.001) after adjustment for change in diabetes distress, age, gender, diabetes duration, insulin treatment, baseline awareness of HbA1c baseline HbA1c result, and number of sessions participated in. This change was associated with a shift in the proportion of individuals meeting target HbA1c &amp;lt;7.0 from 22% at baseline to 37% at follow (p&amp;lt;0.0001 by McNemar’s test). There were additional significant improvements in exercise, diet, medication adherence, and other diabetes self-care behaviors, attitudes and beliefs, suggesting that retail pharmacists were effective in delivering diabetes education programs in Saudi Arabia. Disclosure Y.Khan: None. S.Turkistani: Employee; Self; Nahdi Medical Company. A.H.Bayoumi: Employee; Self; Al Nahdi Pharmacy. M.J.Mcnamara: None. J.Leblanc: None. D.M.Pober: None. W.C.Hsu: Consultant; Self; Onduo LLC.

Amazon’s Decision about Entering Pharmacy Business, is this Going to Affect Other Retail Pharmacy Chains?

Amazon’s Decision about Entering Pharmacy Business, is this Going to Affect Other Retail Pharmacy Chains?

PHP131 - A Naturalistic Observation Study of Current Medication Counseling Practices at Retail Chain Pharmacies in the Houston Area

PHP131 - A Naturalistic Observation Study of Current Medication Counseling Practices at Retail Chain Pharmacies in the Houston Area

Encouraging comprehensive and consistent pharmacist education for provision of contraception

ObjectivesTo initiate a call to action for community pharmacists and key stakeholders to encourage comprehensive and consistent education and certification for contraception services, especially in states where laws have been enacted for pharmacist prescribing of hormonal contraceptives. Date sourcesWebsites for several boards of pharmacy that have implemented pharmacist training for contraceptive prescribing. SummaryFrom the authors’ perspective of helping to implement laws that allow pharmacist prescribing of contraception in Oregon and Colorado, lessons learned have shown that it is better to have 1 consistent resource for pharmacist certification for the following reasons: 1) Boards of pharmacy are able to ensure patient safety because all pharmacists are providing the same level of care to every patient; 2) retail chain pharmacies and pharmacy managers are assured that all their pharmacists, regardless of state, are trained in a similar and appropriate manner; and 3) pharmacists can be reimbursed through medical insurance for the patient encounter because payers are able to identify and credential pharmacists who pass an approved and accredited certification program. ConclusionNew laws allowing pharmacists to prescribe contraception are expanding to other states, and the implementation of these laws provides an important increase in pharmacists’ scope of practice. This exciting new prospect allows the pharmacy community of each state an opportunity to coordinate and learn from each other on best practices for implementation. Having a consistent training program was identified as being one key aspect of successful implementation.

The impact of a retail prescription synchronization program on medication adherence

ObjectivesTo understand the impact of prescription synchronization, offered through the ScriptSync® program at CVS pharmacies nationwide, on adherence and reducing visits to the pharmacy. DesignCohort study, conducted between March 26, 2015, and December 18, 2015. Program enrollment occurred in August 2015, with a 120-day baseline period preceding enrollment and a 120-day follow-up period. Setting and participantsCVS retail community pharmacies across the United States. CVS Pharmacy patients voluntarily enrolling in the prescription synchronization program at CVS retail community pharmacies across the United States who filled 3 or more eligible prescriptions before program enrollment. The study included 126,597 patients who enrolled in the program and 81,355 patients who enrolled after the study enrollment period. Outcome measuresAdherence was defined as the medication possession ratio. The average number of pharmacy visits per month was a second outcome measure. ResultsExposed patients had a 7.5 percentage point adherence improvement (from 79.6% to 87.1%), compared with a 2.8 percentage point improvement among the unexposed (from 78.1% to 80.9%) for a benefit of 4.7 percentage points (P < 0.0001). Among patients with adherence opportunities, the net impact on adherence was 10.6% (P < 0.0001). The program resulted in 0.17 fewer visits per month (P < 0.0001). ConclusionOffering prescription refill synchronization at a large national retail pharmacy chain resulted in improved adherence and fewer visits to the pharmacy in the 4 months following ScriptSync enrollment. Prescription refill synchronization programs should be considered in the care of patients with multiple comorbidities.

