Traditional Pharmacy Research Articles

Beyond the Fill: Navigating Pharmacy's Technological Future in 2050

The pharmacy profession stands at a pivotal juncture as it faces unprecedented technological advancements that will rapidly reshape the healthcare landscape by 2050. This commentary explores the implications of technological advancements for pharmacy practice and how it may impact the workforce in the coming decades. The advent of digital health technologies (DHTs), artificial intelligence (AI), and automation is poised to transform patient engagement and care delivery. The Covid-19 Pandemic has accelerated this shift, and traditional pharmacy roles will evolve to meet these expectations. As AI and DHT adoption increase, it will push the profession beyond its historical focus on logistics and medication dispensing. Several potential scenarios may unfold by 2050, ranging from a diminished workforce overshadowed by technology to an evolved profession that leverages novel technologies to enhance clinical services and patient care. To prepare for these changes, the profession must address key challenges, including advancing education and training to incorporate new competencies, establishing sustainable financial models for emerging roles, embracing advocacy and navigating regulatory constraints to expand scopes of practice, and overcoming societal resistance to change. By embracing continuous learning and adaptability, pharmacists can seize the opportunity to redefine their roles, ensuring they remain indispensable in an evolving healthcare environment.

The Digital Transformation of Pharmacy Services in Germany

The digitalization of retail pharmacy services in Germany has led to a profound change in the pharmaceutical market that is propelled by factors like an aging population, a need to obtain prescription medications, and government regulations that are meant to make the market more efficient. Online pharmacies are quickly expanding, and major players like Doc Morris and Shop-Apotheke Europe are taking their businesses online. The German regulatory system guarantees quality and patient safety, which are managed through the regulation of licensing and operations defined in accordance with given standards. Digital pharmacies have several advantages like accessibility, convenience, and cost savings, but they also have some issues, such as data protection and regulatory compliance. They are creating new realities for conventional pharmacies and forcing them to adopt to the changing environment by having an online presence and adopting technological advancements. The future of digital pharmacies is driven by advanced technology like artificial intelligence and the application of blockchain, and the cooperation of digital and traditional pharmacies can improve patient care. Policy interventions must be in place to facilitate innovation and training in the digital pharmacy sphere to make it a contributing force to healthcare sector development.

The Impact of Tadbir as a Pre-Application Treatment of Medicinal Plants on Their Chemical Profiles and Biological Activities in Traditional Persian Pharmacy

Based on basic traditional medicine practice, many plants undergo primary treatments to improve their pharmacological characteristics or to attenuate unwanted or unfavorable features of drugs before incorporating them into drug formulations. These treatments are called “Tadbir” in Traditional Persian Medicine (TPM). The purpose of these processes includes but is not limited to eliminating unnecessary compounds, excluding harmful properties such as toxicity and poignancy, and improving their overall natural properties and effectiveness. Here, the effect of vinegar and acetic acid treatment on three herbal specimens, including Carum carvi L. fruits (CC), Trachyspermum ammi (L.) Sprague fruits (TA), and Nigella sativa L. seeds (NS) were investigated. The treated and non-treated samples were subjected to essential oil and methanol extraction. Further, to assess the alterations in the essential oil constituents caused by Tadbir, samples were analyzed by Gas Chromatography/Mass Spectrometry (GC/MS) and HPTLC fingerprinting techniques. Total phenol and flavonoid content and DPPH free radical scavenging activity of methanol extracts were evaluated. As a result of the treatments, TA extracts showed significant rise in phenol and flavonoid contents. Total phenol content increased from 98.50±1.01 in non-treated increased to 181.20±0.27 mg GAE/g Ext. in the vinegar-treated TA fruit extract and total flavonoid showed a rise from 8.97±1.12 to 12.89±0.41 mg QE/g Ext. This may be the reason behind its lower IC50 values in DPPH free radical scavenging assay. Interestingly, Tadbir treatment of TA fruits with 4% acetic acid, lowered the IC50 value from 1019.42±75.65µg/mL in non-treated control to 274.2±17.22 µg/mL; while vinegar caused a lower degree of reduction in IC50 value (369.4±5.54 µg/mL) in DPPH free radical scavenging assay. However, CC fruit extracts, showed a decrease in phenolic content; while demonstrating an increase in flavonoids. Interestingly, phenol and flavonoid contents were significantly enhanced in treated NS seed extracts. The results of all extracts were found significantly different (p<0,05) from each other and the non-treated control. The conclusive results of the present study may partly justify the pre-application of Tadbir treatments of medicinal plants in traditional pharmacy.

