Selected Community Pharmacies Research Articles

Community pharmacies: Key players in point-of-care diagnostics for STI screening in Africa.

Sexually Transmitted Infections (STIs) rank in the top 5 disease categories for which adults in developing countries seek healthcare services. Community pharmacies offer clients convenience, proximity, extended opening hours, privacy, and efficiency, which could make them desirable locations for HIV and STI screening and treatment. We examined the feasibility of using point-of-care (POC) STI tests for screening HIV and other STIs at community pharmacies. We conducted a prospective cohort study of persons seeking medication and other services at 18 purposively selected community pharmacies in Kampala, Uganda. Study participants comprised two broad categories: i) Symptomatic persons aged 18 years who presented with at least one STI sign or symptom and were purchasing treatment for themselves; ii) persons presenting with no STI symptom who had come to purchase any other medication, including family planning services such as emergency contraception. POC tests were used to test HIV, Chlamydia trachomatis (Ct), Neisseria gonorrhoeae (Ng), Trichomonas vaginalis (Tv), and Syphilis. Test results were returned on-site or via telephone within 48 to 72 hours. Descriptive statistics were used to estimate the prevalence of STIs. Of the 450 participants enrolled, 235 (52.2%) were symptomatic, 215 (47.8%) were asymptomatic, and 280 (62.2%) were females. STI testing was feasible, with an acceptability rate of 99.8%. 135 (30%) of participants had at least one STI; HIV prevalence was 39 (8.7%), Syphilis prevalence was 14 (3.1%), 50 (11.1%) tested positive for Ng, 39 (8.7%) were positive for Ct while. The prevalence of Tv was 25 (8.9%) (tested among women). A total of 107 (23.8%) participants had used an antibiotic in the preceding month. Our research underscores the potentially pivotal role of community pharmacies in deploying POC diagnostics for STIs and antimicrobial stewardship by decreasing unnecessary antibiotic dispensation across Africa.

Community pharmacists' role towards preventing abuse or misuse and dependence of codeine-containing analgesic medications in Saudi Arabia: a multicenter cross-sectional study.

The misuse or abuse and dependence of medications containing codeine continue to be a major global public health concern. This study aimed to investigate the role of community pharmacists in preventing the abuse or misuse and dependence of codeine-containing analgesic drugs in Saudi Arabia. A cross-sectional study involving 226 community pharmacists from various community pharmacies across multiple cities of Saudi Arabia was conducted from 09 May 2023 to 09 October 2023. Study data were collected and managed using Research Electronic Data Capture tool. Fourteen trained data collectors visited randomly selected community pharmacies in different cities, provided pharmacists with an electronic questionnaire link, and collected their responses electronically. The dataset was downloaded in SPSS format, and analyzed for both descriptive and inferential purposes. The primary indicators that community pharmacists considered when suspecting cases of abuse or misuse and dependence included customers who requested a larger quantity of the medication (88.5%), frequently visited the pharmacy and sought the specific medicine (82.7%), and those who took advantage of the crowd (70.8%). Pharmacists have been instrumental in preventing abuse or misuse and dependence by ensuring that medicines with abuse potential are not easily accessible to consumers (87.6%), providing alternative options (81%), reducing the dose (65%), referring patients to physicians (62.4%), and refusing to sell or denying availability (54.9%). Additionally, pharmacists primarily focused on raising public awareness (85%) as a noteworthy proportion of customers (54.9%) became desperate to obtain the drug after missing a dose. It was also suggested that community pharmacists should receive specialized training in substance abuse or misuse, as 46.9% of them lacked such training. Community pharmacists, being frequently the initial point of contact easily reachable, possess the capability to greatly assist in identifying the patients and averting abuse or misuse and dependence during the dispensing of medication. Further, they can provide valuable guidance to those involved in efforts to reduce drug abuse or misuse and dependence.