A nationwide pharmacy chain responds to the opioid epidemic

ObjectivesTo describe the 3-pronged approach taken by a large national retail pharmacy chain to address the opioid epidemic and associated overdoses. SettingLarge national retail pharmacy chain with more than 8200 stores in 50 states. Practice descriptionEight million customer interactions daily through in-store and digital settings. This is a company with a long history of responding to public health crises. Practice innovationInitiated 3 programs to respond to the opioid crisis: 1) provide safe medication disposal kiosks; 2) expand national access to naloxone; and 3) provide education on the risk and avoidance of opioid overdose. Used the RE-AIM framework to evaluate and enhance the quality, speed, and public health impact of the interventions. EvaluationNot applicable. ResultsEarly results are safe medication disposal kiosks in more than 43 states, naloxone-dispensing program in 33 states, and patient and support system education using the Opioid Overdose Toolkit from the Substance Abuse and Mental Health Services Administration. ConclusionThe availability of safe drug-disposal kiosks, naloxone dispensing at pharmacies, and patient education are key prevention initiatives to address the opioid epidemic and reduce the increasing national burden of opioid overdose. Early results are quantitatively and qualitatively promising.

Adherence to Glaucoma Medications Over 12 Months in Two US Community Pharmacy Chains

This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies. Methods: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45) receiving glaucoma medications from two retail pharmacy chains (64 stores in total) were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC) and the medication possession ratio (MPR). The overall 12-month mean PDC was only 57%, and the mean MPR was 71%. Using a criterion by which 80% coverage was considered satisfactory adherence, only 30% had satisfactory overall 12-month PDC coverage, and only 37% had satisfactory overall 12-month MPR coverage. Refill adherence increased with age and was highest in the 65-and-older age group (p < 0.001). Differential adherence was found across medication classes, with the highest satisfactory coverage seen for those taking alpha2-adrenergic agonists (PDC = 36.0%; MPR = 47.6%) down to those taking direct cholinergic agonists (PDC = 25.0%; MPR = 31.2%) and combination products (PDC = 22.7%; MPR = 31.0%). Adherence to glaucoma medications in the community setting, as measured by pharmacy refill data, is very poor and represents a critical target for intervention. Community pharmacists are well positioned to monitor and reinforce adherence in this population.

Accuracy of monitors used for blood pressure checks in English retail pharmacies: a cross-sectional observational study

Free blood pressure (BP) checks offered by community pharmacies provide a potentially useful opportunity to diagnose and/or manage hypertension, but the accuracy of the sphygmomanometers in use is currently unknown. To assess the accuracy of validated automatic BP monitors used for BP checks in a UK retail pharmacy chain. Cross-sectional, observational study in 52 pharmacies from one chain in a range of locations (inner city, suburban, and rural) in central England. Monitor accuracy was compared with a calibrated reference device (Omron PA-350), at 50 mmHg intervals across the range 0-300 mmHg (static pressure test), with a difference from the reference monitor of +/- 3 mmHg at any interval considered a failure. The results were analysed by usage rates and length of time in service. Of 61 BP monitors tested, eight (13%) monitors failed (that is, were >3 mmHg from reference), all of which underestimated BP. Monitor failure rate from the reference monitor of +/- 3 mmHg at any testing interval varied by length of time in use (2/38, 5% <18 months; 4/14, 29% >18 months, P = 0.038) and to some extent, but non-significantly, by usage rates (4/22, 18% in monitors used more than once daily; 2/33, 6% in those used less frequently, P = 0.204). BP monitors within a pharmacy setting fail at similar rates to those in general practice. Annual calibration checks for blood pressure monitors are needed, even for new monitors, as these data indicate declining performance from 18 months onwards.