Construction and Practice of Hospital Pharmacy Practice Teaching Mode under the Reform of DRG Payment Method

Objective: this research for DRGs payment reform, in order to build a new teaching mode of traditional pharmacy practice and DRGs payment reform background, the pharmaceutical interns add DRGs disease grouping and ICD disease coding teaching and DRGs disease grouping of pharmacoeconomics teaching, training more able to adapt to the medical reform of drug service personnel and hospital performance management and internal cost control training practical pharmaceutical service talents. Methods: Through the implementation of different internship programs, to make the effect evaluation. Results: Combining the traditional clinical pharmacy practice with the background of DRGs payment reform, the teaching of DRGs disease grouping, ICD disease coding teaching and pharmacoeconomics of DRGs disease grouping. Conclusion: In this study, the practice of Chinese pharmacy, prescription practice, clinical pharmacy and ward practice combined the teaching of DRGs disease grouping and ICD disease coding with the medical insurance department, which promoted the smooth implementation of DRGs and reflected the value of clinical pharmacists in ensuring effective, safe and economical drug use.

Perception of Community Pharmacy Owners Regarding Online and Chain Pharmacy Services

Background: Community pharmacies, also known as retail pharmacies, is the last point of contact for patients to get access to their medications. Retail pharmacies are an integral component of India’s health care ecosystem and are thriving now. The Community pharmacies are considered a “Chain community pharmacies” if the organization consists of four or more stores in which an individual consumer may have a prescription order filled. Online pharmacies are an internet-based vendor and includes both legitimate and illegitimate pharmacies. It is a business model that deals with the preparation and sale of prescription and non- prescription medicines as in the traditional pharmacies. Methodology: This was a prospective questionnaire-based study in which 250 Community pharmacy owners were enrolled. The survey instrument was a structured, self-administered questionnaire. Result: Out of 250 surveyed Community pharmacy owners, 96% reported serving less than 100 customers daily. Most pharmacies offer discounts and home delivery. 99% were aware of both chain and online pharmacies, with high familiarity with Apollo (98.4%), MedPlus (98.4%), and Aster (87.2%). 87.2% reported 25-50% sales reduction due to the rise of chain pharmacies. 68% are willing to provide online pharmacy services and 98% believe chain and online pharmacies will disrupt working of independent pharmacies. 83.6% reported that delivery impacting potency of medicines were the drawbacks of online pharmacies to the public. Conclusion: Our study highlights the need for standardized approach to improve quality of services in independent pharmacies as well as to enforce stricter regulatory framework for online and chain pharmacies to improve customers confidence and to alleviate from the concerns raised about online and chain pharmacies. Independent pharmacies can provide value added services such as patient counselling, screening of blood pressure/diabetes etc to attract the customers. Aim: To understand the perception of owners of independent pharmacies regarding online and chain pharmacy services.

Permissionless innovation in the pharmacy business model: The case for the membership pharmacy model

BackgroundThere continue to be calls to move away from traditional “fee for service” health care models in favor of patient-centered, value-based models. Concurrent with national efforts, grassroots innovation with novel practice change models are developing at the local level and holds similar potential to transform the pharmacy practice model. One of these innovative models, the membership pharmacy model, may be the least dependent on existing barriers to practice transformation because it is centered on the sale of services rather than products. ObjectiveTo discuss the difference between volume-based and value-based pharmacy models, focusing on how these models impact prescription adherence and patient outcomes. Application of the value-based pharmacy model will be described in the context of Good Shepherd Pharmacy located in Memphis, TN. Case SummaryThe volume-based model is centered on prescription fulfillment, with pharmacies incentivized to maximize the number of prescriptions filled. Conversely, the value-based model treats prescription fulfillment as an expense and emphasizes medication adherence as the primary goal. This shift in focus leads to a radical change in the pharmacy’s business model, aligning economic incentives with patients’ best interests. In the value-based model, pharmacies operate on a membership or subscription basis, where revenue is generated through recurring membership fees instead of individual prescription fills. This encourages pharmacies to manage prescription fulfillment efficiently and helps patients reduce their prescription burden, ultimately improving their bottom line. Practice ImplicationsThe value-based pharmacy model is distinguishable from the volume-based model in several aspects. In the value-based model, prescription fills are considered an expense rather than a profit center, and the inventory model shifts from “Just-in-Case” to “Just-in-Time.” Medication synchronization of patients’ refills is a key feature of the value-based model, as it reduces operational costs and maximizes profit per patient. Key performance indicators also shift from being product-centric to patient-centric and reward the organization for improving adherence. ConclusionThe value-based pharmacy model represents a significant departure from traditional pharmacy practices. By incentivizing pharmacies to promote medication adherence and focus on long-term customer relationships, this model has the potential to improve patient outcomes. Further research is needed to study the model’s impact across different settings and patient populations, financial sustainability, and means of spread and scale.