Implementation strategies and outcomes in the delivery of HIV test services (HTS) in community pharmacies in Nigeria

BackgroundStudies have shown that training interventions fail when proper strategies are not in place for their implementation. The study described the implementation strategies used in the delivery of the HIV test services (HTS) and measured implementation outcomes in the delivery of the services.MethodsThe study was conducted between August and November 2019 among 50 selected community pharmacies in Oyo State, Nigeria using a mixed-method quantitative and qualitative data survey design. The implementation strategies and activities used in the delivery of HTS in the pharmacies and during outreaches were described while both observational and survey methods were used to collect data. Implementation outcomes were measured and analysed in terms of penetration, adoption, acceptability, feasibility, fidelity, and appropriateness of the intervention.ResultsPenetration among respondents was 90%. Acceptability of the HTS was high (77.3%) among clients 20–49 years of age with 919 clients participating in the HIV screening. While 919 HIV tests were conducted, only 19 (2.1%) were positive. Adherence to the protocol of delivery of HTS (fidelity) indicated that all the respondents conducted rapid HIV testing, pre-testing counselling (43, 95.6%), post-testing counselling (40, 88.9%), and provision of confidential test results (39, 86.7%). Respondents’ responsiveness indicated that 23 (51.1%%) of the respondents could use up to 80% and above of the test strips given within the period. Researchers’ observations showed respondents’ ability to perform the tests as intended with little challenges. Participants felt that rendering the services was an interesting experience, and fulfilling, and allowed them to improve on their professional deliverables and practice. It also showcased the relevance of pharmacists in rendering HTS, creating awareness of the menace of HIV/AIDS, and helping people to stop the spread.ConclusionThe study showed that HTS is acceptable, appropriate, feasible, and easy to adopt in community pharmacies and penetration was high. For sustainability, community pharmacists should be well remunerated, and need for an established policy to include this scope in community pharmacy practice.

Exposure of Pharmacists and Pharmacy Technicians to Violence in Community Pharmacies in Southeast Europe: Frequency and Ethical Considerations.

Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types of violence, as well as the common perpetrators that community pharmacy staff in SEE (Southeast Europe) are dealing with. A cross-sectional study was conducted using an online questionnaire created for this purpose. Selected community pharmacies in Croatia, Serbia, Bosnia and Herzegovina, and Montenegro participated in this study. In total, 732 responses were collected from 24 pharmacy chains or independent pharmacies including all community pharmacy staff. More than 80% of pharmacists and pharmacy technicians reported having been exposed to verbal violence at the workplace, while more than 20% of them reported physical and sexual violence in the preceding 12 months. There were no statistically significant differences between pharmacists and pharmacy technicians, gender, age groups, or countries in relation to exposure to physical, verbal, and sexual violence. The most common perpetrators were identified as patients/clients. More than 90% of pharmacy staff reported they did not receive any kind of support from their employer nor any other help after experiencing a robbery. There is a need for a structured approach to addressing violence in pharmacies including organized support for pharmacy staff. Achieving quality patient care, despite dealing with violent individuals or situations daily, is one of the greatest ethical challenges for healthcare providers in community pharmacies to be empowered.

Availability, storage, handling and administration of vaccines in community pharmacies: Southwest Nigeria as a case study

Background: Vaccines have been instrumental in thwarting the spread of infectious diseases and have been a major public health success. Community pharmacies are a critical resource for success of any immunization programme. However, pharmacists’ involvement in immunization programme in Nigeria has not been thoroughly investigated. This study assessed the involvement of pharmacists in immunization services.Methodology: A cross-sectional survey was conducted among community pharmacists, using a structured pre-tested questionnaire. The survey tool, which consisted of 72-item questions spread over five different domains, assessed vaccine availability in community pharmacies and pharmacist’s knowledge on vaccine. This (knowledge) addresses vaccine handling and administration as well as storage. The questionnaire was administered to selected community pharmacies by a combination of physical interview and electronic version through Google form link sent to pharmacist’s WhatsApp platform. Association between patients’ socio-demographics and some variables of interest was determined using Chi-square statistic.Result: One hundred and ninety-one (191) pharmacists responded to the questionnaire (99.5% response rate). About half, one hundred and three (53.93%) of the respondents were aged between 31 and 50 years. One hundred and twenty-nine (67.54%) of the pharmacists had B.Pharm degree as the highest level of education. There was a significant association between pharmacists’ age (χ2 = 30.5, p<0.01), years of experience (χ2 = 25.9, p<0.01), level of education (χ2 = 19.6, p<0.05) and knowledge on vaccine handling and administration. Also, significant association (p<0.01) existed between pharmacists’ age (χ2 = 45.1), years of experience (χ2 = 45.3), level of education (χ2 = 31.6) and knowledge of vaccine storage. Furthermore, there was a significant association (p<0.01) between being trained as a vaccine administrator and level of knowledge on vaccine storage (χ2 = 57.8) as well as handling and administration (χ2 = 45.2).Conclusion: Pharmacists’ level of education and training (as vaccine administrator) were key factors in pharmacists’ involvement in immunization care service.

