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Journal of General Internal Medicine Aug 2020
Topics: Humans; Naloxone; Pharmaceutical Services; Pharmacies; Pharmacy; Prescriptions
PubMed: 32193816
DOI: 10.1007/s11606-020-05760-y -
Research in Social & Administrative... Mar 2023There is an urgent need for health care systems to be more efficient and efficacious. An approach to integrate public and private provider organizations such as... (Review)
Review
BACKGROUND
There is an urgent need for health care systems to be more efficient and efficacious. An approach to integrate public and private provider organizations such as community pharmacies and public primary health care (PHC) merits consideration. The objective of this review was to identify the types of integration in health care settings and discuss their applicability to the potential integration of community pharmacy and PHC.
METHODS
A narrative review using Medline, Scopus and SciELO databases was performed in which terms related to health were combined with terms related to integration. Levels and Types of integration: 14 types of integration were identified (two in breadth, seven as enablers and five in system levels). A model was created which classifies and assigns the types of integration to the different levels of the health system and to the breadth, intensity, and enablers of the integration process. Due to the nature of community pharmacy and PHC system, a horizontal integration at the micro level, supported by meso and macro levels policy, is suggested. The different elements of intensity and enablers can significantly influence the process.
CONCLUSION
The application of principles, concepts and types of integration suggest that it might be feasible and practical to integrate community pharmacies and PHC. However, the conflictive historical context would need to be overcome with appropriate policy and incentives.
Topics: Humans; Pharmacies; Primary Health Care; Delivery of Health Care; Community Pharmacy Services
PubMed: 36336618
DOI: 10.1016/j.sapharm.2022.10.007 -
Journal of the American Pharmacists... 2021Adderall (amphetamine-dextroamphetamine) is a controlled substance with harmful adverse effects if abused or misused. We assessed the availability of Adderall from...
OBJECTIVES
Adderall (amphetamine-dextroamphetamine) is a controlled substance with harmful adverse effects if abused or misused. We assessed the availability of Adderall from common search engines, and evaluated the safety and marketing characteristics of online pharmacies selling Adderall.
DESIGN
Cross-sectional study.
SETTING AND PARTICIPANTS
From December 2019 to February 2020, the phrase "buy Adderall online" was queried in four search engines: Google (N = 100), Bing (N = 100), Yahoo (N = 50) and DuckDuckGo (N = 50). Online pharmacies that claimed to sell Adderall and had unique Uniform Resource Locators, were active, free-access, and in English language were included.
OUTCOME MEASURES
Online pharmacies were categorized as rogue, unclassified, or legitimate on the basis of LegitScript classifications. Safety and marketing characteristics, and costs were collected.
RESULTS
Of the 62 online pharmacies found to sell Adderall, 61 were rogue or unclassified. Across all rogue and unclassified online pharmacies, prescriptions were not required (100%), pharmacist services were not offered (100%), and quantity limits were not placed on the number of Adderall purchases (100%). Rogue and unclassified online pharmacies appealed to cost, offering price discounts (61%), bulk discounts (67%), and coupon codes (70%). Contrary to their claims, cheaper prices were available for all formulations and dosages of Adderall from GoodRx than from these online pharmacies. Rogue and unclassified online pharmacies promoted and enabled the illicit purchase of Adderall, appealing to privacy (74%), offering purchase through cryptocurrency (74%), and claiming registration or accreditation of their sites (33%).
CONCLUSION
Rogue online pharmacies are pervasive in search engine results, enabling the illicit purchase of Adderall without a prescription. Consumers are at risk of purchasing Adderall, a medication with high abuse potential, from unsafe sources. Law enforcement, regulatory agencies, and search engines should work to further protect consumers from unregistered and illegitimate online pharmacies selling Adderall.
Topics: Amphetamines; Controlled Substances; Cross-Sectional Studies; Humans; Internet; Pharmaceutical Services, Online; Pharmacies
PubMed: 32912756
DOI: 10.1016/j.japh.2020.07.022 -
Rural and Remote Health Jan 2023To strengthen and demonstrate the ability of rural pharmacists to address their communities' health needs, we developed the first multi-state rural community pharmacy... (Review)
Review
INTRODUCTION
To strengthen and demonstrate the ability of rural pharmacists to address their communities' health needs, we developed the first multi-state rural community pharmacy practice-based research network (PBRN) in the USA called the Rural Research Alliance of Community Pharmacies (RURAL-CP). Our objective is to describe the process for developing RURAL-CP and discuss challenges to creating a PBRN during the pandemic.