State Telepharmacy Policies and Pharmacy Deserts

Pharmacy deserts have increased, potentially affecting patient access and care. Historically, telepharmacies have been used to reduce pharmacy deserts to restore access, but states frequently restrict their operation. To analyze whether telepharmacy policy is associated with pharmacy deserts and access to pharmacy services. This cohort study analyzed pharmacy location and census data from 2016 through 2019 for US states with new telepharmacy policies. Nearby control states were used for comparison in a pretest-posttest nonequivalent group design. Statistical analysis was performed from January 2022 to July 2023. Intervention states were selected if a change in telepharmacy policy was adopted in 2017 or 2018. Pharmacy deserts were defined as any geographic area located at least 10 miles from the nearest pharmacy. Primary outcomes included the change in number of telepharmacies, pharmacy deserts, and population in pharmacy deserts. Secondary outcomes included the percentage of telepharmacies located in medically underserved areas or populations (MUA/Ps), and the association between a telepharmacy opening nearby and the transition of a pharmacy desert into a nonpharmacy desert. Twelve US states were included in the study (8 intervention states, 4 control states). Intervention states experienced an increase in the mean number of telepharmacies to 7.25 with a range of 4 (Arizona, Indiana) to 14 (Iowa), but control states remained at a mean of 0.25 telepharmacies with a range of 0 to 1 (Kansas). Compared with controls, intervention states experienced a 4.5% (95% CI, 1.6% to 7.4%) decrease in the percentage of places defined as pharmacy deserts (P = .001) and an 11.1% (95% CI, 2.4% to 22.6%) decrease in the population in a pharmacy desert (P = .03). Telepharmacies were more likely to be located in a MUA/P than traditional pharmacies (preperiod in MUA/P: 63.2% of telepharmacies [12 of 19] vs 33.9% of traditional pharmacies [5984 of 17 511]; P = .01; postperiod in MUA/P: 62.7% of telepharmacies [37 of 59] vs 33.7% of traditional pharmacies [5998 of 17 800]; P < .001). When a telepharmacy was established in pharmacy deserts, 37.5% (30 of 80) no longer met the study's definition of a pharmacy desert the following year. In contrast, only 1.8% of places (68 of 3892) where a nearby telepharmacy did not open experienced this change (χ21=416.4; P < .001). In this cohort study, intervention states experienced a reduced population in pharmacy deserts, suggesting an association with new telepharmacy openings. States aiming to improve pharmacy access might consider less restrictive telepharmacy policies to potentially elicit greater patient outcomes.

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.