Workplace wellbeing in community pharmacy practice: A cross-sectional study in Can Tho, Vietnam.

Among pharmacy workers, low workplace wellbeing can lead to reduced effectiveness. However, to date, studies on this issue are limited within the community pharmacy setting in Vietnam. This study was conducted to identify the component aspects of workplace wellbeing and their associations with demographic characteristics. The cross-sectional descriptive study was conducted in Can Tho, Vietnam. Self-administered questionnaires were hand-delivered to all pharmacy workers working at selected community pharmacies. The workplace wellbeing scale comprised 18 items. In total, 382 pharmacy workers participated in this study. Factor analysis revealed three fundamental aspects to workplace wellbeing: Factor 1 - perceived self-worth and job satisfaction, Factor 2 - positive emotions with work, and Factor 3 - negative emotions with work. Factor 1 showed a positive correlation with Factor 2, with a correlation coefficient (ρ) of 0.509, while both Factor 1 (ρ = -0.399) and Factor 2 (ρ = -0.416) demonstrated negative correlations with Factor 3. Higher income was associated with higher positive emotions with work (P = 0.008), higher perceived self-worth and job satisfaction (P = 0.013), and lower negative emotions with work (P < 0.001). Workplace wellbeing of pharmacy workers in their professional environments was associated with financial aspects. These findings suggest that policies aimed at improving income for pharmacy workers could bring benefits to enhancing job satisfaction and workplace wellbeing.

Patients' satisfaction towards Wasfaty services in Al Ahsa province, Saudi Arabia - 2022.

The e-prescriptions service connects primary healthcare centers and hospitals to selected community pharmacies in various locations to allow easy access to the nearest pharmacy in the neighborhood, thus facilitating the process of drug dispensing. This study aims to assess patients' satisfaction towards Wasfaty services delivered by Ministry of Health healthcare centers. A cross-sectional study was conducted in Al Ahsa province in Saudi Arabia among adult patients who used Wasfaty services. An electronic Arabic questionnaire including demographic characteristics of patients and questions to assess their satisfaction level with the e-prescription "Wasfaty" service in terms of different aspects. A total of 481 participants were included in the study. Females represented 53.4% of them, and 28.1% were aged 50 years or over. Overall, most of the patients (84.1%) were either satisfied or strongly satisfied with the service (4.28 ± 0.57). After controlling for confounding, patients with chronic diseases were more satisfied with the "wasfaty" service compared to those without chronic diseases. The history of chronic disease was responsible for approximately 2.4% variability of patient satisfaction (r-square = 0.024). Patients' geographic region, age, sex, and educational level were not significantly associated with their satisfaction with "wasfaty" service. The majority of patients, particularly those with chronic diseases, were satisfied with Wasfaty service. However, less satisfaction was observed regarding medication availability.

Pharmacy professionals’ knowledge, attitude and practice towards doping in sports: A Cross-sectional study in Ethiopia

BackgroundDoping is appearing as a major problem in Ethiopia, a country decorated with medium and long-distance runners. To protect athletes from doping, pharmacists can be the first port of call for advising athletes on drug treatment. Hence, to fuel the anti-doping movement, it is crucial to explore the knowledge, attitude, and practice of community pharmacy professionals. Therefore, this study aimed to assess the community pharmacy professionals’ knowledge, attitude, and practices towards doping in sports in Addis Ababa, Ethiopia. Materials and methodsA cross-sectional survey, involving 336 study participants, was conducted in selected community pharmacies of Addis Ababa, Ethiopia from April to May 2018. ResultsOf 336 study participants, most of them knew the word “doping” and out of these, 51.9 % of them wrote the definition of doping correctly. Most respondents classified narcotics, hormone modulators, growth factors, and β-2 agonists correctly. Almost one-third of the professionals agreed that they have adequate information about doping and that doping is a public health problem. Among the participants, only 33.4 % were confronted with "suspicious of doping substance” without a prescription over the last 12 months. ConclusionsAlthough most pharmacy professionals lack doping-specific knowledge and adequate training required to be operative in doping prevention, most of them perceive doping as a public health problem although the curriculum does not have good coverage about doping.