Using Nutrition Labels of Pediatric Multi-vitamin Supplements to Identify Risk of Over-exposure to Fat-Soluble Vitamins

Objective: To calculate the proportion of pediatric multivitamin supplements marketed by three retail pharmacies that exceed the recommended daily allowance (RDA) for fat-soluble vitamins for toddlers and children. Design, Setting and Participants: Online websites of the three largest retail chain pharmacies in the United States were accessed to obtain product descriptions of the pediatric multivitamin supplements marketed. Nutritional information was obtained from the manufacturers’ websites. Outcome Measures and Analysis: Percent daily value (per serving size) for vitamins A, D, E and K were calculated. The proportions of the marketed supplements that contained these vitamins in amounts exceeding the RDA for toddlers and children were calculated. Results: More than two-thirds and almost 85 percent of the 52 analyzed multi-vitamins contained vitamin A in amounts exceeding the RDA for toddlers and children respectively. Corresponding proportions for vitamin D were 4% and 15% respectively. More than half the samples exceeded the RDA for vitamin E and almost 2% exceeded the RDA for vitamin E for children. Conclusions and Implications: The high prevalence of pediatric supplements that have vitamin A levels exceeding the RDA poses a risk for toxicity, even when consumed at the recommended serving sizes. Pediatric health care providers and parents should be made aware of possible risks related to toxicity due to over-consumption of multi-vitamin supplements and encouraged to use a balanced diet as the main source of micro-nutrients. Funding: None.

Изучение взаимоотношений руководителей розничных филиалов с вышестоящим руководством аптечной сети

Изучение взаимоотношений руководителей розничных филиалов с вышестоящим руководством аптечной сети

Walgreens merges with US retail pharmacy chain Rite Aid

Walgreens merges with US retail pharmacy chain Rite Aid

An examination of product packaging marketing strategies used to promote pediatric multivitamins.

The purpose of this study was to describe the nature of marketing strategies for multivitamin and multimineral (MVM) supplement packaging and to assess the extent to which these supplements are marketed as food products. A cross-sectional study of children's supplement packaging was conducted. Descriptive statistics identified common marketing practices. Websites of the three largest retail chain pharmacies in the United States and MVM manufacturers were accessed. The study's sample consisted of packaging for 52 children's MVM supplements. Child-targeted marketing included reference to trademarked characters on 42.3% of MVM packaging (n = 22). More than 80% of the sample (n = 42) listed fruity flavors and almost all packaging included descriptive words related to the MVMs' shape and/or flavor (88.5%, n = 46). Nearly one-fifth of the packaging (n = 10) pictured a food item. With respect to parent-targeted promotional language, almost 83% of the supplement packages (n = 43) included text on the support of bodily structure/function. More than half of the sample (53.8%, n = 28) had promotional language related to dietary practice (e.g. organic, gluten-free). Pediatricians can play a role in ensuring that parents are aware of (1) possible risks associated with MVM overconsumption, and (2) the importance of deriving vitamins and minerals from a balanced diet. Given the high number of exposures to pediatric MVMs among youth and established influence of food marketing on shaping children's perceptions and behaviors, further research is necessary to determine the extent to which children's MVMs are marketed as a food product and perceived as such by children.

Joint Modeling of Primary and Secondary Non-Adherence Outcomes.

Medication non-adherence to chronic therapies may severely impact effectiveness of treatment. Non-adherence may occur at different stages in a patient’s treatment journey. It may occur at the very beginning of therapy if a patient receives the initial prescription but does not redeem it at a pharmacy (primary non-adherence), or it may happen after the patient fills a prescription at a pharmacy but fails to follow the instructions or fails to refill the prescription (secondary non-adherence). The purpose of this study is to demonstrate that both primary and secondary non-adherences can be jointly described by a hurdle model, which has the interpretation as a two-part model. The first part is a binary outcome model, and the second part is a truncated count model (Poisson or negative binomial). The hurdle model is an example of the finite mixture models which can be fitted by SAS’s new procedure PROC FMM. Data in this retrospective cohort study of medication non-adherence was obtained from blind computerized pharmacy records of a national retail pharmacy chain. Primary non-adherence was defined as a binary outcome representing failure to fill a new prescription within 30 days after the medication was prescribed to the patient and secondary non-adherence was defined as a number of refills obtained by a patient within a 12 month follow up period. Various measured patient, prescription, and prescribing physician characteristics were included in the model. Hurdle model results indicate that important predictors are missing from the single-component models, but exist in the joint model of primary and secondary non-adherence. The authors conclude that a hurdle modeling approach enables the taking of simple, well-understood models primary (logistic regression) and secondary non-adherence (count regression) and combine them in a way that provides a better description of the data than a single-component models provide separately.