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

AbstractIntroductionA critical aspect of human immunodeficiency virus (HIV) infection management and prevention is adherence to antiretroviral (ARV) medications. There are limited recent studies focused on the impact of community pharmacy interventions on ARV adherence; previous studies were conducted between 2004 and 2012 with more complicated regimens.ObjectivesThe primary objective was to compare the adherence rates for ARV medications for both HIV treatment and prevention in patients using HIV‐focused (HIV‐F) pharmacies compared with traditional (non‐HIV focused) pharmacies in a supermarket‐based community pharmacy. The secondary objectives were to determine which factors impact adherence rates as well as the demographic information of patients using HIV‐F pharmacies.MethodsThis was a retrospective study of de‐identified pharmacy dispensing data for patients filling ARV medications from October 2018 to July 2021 at a Safeway pharmacy in the Washington D.C., Maryland, and Virginia (DMV) area. Patients 18 years and older who had fill records at a Safeway pharmacy in the DMV area of at least two 30‐day supplies of ARV medication were included. For all eligible patients, medication adherence was measured by assessing the proportion of days covered (PDC).ResultsOf the 1496 patients who met the inclusion criteria, 971 patients used an HIV‐F pharmacy. Overall, patients were predominantly male (78.9%) with a median age of 44 years. The median PDC score of HIV‐F pharmacies was higher than traditional pharmacies, but the difference was not statistically significant (97.1% vs. 96.6%, respectively, p = 0.2).ConclusionPatients using this regional division supermarket‐based community pharmacy have a high PDC score regardless of pharmacy type. Use of newer ARV agents may have facilitated patients' adherence and diminished the potential benefit of utilizing HIV‐F pharmacies. Pharmacies currently providing specialized patient care for ARV medications may need to re‐evaluate how best to promote medication adherence.

Patient perspectives of antiretroviral pharmacy services: A cross-sectional cohort study.

Adherence to antiretroviral therapy (ART) remains the main predictor of sustained HIV virologic suppression for people with HIV (PWH). Mail-order pharmacy services are often offered to patients as an alternative option to traditional pharmacy services. Some payers mandate ART to be dispensed from specific mail-order pharmacies regardless of patient choice complicating ART adherence for patients affected by social disparities. Yet, little is known about patient perspectives regarding mail-order mandates. Eligible patients of the HIV program at University of Nebraska Medical Center with experience receiving ART from both a local and mail-order pharmacy were invited to complete a 20-question survey with three core sections: experiences/perspectives on local and mail-order pharmacy settings; pharmacy attributes rankings; and pharmacy preference. Paired t-tests and Mann-Whitney tests were used to compare the agreement scores of pharmacy attributes. Sixty patients (N = 146; 41.1%) responded to the survey. Mean age was 52 years. Most were male (93%) and White (83%). The majority of participants were on ART for HIV treatment (90%) and 60% were using mail-order pharmacies for their prescription services. Significant scoring differences (p<0.05) were observed for all pharmacy attributes favoring local pharmacies. Refilling ease was the most important attribute noted. More respondents (68%) preferred local pharmacies versus mail-order pharmacies. Payer associated mail-order pharmacy mandates were experienced by 78% with half believing the mandates impacted their medical care negatively. In this cohort study, respondents preferred local pharmacies compared to mail-order pharmacy for ART prescription services and noted ease of refilling as the most important pharmacy attribute. Two-thirds of respondents believed mail-order pharmacy mandates negatively affected their health. Insurance payers should consider the removal of mail-order pharmacy mandates to allow patient choice of pharmacy, which may help remove barriers to ART adherence and improve long-term health outcomes.

Ensuring Doctor of Pharmacy Graduates Have the Essential Competencies for Innovative Practice

As the pharmacy profession continues to evolve from product oriented to patient centered, pharmacy programs have been transitioning from a traditional pharmacy curriculum to a competency-based education pedagogy. Competency-based education has been developed to instill the required clinical competencies in graduates to better meet the contemporary role of pharmacists in accordance with the latest scientific knowledge and evidence-based practices in an ever-evolving health care landscape. While these ideas have helped shape the new Accreditation Council for Pharmacy Education (ACPE) Standards and Center for the Advancement of Pharmacy Education (CAPE) Educational Outcome domains, recent publications have indicated that it is integral for these Standards to include public health emergency preparedness and response. Updated Standards and Educational Outcomes must be integrated longitudinally in pharmacy curricula to ensure that graduates will be practice-ready health care professionals. This commentary highlights the strategic use of workforce development of population health based on two perspectives: emergency preparedness and response and digital health.

Attitudes and behaviors regarding online pharmacies in the aftermath of COVID-19 pandemic: At the tipping point towards the new normal.