Assessment of public knowledge and attitude toward antibiotics use and resistance: a community pharmacy-based survey

BackgroundAntimicrobial resistance is a public health challenge affecting all aspects of healthcare systems. Policies to reduce antimicrobial resistance should be implemented and monitored in community pharmacies, because they are patients' first point of care. Public awareness of relevant knowledge and attitudes on antimicrobials is a feasible strategy to mitigate the spread of antimicrobial resistance by exploiting the relationship between pharmacists and patients in the community pharmacy setting. The study evaluated and determined predictors of antibiotic knowledge and attitudes toward antibiotic use and resistance in community pharmacy patients.MethodsA cross-sectional design was used to retrieve data in five randomly selected community pharmacies in Lagos and Abuja using a self-administered questionnaire. Descriptive and inferential statistics were utilized for characterizing and determining the associations between predictors and outcomes at p < 0.05. Logistic regression was used to identify predictors of patients’ knowledge and attitude to antibiotic use.ResultsA total of 964 clients participated in the study: 526(54.7%) were females, and 358(37.3%) were aged 25–34. chlorpheniramine–maleate and levonorgestrel were wrongly identified as antibiotics by 621 (64%) and 490 (50%) respondents, respectively. Many respondents, 448(46.5%), strongly agree that antibiotic creams should be mixed with body creams. The result of the multivariable logistic regression showed secondary education [Odds Ratio (OR): 0.31, 95% CI 0.10–0.97, p value: 0.044], urban residence (OR: 1.45, 95% CI 1.01–2.08, p value: 0.043) and age 34 (OR: 1.55, 95% CI 1.01–2.37, p value: 0.045) were strong predictors of knowledge on antibiotics, while community pharmacy location (OR: 5.48, 95% CI 3.45–8.70, p value: ≤ 0.001), urban residence (OR: 2.57, 95% CI 1.67–3.96, p value: ≤ 0.001), and antibiotic recommender (OR: 0.55, 95% CI 0.35–0.85, p value: 0.008) were predictors of respondents’ attitude to antibiotic use.ConclusionsThe study established that sociodemographic factors could impact community pharmacy clients' knowledge and attitude toward antibiotic use and resistance and should be considered when developing policies to curb the spread of resistant microbes. Community pharmacies should educate community pharmacy clients on the dangers associated with the misuse of antibiotics with stringent antibiotic stewardship programs and restrict access to antibiotics over-the-counter.

Community pharmacists' perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis.

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care. Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care. Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%-74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%-79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1-1.019), postgraduates (OR 1.77; 95% CI 1.66-1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11-1.39), pharmacists in charge (OR 1.22; 95% CI 1.01-1.47), pharmacists with >10years of experience (OR 11.3; 95% CI 6.01-15.62), pharmacists with 6-10years of experience (OR 4.42; 95% CI 3.90-5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15-1.46). Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients' weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care.

Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies.