Customers’ Expectations and Perceptions of Service Quality: The Case of a Retail Pharmacy Chain in South Africa

Recent legislative changes have permitted rapid expansion of pharmacy chains in South Africa. The early effect of this appears to be lowered prices and greater competition amongst pharmacy chains. Whilst research has been conducted on general aspects of customer service quality in various industries, there appears to be few studies on customer satisfaction within the South African retail pharmaceutical sector in particular. This paper therefore seeks to assess customer satisfaction at a selected pharmacy chain within the greater Durban area. A study was conducted among 400 customers, using the SERVQUAL model as the measuring instrument. The results indicate that there are gaps between customers’ expectations and perceptions on the five service quality dimensions. The chi square test was performed to determine significant differences between four biographical variables viz. gender, age, educational level of respondents and frequency of shopping versus the five dimensions of service quality, on both expectations and perceptions. Recommendations are presented on how the pharmacy chain can enhance service quality in order to offer superior customer service in the face of growing competition. DOI: 10.5901/mjss.2014.v5n20p2648

Side Effects from Use of One or More Psychiatric Medications in a Population-Based Sample of Children and Adolescents

The purpose of this study was to investigate the side effect risks from using one or more psychiatric medications (including antipsychotics, antidepressants, α-2 agonists, benzodiazepines, mood stabilizers, and stimulants) among a national cohort of children and adolescents. A questionnaire survey was administered to parents who filled a prescription for a psychiatric medication for their child at a large national retail pharmacy chain. Primary outcome variables were the total count of side effects from a list of 12 problem areas, as well as parent-reported side effect intensity (mild/moderate/severe). Modifiers investigated included specific medication and number of medications utilized, demographics, and difficulties with access to care. A total of 1347 parents of study subjects ages 3-17 years from 30 U.S. states who were taking psychiatric medications for any indication purchased at one retail pharmacy chain enrolled following a single mail invitation (7.5% response). Of the study subjects, 80% were white/non-Hispanic, 64% were male, 63% had private health insurance, and 67% had used a current medication for >1year. Most (84%) had one or more parent-reported side effect. After adjusting for covariates, subjects with two medications reported 17% (p<0.001) and with three or more medications reported 38% (p=0.002) increases in their average number of side effects than did children taking one medication. Parental reporting of difficulties in accessing care also predicted a 42% (p<0.001) greater number of side effects than for those who had no access difficulties. Side effects were particularly more common in medication combinations including either selective serotonin reuptake inhibitors (SSRIs) (77% higher odds, p<0.001) or antipsychotics (99% higher odds, p<0.001). Side effects from psychiatric medications appear to be both more common and more severe overall with increasing numbers of medications utilized, and with perceived difficulty in accessing care. Polypharmacy regimens including either SSRIs or antipsychotics were especially associated with experiencing side effects, within this study sample.

Community Child Psychiatric Medication Experiences Measured by an Internet-Based, Prospective Parent Survey of Retail Pharmacy Customers

One thousand five hundred parents filling a psychiatric prescription for their 6-18 year old child with a multi-state retail pharmacy chain received a single mailed invitation to complete a detailed online survey. 276 parents responded (18.4%). 60% of children on medications had a parent rated CBCL scale score in the clinically significant range at enrollment (T score ≥65), with a similar frequency of clinically significant CBCL scores through 15 months of survey followup. 47% of medication regimens were noted to be causing persistent side effects. This simple community based data collection method can offer a unique way to investigate naturalistic treatment outcomes.

From COWs to BYOD

From COWs to BYOD

Comparing Prescription Sales, Google Trends and CDC Data as Flu Activity Indicators

This study compared prescription sales data from a large retail pharmacy chain in the United States with Google Flu trends and US Outpatient ILI Surveillance Network data for 2007 by Centers for Disease Control and Prevention as a flu activity indicator. For Google trends the correlation coefficient (Pearson ‘r’ ) for five years aggregate data (2007-2011) was 0.92 (95% CI, 0.90-0.94, P = 0.05) and for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. For CDC data the same was 0.97 (95% CI, 0.95-0.98, P = 0.05).