The COVID-19 pandemic accelerated the online purchase of goods and services in which today's e-pharmacy is now an integral part of healthcare provisions in developed countries. The aim of our research was to assess the frequency and attitudes of European consumers purchasing medications online prior to and following the pandemic in the Visegrad Group countries (V4). An online cross-sectional study was conducted between May-August 2022. A 25-item questionnaire with single choice and 5-point Likert scale answers was used and implemented in Google forms and Pollfish. A sampling of 2087 responses was collected. A majority (92.8%) of the respondents were aware medicines can be purchased online, yet prefer traditional pharmacies (4.6 ± 0.8) and somewhat oppose the internet channel (2.8 ± 1.3). Following the outbreak of COVID-19 pandemic, respondents' attitude towards purchasing consumer goods (3.65 ± 0.89) and medications (3.26 ± 0.91) online increased, however, the change regarding medications is significantly smaller (p < 0.01). A distinct increase in the frequency of buying medicines (from 49.16% to 55.48%) and health products (from 60.61% to 63.0%) online was measured since the breakout of the COVID-19 pandemic (p < 0.05). Despite the relatively high prevalence witnessed in previous purchases, our results highlight the trend in which 18.3% of participants will definitely purchase medications online while a proportionate 17.7% will not in the future. Although long-term post-COVID attitudes towards the internet pharmacy channel have modestly increased, in comparison to previously published research the frequency of purchasing medications online has significantly increased during the past years. As national legislation in V4 countries permit only non-prescription online sales, our findings are primarily applicable to countries with similar regulatory environment. The rapid global spread of the coronavirus has transitionally affected medicinal purchase behaviors, augmenting potential public health concerns related to online sourcing. Consequently, public awareness campaigns are needed to promote verified online pharmacies and prevent the utilization of illicit websites and the use of unregistered, substandard and falsified medicinal products.

Self-pay pharmacies, the next step toward affordable medications?

Nate Hux, PharmD, is a pharmacist in Pickerington, OH, who owns two different pharmacies that are right next to each other. One is a traditional pharmacy that accepts commercial insurance, and the other is a self-pay pharmacy.

The Intervention of Data Mining in the Allocation Efficiency of Multiple Intelligent Devices in Intelligent Pharmacy.

With the wide application of artificial intelligence and big data technology in the medical field, the problems of high cost and low efficiency of traditional pharmacy management were becoming more and more obvious. Therefore, this paper proposed to use data mining technology to design and develop the dispensing process and equipment of intelligent pharmacy. Firstly, it summarized the existing data mining technology and association rule methods and expounded its application value in the related fields. Secondly, the data standard and integration platform of dispensing in intelligent pharmacy were established. Web service technology was used to design the interactive interface and call it to the intelligent device of pharmacy. Finally, an intelligent pharmacy management system based on association rule mining was constructed through the data mining of intelligent pharmacy equipment, in order to improve the intelligence and informatization of modern pharmacy management. For the emergency dispensing process of intelligent equipment failure, data mining was used to optimize the intelligent pharmacy equipment and dispensing process and change the pharmacy management from traditional prescription to patient drug treatment, so as to improve the dispensing efficiency of intelligent pharmacy equipment. Through the systematic test and analysis, the results showed that through the real-time risk prevention and control, the formula accuracy and operation speed of the intelligent dispensing machine were improved and the dispensing time was shortened. Through intelligent drug delivery, the unreasonable drug use of patients was reduced, the safety and effectiveness of clinical drug use were ensured, and the contradiction between doctors and patients was reduced. This study can not only optimize the medical experience of patients and provide patients with more high-quality and humanized pharmaceutical technical services but also provide some support for the intelligent management of modern hospitals.

Antioxidant and Antimicrobial Activity of Plant Hydrosol and Its Potential Application in Cosmeceutical Products

Context: Hydrosol is a residual product from the steam or hydro distillation process of abundant types of plants. It can be separated from the essential oil mixture by the liquid-liquid extraction process. Hydrosols from a variety of plants are becoming increasingly popular in cosmetology, aromatherapy, traditional pharmacy, and food sector; thus, their prospective applications should be further explored. Evidence Acquisition: Hydrosol may generally contain chemicals such as alcohol, ketone, and ester. Based on the previous studies using gas chromatography-mass spectroscopy (GC-MS) analysis, linalool, carvacrol, and α-terpineol are the major chemicals present in plant hydrosol. Results: The chemical composition is either showing antimicrobial or antioxidant properties. The antioxidant properties are important in cosmeceutical products to prevent oxidation of the cosmetic ingredients, while the antimicrobial properties maintain the quality of the cosmetics. Hitherto, hydrosol usage is still unfamiliar in the market, but several cosmetic products have been formulated using hydrosol, such as shampoo, soap, and conditioner. Conclusions: This work will review the hydrosol compound from plants, extraction methods, chemical composition, antioxidant and antimicrobial activities, and the potential of hydrosol in cosmeceutical application.