Background and Objectives: Overprescribing of antibiotics is one of the important contributors of antimicrobial resistance globally. A high proportion of antibiotics prescribed in community settings are unnecessary or inappropriate. This study assesses the prescribing practices and factors related to antibiotic prescribing in community pharmacies in United Arab Emirates (UAE). Materials and Methods: A cross-sectional study utilizing a quantitative approach was carried out in the community pharmacies of Ras Al Khaimah (RAK), UAE. Six hundred and thirty prescription encounters from 21 randomly selected community pharmacies were investigated using World Health Organization (WHO) core prescribing indicators. Factors related to antibiotic prescribing were identified using logistic regression analyses. Results: In 630 prescription encounters, a total of 1814 drugs were prescribed. Out of these, the most commonly prescribed drug class was antibiotics (43.8% prescriptions) and the antibiotic was amoxicillin/clavulanic-acid (22.4%). The average number of drugs per prescription was 2.88, which was higher than the WHO recommended value of 1.6-1.8. In addition, more than half of the prescriptions (58.6%) had drugs by generic names and the majority of the drugs prescribed (83.8%) were from the essential drug list, which were lower than the optimal values of 100%. The majority of the antibiotics prescribed in the study were from the WHO's Access group antibiotics. Multivariable logistic regression analysis identified patient age (children-OR: 7.40, 95% CI: 2.32-23.62, p = 0.001 and adolescent-OR: 5.86, 95% CI: 1.57-21.86, p = 0.008), prescriber qualification as general practitioner (OR: 1.84, 95% CI:1.30-2.60, p = 0.001), and number of drugs per prescription (OR: 3.51, 95% CI: 1.98-6.21, p < 0.001) as independent factors associated with antibiotic prescribing. Conclusions: This study reveals considerable variations from the WHO recommendations for the different prescribing indicators in the community pharmacies of RAK, UAE. In addition, the study reports overprescribing of antibiotics in the community setting, indicating the need for interventions to promote rational use of antibiotics in a community setting.

An observational study on drug interactions caused by proton pump inhibitors

Proton pump inhibitors (PPIs) are widely used to treat gastric acid-related diseases worldwide and in our country. The high reliability of PPIs also allows long-term use for appropriate indications in chronic diseases, which increases the possibility of drug-drug interactions. Therefore, it is clear that the usage of PPIs should be monitored in terms of drug-drug interactions to provide drug treatment success and patient safety. The ability of pharmacists, the closest health consultants, to identify these interactions during prescription fulfillment will significantly contribute to treatment success. Although many studies deal with the rational use of PPIs and drug interactions, the number of studies revealing observational drug interactions is minimal. This research aims to determine drug-drug interactions frequently encountered in community pharmacies for PPIs, which interact with many drug groups and are commonly prescribed. For this purpose, approximately 1700 prescriptions supplied by a selected community pharmacy, serving in Van, were examined. One hundred sixty-four of the prescriptions were evaluated by considering the study’s limitations. Drug-drug interactions were checked by three different electronic database. It was determined that 73 of 164 prescriptions had interactions in at least one of the three databases. In 73 prescriptions, 86 drug interactions were observed. 34% of the interactions detected in the study were caused by lansoprazole.

Evaluation of Telepharmacy Services in Community Pharmacies in Abuja, Nigeria

Globally, pharmacists play a key role in the provision of quality-assured medicines in sufficient quantities. Access to essential medicines is a major challenge to Universal Health Coverage, however, Telepharmacy has been used in other parts of the world as a solution to poor access to medicines and pharmacists faced in rural areas. The aim of this study is to evaluate the awareness of availability of Telepharmacy services amongst residents of Abuja Nigeria, their attitude towards these services, and their readiness to use the services. A cross-sectional descriptive study was conducted among clients visiting selected community pharmacies that offer Telepharmacy services in Abuja using simple random sampling method. Data was collected with the aid of a thirty-eight (38) item self-administered questionnaire which had five (5) sections. The data collected was computed into a Microsoft Excel spreadsheet and analyzed using descriptive statistics, Chi-square test and Logistic regression. Of the 381 respondents, 250 (65.6%) are urban dwellers while 173 (45.5%) have acquired tertiary education. About 305 (80.1%) purchase data out-of-pocket while 23(6%) do not have access to the internet. About 182(47.6%) are aware of Telepharmacy services. There was a significant association between awareness of Telepharmacy services and location of the respondent (P=&lt;0.001), educational level (P=&lt;0.001) and employment status (P=&lt;0.001). About 187(49.1%) had poor attitude towards Telepharmacy services while 215(56.4%) had good readiness to adopt Telepharmacy services. The clients’ awareness of Telepharmacy services was poor although they had good readiness for Telepharmacy services. There are several barriers that need to be overcome for Telepharmacy to be fully implemented.

Adaptive Changes in the Working Environment of Community Pharmacists during the Covid-19 Pandemic in the Kano Metropolis, North-Western Nigeria.

Background: Rapid spread of COVID-19 and the resultant strict access to conventional hospitals forced the public to turn to community pharmacies being the most accessible points of primary healthcare, thus overloading the pharmacy services. This study aims to assess the coping strategies and adaptive changes in the work environment of community pharmacists in Kano Metropolis, NorthWestern Nigeria during the lockdown periods due to the COVID-19 pandemic Methods: A questionnaire-based cross-sectional study was carried out across selected community pharmacies within Kano Metropolis, North-Western Nigeria. A non-probability (convenience) sampling was used in this study. Convenience sampling also known as availability sampling, here units are selected for inclusion in the sample because they are easiest for the researcher to access. The survey retrieved relevant data from the participants, including socio-demographic data and changes in the work environment during the COVID-19 pandemic lockdown periods. Data were analysed using IBM SPSS version 23.0. Results: A total of 97 licensed pharmacists responded to the survey. Majority of the pharmacists (73.2%) reported increased workload, caused mostly by more prescriptions, and higher demand for safety equipment, antiseptics, and disinfectants. Moreso, 79.4%, reported higher stress levels during the pandemic as compared to the pre-pandemic era. About 89.9% of participants reported adjusting their working conditions to include the use of facemasks as protective equipment which is available in sufficient quantities as reported by 61.9% of pharmacists. The pandemic and subsequent lockdowns aroused concerns in the majority of participants (90.7%) for their health and that of their families. This prompted majority of the community pharmacists (92.7%) to suggest that pharmacists should be authorized to independently renew prescriptions of patients with stable chronic conditions during the COVID-19 pandemic. Likewise, 91.8% supported the idea that pharmacists should be authorized to participate in the COVID-19 immunization process to widen coverage. Conclusions: The COVID-19 pandemic resulted in an increased workload and altered working conditions of community pharmacists in Kano metropolis of North-Western Nigeria. This prompted pharmacists to professionally re-strategize to accommodate such an increased workload despite being frontline healthcare providers in the healthcare system.

Isolation and Identification of Coliform Bacteria and Multidrug-Resistant Escherichia coli from Water Intended for Drug Compounding in Community Pharmacies in Jordan.

(1) Background: Water is necessary for the preparation of some medicines found in pharmacies where the local water source does not meet the required purity. This study aimed to investigate the presence of coliform contamination in water used for drug reconstitution in community pharmacies in Jordan. (2) Methods: Two water samples from 50 randomly selected community pharmacies representing all Jordanian governorates were filtered and then cultured in plate count agars to determine total microbial count, and in m-Endo Agar Les and Eosin Methylene Blue (EMB) agar to cultivate Escherichia coli (E. coli). The presence of E. coli was further characterized with gram stains, biochemical tests, and Polymerase chain reaction (PCR). Antibiotic susceptibility of isolated E. coli was tested against a variety of standard antibiotics. (3) Results: Community pharmacies used droppers filled with water from coolers (62%), bottled water (20%), boiled tap water (16%) and tap water (2%). The majority of the sampled water contained coliform bacteria (88%), and E. coli was isolated from 26% of all samples. Statistical analysis showed no significant difference in the percentage of contaminated water samples based on its source location. Nonetheless, the results showed a tendency for higher proportions of contamination in droppers filled from boiled tap water (37.5%; SE: 17.1), followed by water from water coolers (25.8%; SE: 7.9), and then from bottled water (20%; SE: 12.7). All of the isolated E. coli were sensitive to gentamycin, ciprofloxacin and levofloxacin. The susceptibility of the isolates to ceftazidime, doxycycline, tetracycline, azithromycin and amoxicillin/clavulanic acid were 92%, 61%, 46%, 23% and 15%, respectively. (4) Conclusions: This study confirms the widespread presence of multidrug-resistant bacteria in water intended for reconstituting drugs in local pharmacies. These findings expose an alarming situation that needs special attention by the acting pharmacists and competent authorities. Higher levels of personal hygiene in the pharmacies coupled with regular inspection of water quality may reduce the risk of microbial contamination in compounded products, especially multidrug-resistant strains of E. coli and other index microorganisms.