Consumer Perception Towards Online Pharmacy And Offline Pharmacy With Reference To Mumbai City

E-commerce investment in medical and pharmaceuticals is skyrocketing, which is assisting in the growth of either the online and offline supply of options for acquiring drugs to customers. This measure would ultimately assist the Indian drug industry in better meeting the demands of customers. The convenience given by e-medicines is allowing patients to shift from offline to online ordering modalities, particularly with the increased usage of the World Wide Web currently. Although a greater proportion of people, such as the elderly, disabled, and those living in remote areas, have begun to use this advanced practise on a regular basis, there remains a sizable segment of society that is still reliant on the traditional method of obtaining meds from drug stores and relies on it. Certain cases of fraudulent and inadequate information regarding pharmaceuticals and medicines being shown on these sites of "Pharmacies" and apps have been detected, making them unethical. Furthermore, it is clear that Internet prescription cannot replace the real physician's care of the patient, since patients are still at danger of significant medication interactions and adverse effects while using the online treatment approach.&#x0D; Purpose: Study was done to investigate consumer perceptions about online and offline pharmacies in Mumbai, India, and if there is any danger involved with purchasing drugs from all these sources.&#x0D; Design/ Methodology: The survey looked at people's attitudes about online and traditional pharmacies. Which of these do individuals in India tend to favour for their frequent pharmaceutical purchases? The investigation is conclusive in nature, and a casual research strategy was employed to assess people's behaviour and preferences regarding online and physical pharmacies. The research also included a qualitative component since the behaviour of buyers/consumers was examined. The descriptive component of the research is there just to analyse and comprehend the consumer's behaviour and the variables that lead to this choice.&#x0D;

Adaptation and validation of the patient assessment of chronic illness care in United States community pharmacies

BackgroundRoles for United States (US)-based community pharmacists in caring for persons with chronic conditions have greatly expanded. The Patient Assessment of Chronic Illness Care (PACIC) was developed to assess patients’ perspectives of care received. However, successful application of this instrument in community pharmacies is uncertain. The objective of this study was to adapt the PACIC for use in community pharmacies (CP-PACIC), assess validity of the CP-PACIC and examine CP-PACIC scale score differences relative to patient characteristics.MethodsThis cross-sectional study surveyed chronically ill adults in Indiana, US who receive care from pharmacists in community pharmacies. The modified CP-PACIC scale consisted of 20-items, which were rated on a 5-point Likert scale from 0 (none of the time) to 4 (always). The total possible score ranged from 0 – 80. An exploratory factor analysis (EFA) was conducted to assess performance and dimensionality. CP-PACIC validity, including face validity, construct validity (via exploratory factor analysis) and internal consistency were assessed. Relationships between patient characteristics and scale scores were evaluated using appropriate statistical tests.ResultsFive hundred forty-six respondents’ data were analyzed. EFA revealed a 2-factor solution (termed advanced pharmacy chronic illness care (AP) and traditional pharmacy chronic illness care (TP) subscales) accounting for 64.7% of variance; all 20 items were retained. The total 20-item CP-PACIC scale had a Cronbach’s alpha (internal consistency) of 0.96; with a 12-item AP subscale Cronbach’s alpha of 0.97 and 8-item TP subscale Cronbach’s alpha of 0.89. Median total score was 12.0 [interquartile range = 27.3]. Median CP-PACIC sores varied across many respondent demographics (i.e., survey administration type, age, sex, education, health condition, number of pharmacy services received, community pharmacy type) such as whether respondents participated in one or more pharmacy service or not (29 vs. 10; p < .001).ConclusionsUnlike the original 5-subscale (patient activation, delivery system design, goal setting, problem solving, and follow-up/coordination) PACIC, analysis demonstrated a 2-factor (AP, TP) solution for the CP-PACIC scale with good internal consistency. As there are no standardized evaluation tools that exist, community pharmacies could find great value in using this CP-PACIC tool to benchmark performance and inform quality improvement strategies for patient care delivery.