A study on over-the-counter drug use in community pharmacies

Background: The usage of over-the-counter (OTC) medications has steadily increased in recent years. Improper use of OTC medications might result in health and other drug-related issues. Easy access to OTC medications has become a more critical concern in developing countries. Objective of the study was to assess the OTC drugs dispensed in community pharmacies.Methods: A prospective cross-sectional study was conducted in selected community pharmacies. To evaluate the OTC drugs dispensed; 700 participants were polled using questionnaires through a validated data collection form, and a patient interview respectively. Descriptive statistics and multivariate logistic regression were performed using statistical package for the social sciences (SPSS) (version 20). The Chi-square test was used to test for significant differences between groups (p&lt;0.05).Results: A total of 700 patients were recruited for the study to assess the use of OTC drugs. Analgesics/NSAIDs are the most often used OTC medications, accounting for (30.4%), followed by antacids (15.7%). The primary sources of information to purchase OTC medications were taken from community phapharmacists1.6%). Recurrence of minor ailments (68%) is the major influencing factor for OTC drug purchase, whereas (80.9%) agree that OTC medication is cheaper and more convenient.Conclusions: As per the findings of the study; OTC medication dispensing is prominent, and there is a need for awareness programs to ensure rational drug usage.

Characteristics of the sore throat test and treat service in community pharmacies (STREP) in Wales: cross-sectional analysis of 11 304 consultations using anonymized electronic pharmacy records.

An NHS-funded sore throat test and treat (STTT) service was introduced in selected community pharmacies in Wales. Service users were screened using FeverPAIN/Centor scores, offered rapid antigen detection testing (RADT) to detect group A Streptococcus if appropriate, and supplied with antibiotics (by the pharmacist) if indicated. Following an initial evaluation, the service was rolled out nationally. This study forms part of the long-term STTT evaluation. The aim was to describe characteristics of the service and service users, the delivery, service outcomes, patient safety and antibiotic prescribing. Cross-sectional descriptive study using anonymized individual-level data from electronic pharmacy records of all eligible STTT service users between November 2018 and February 2020. We identified 11 304 pharmacy STTT consultations in service users aged 6 years and over, with a median age of 25 years (IQR: 12 to 44). RADT was undertaken in 8666 (76.7%) consultations with 2503 (28.9% of RADT) positive tests. In total, 2406 (21.3%) service users were supplied with antibiotics. Pharmacists managed 91% of consultations in the pharmacy and referred only 937 (9.3%) service users to a GP and 27 (0.2%) to the Emergency Department. Higher rates of antibiotic supply were observed in out-of-hours consultations when compared with in-hours (24.9% versus 20.9%). This is the largest description of a pharmacy-led STTT service to date and suggests it can be delivered at scale to align with a pre-specified pathway that promotes appropriate use of RADT and antibiotics. The service could substantially reduce workload from a common illness in other heavily pressurized areas of primary and emergency care.

Pharmacists’ involvement with and pharmacy clients’ awareness of adverse drug reaction reporting in Nigeria – a mixed-methods approach

Abstract Objectives Adverse drug reactions are one of the leading causes of death, yet they are under-reported. This study assessed the involvement of community pharmacists in the identification, documentation, and reporting of adverse drug reactions and pharmacy clients’ awareness of the adverse drug reaction reporting system. Methods A cross-sectional questionnaire-guided survey was conducted among 780 pharmacy clients in six selected community pharmacies, and seven mystery clients visited 125 community pharmacies in Ibadan, Nigeria. Information on pharmacy clients’ experience of adverse drug reactions, to whom and how they were reported, was obtained. Female and male mystery clients’ performed two scripted scenarios, complaining of black patches on their thighs and blood in their faeces, respectively. The proportion of pharmacists who identified the complaints as adverse drug reactions, documented and reported them, was described. Key findings The response rate for the pharmacy clients’ survey was 98.5%. Some pharmacy clients, 385 (50.1%), had experienced adverse drug reactions; 49 (12.7%) of these pharmacy clients were hospitalised and 73 (19.0%) of them reported the adverse drug reactions to physicians or pharmacists. Most of the pharmacy clients, 706 (91.9%), did not use the available reporting system. A total of 218 mystery client visits were made. The proportion of pharmacists who recognised the mystery client complaints as adverse drug reactions was 4.9–60.3% depending on the scenario presented and up to two pharmacists documented and supposedly reported the adverse drug reactions. Conclusions Some of the pharmacy clients reported experiencing adverse drug reactions to healthcare professionals, but most did not report through the existing reporting scheme. Community pharmacists could identify adverse drug reactions but most failed to document or report them.

Evaluation of a Sore throat Test and tReat servicE in community Pharmacies (STREP).

ObjectivesA Sore Throat Test and Treat (STTT) service was introduced in selected community pharmacies to screen against Streptococcus A and appropriately treat infections, relieving pressure on General Practices (GP). The long-term impact on patient and NHS outcomes is unclear. A robust evaluation is required to inform future policy and roll-out. ApproachA matched cohort study comparing patients who received an STTT consultation in community pharmacy (exposed) compared to consultation with GP (unexposed). Individual-level data from participating STTT pharmacies were extracted from the Choose Pharmacy IT platform, anonymised and acquired into the Secure Anonymised Information Linkage (SAIL) Databank. Both cohorts were linked to other longitudinal health and administrative data within SAIL to create study outcomes (e.g. antibiotic prescribing, re-consultation, attendance/admission at Emergency Department/hospital). The impact of the STTT service was evaluated by modelling the outcomes using logistic regression to calculate odds ratios. Results7553 patients exposed to the STTT service (8,313 consultations) in community pharmacies in Cwm Taf Morgannwg and Betsi Cadwaladr University Health Boards between 1st November 2018 and 28th February 2020, were successfully anonymised and acquired into the SAIL Databank (97.16%). 99.5% of these individuals were then linked to the Welsh Demographic Service Dataset (WDSD), enabling demographics to be generated. 6,665 distinct consultations remained in the exposed group after exclusion criteria were applied. A matched unexposed cohort will be created, and odds ratios will be presented to compare the risk of each outcome for those exposed to the STTT service compared to usual care. ConclusionThis innovative study is the first to link national pharmacy service data to individual-level population-scale longitudinal health and administrative data in the SAIL Databank. Our findings will inform clear and actionable recommendations regarding the service design and future roll-out of STTT services across the UK and internationally.

Intervention of Screening Programme for Hypertension and Lipid Profile on Prescribing Pattern of Antihypertensive and Antihyperlipidemic Agents

The aim of the present study is to assess the impact of screening programme for the patients visiting community pharmacies and factors influencing the prescribing pattern of antihypertensive and/ or antihyperlipidemic agents. The study was designed as a prospective cohort study conducted between December 2017 and November 2019. Data were collected from the hypertensive patients visiting regularly in the 5 selected community pharmacies located at 5 Taluks of Erode district, Tamil Nadu, India. The required data were collected either from the patient’s record or interview. Data were collected from 946 (75.68%) patients of 1250 patients visited the selected community pharmacies.49.4% and 50.6% of patients were randomly allotted to the control (group I) and intervention (group II) groups respectively.In this study 50.56% and 46.67% of males were in group I and II respectively. Average SBP was measured as 151.5 ± 11.8 mmHg and 168.1 ± 13.6 mmHg for the patients in group I and II respectively whereas 92.9 ± 9.3 mmHg and 92.6 ± 9.5 mmHg were the DBP readings among the patients in group I and II respectively. Average total cholesterol was measured as 253.66 ± 33.67 mg/dL and 271.04 ± 39.91 mg/dL for the patients in group I and II respectively. The difference in the prevalence is 0.7 and 2.05 for the antihypertensive and antihyperlipidemic agents respectively whereas the incidence was observed as 4.75 and 2.5 for the antihypertensive and antihyperlipidemic agents respectively. The odds ratio of SBP and DBP is 1.12 and 0.99 respectively in the group II. The values of multivariate analysis showed that there is an agreement between intervention and utilization pattern of antihypertensive and antihyperlipidemic agents. It is to conclude that the preliminary screening of blood pressure and lipid profile showed many patients were not visiting regularly for consultations. The screening programme has resulted in good improvement in the utilization pattern of antihypertensive and antihyperlipidemic agents. The age, lipid levels and comorbid conditions were main factors among the individuals which have determined the prescribing pattern of agents.