Provision of community pharmacy services during the first wave of COVID-19 pandemic in Estonia – experiences and future implications

The spread of COVID-19 outbreak in 2020 had significant impact on the functioning of the existing healthcare system and required fast adaption to new circumstances for continuing with daily practices. Community pharmacists shared responsibility of ensuring supply of medicines and medical devices, educating people on health related issues, providing pharmaceutical care etc. The aim of this study was to understand how the provision of community pharmacy services changed during the first wave of COVID-19 pandemic in spring of 2020 in Estonia. Qualitative in-depth semi-structured interviews were conducted. Recorded interviews with community pharmacists (n = 21) and experts (n =10) were transcribed verbatim and a systematic text condensation method for textual content analysis was performed. The findings indicated that a number of changes took place in provision of community pharmacy services to assure continuity in providing high-quality pharmacy services in crisis, including addressing difficulties in the supply of medicines; at the same time, to acquire new knowledge for counselling health related topics and personal protective equipment, and to provide psychological support to people in stress. Pandemic had an impact on the content and structure of traditional community pharmacy services in Estonia. The need for expanded professional role of pharmacists was clearly expressed in an emergency situation.

Head of a Serpent, a Pinch of Rue

French physicians denigrated traditional medicines in Morocco as the magic and sorcery of Moroccan women—ancient <i>“matrones”—</i>even as French pharmaceutical companies, pharmacists, and scholarly societies bioprospected among Moroccan healing plants looking for new drugs. Morocco had centuries of male Galenic physicians whose pharmacological texts informed popular practice, and Muslim women historically translated between this “high” tradition and family health. Because Moroccan women were identified as the primary practitioners of traditional pharmacy, but they were protected from official French interference, French women were enlisted to report on their practices. Among these was colonial wife Aline Reveillaud de Lens <i>(Pratiques des harems marocains)</i> and physician Dr. Françoise Legey <i>(Essai de folklore marocain).</i> Dr. Abel Charnot, founder of the first toxicology laboratory in Morocco, viewed Moroccan women as criminals and toxicology as the civilizing science to conquer women’s sorcery. French colonial pharmacy was thus patriarchal as well as colonizing and positivist. Healing plants in colonized Morocco were polysemous—simultaneously circulating in healing systems, colonial political economies, and the epistemic struggle of French colonialism against Moroccan knowing. Traditional pharmacopeia remains popular therapy in postcolonial Morocco. Argan oil, <i>souak,</i> and other “women’s” plants are popular on the global market with ambivalent implications for local women’s empowerment.

Multi-center survey on the training status of staff working in pharmacy intravenous admixture services (PIVAS) in mainland China: Perspectives of PIVAS staff.

The technical level and comprehensive quality of pharmacy intravenous admixture services (PIVAS) staff are central to ensure the safety and effectiveness of intravenous infusions. However, these aspects are lacking in traditional pharmacy education. This study aimed to investigate the training status of staff working in PIVAS and explore factors that affected training status, which might contribute to the establishment of a comprehensive, standardized training system.A multi-center cross-sectional survey was conducted via a WeChat Group targeting PIVAS staff in hospitals to investigate the differences of current training status between different regions, hospital levels, genders, job titles, educational degrees, employment types, and working years.In total, 501 participants completed the questionnaires. The main contents of training for PIVAS staff included: professional theoretical knowledge (99.40%, 498/501), practical operation abilities (97.01%, 486/501), pre-job training (92.61%, 464/501), and standard operating procedures (90.22%, 452/501). The most common frequency of staff training was 1–2 times a month (51.9%, 260/501). Overall, 56.5% (283/501) of participants thought staff training was sufficient and 60.1% (301/501) of participants thought PIVAS attached importance to staff training. However, only 45.7% (229/501) of the participants were satisfied with the training modes.The contents of training for PIVAS staff in mainland China were relatively rich, but the aspects of management tools, comprehensive ability development, and career development planning tend to be relatively weak. It is necessary to develop training standards for PIVAS staff to improve employee capabilities and job satisfaction.