METHODS
We conducted a literature review of community pharmacy PBRNs and met with expert consultants to gain insight into PBRN best practices. We obtained funding to hire a postdoctoral research associate, conducted site visits, and administered a baseline survey, which assessed many aspects of the pharmacy, including staffing, services, and organizational climate. Pharmacy site visits were initially conducted in-person but were later adapted to a virtual format due to the pandemic.
RESULTS
RURAL-CP is now a PBRN registered with the Agency for Healthcare Research and Quality within the USA. Currently, 95 pharmacies across five southeastern states are enrolled. Conducting site visits was critical for developing rapport, demonstrating our commitment to engage with pharmacy staff, and appreciating the needs of each pharmacy. RURAL-CP pharmacists' main research priority was expanding reimbursable pharmacy services, especially for diabetes patients. Since enrollment, network pharmacists have participated in two COVID-19 surveys.
DISCUSSION
RURAL-CP has been instrumental in identifying rural pharmacists' research priorities. COVID-19 provided an early test of the network infrastructure, which allowed us to quickly assess COVID-19 training and resource needs. We are refining policies and infrastructure to support future implementation research with network pharmacies.
Topics: Humans; Pharmacies; Community Pharmacy Services; COVID-19; Pharmacy; Pharmacists
PubMed: 36802618
DOI: 10.22605/RRH8092 -
Journal of the American Pharmacists... 2022
Topics: Health Services Accessibility; Humans; Pharmaceutical Services; Pharmacies; Pharmacy; Pharmacy Residencies
PubMed: 35798508
DOI: 10.1016/j.japh.2022.04.020 -
American Journal of Pharmaceutical... Mar 2023Currently, there is no set of accreditation standards for integrating the dangers of illegal online pharmacies into Doctor of Pharmacy (PharmD) curricula. As a result,...
Currently, there is no set of accreditation standards for integrating the dangers of illegal online pharmacies into Doctor of Pharmacy (PharmD) curricula. As a result, many pharmacists are unable to recognize the differences between a legal and illegal online pharmacy or educate patients on the dangers of online pharmacies. The objectives of this study were to assess gaps in student pharmacists' knowledge and to assess the impact of adding education regarding online pharmacies into PharmD programs. A pre- and postsurvey design was developed. Data were collected through an electronic questionnaire distributed to second-year pharmacy (P2) students to evaluate student knowledge gaps at baseline and after education on illegal online pharmacies. A total of 102 students responded to the presurvey, with 93 (91%) consenting to participate. Out of 100 respondents to the postsurvey, 84 (84%) students consented. Approximately 87% (81/93) of respondents indicated some awareness of prescription medications being purchased online. Most students (89%, 77/86) stated that they do not believe the university has provided adequate curriculum on illegal online pharmacies and counterfeit medications. After receiving education on the relevant topics, 64% (55/85) stated they now felt their education was adequate. Although pharmacy students were aware of the existence of illegal online pharmacies, they were not aware of the significance of this patient safety issue or how to accurately identify suspicious websites. It is imperative that PharmD programs incorporate formal education on the risks that illegal online pharmacies pose to patient and medication safety.
Topics: Humans; Pharmaceutical Services, Online; Education, Pharmacy; Pharmacists; Students, Pharmacy; Pharmacies
PubMed: 35296458
DOI: 10.5688/ajpe8933 -
Journal of Primary Care & Community... 2023The effects of climate change are seen with a rise of extreme weather and climate events (EWCEs) which lead to the closures of many healthcare facilities, such as... (Review)
Review
BACKGROUND
The effects of climate change are seen with a rise of extreme weather and climate events (EWCEs) which lead to the closures of many healthcare facilities, such as community pharmacies. Pharmacists in community pharmacies are seen as the most accessible healthcare professional to the public and are responsible for the continued delivery of care to patients. However, amid closures due to EWCEs and the emergence of pharmacy deserts, there is decreased access to pharmacies and a disruption of care.
OBJECTIVE
It is important to address the preparedness and accessibility of pharmacies post-EWCEs to guide future research and policy. Additionally, to tackle health disparities that arise due to pharmacy deserts, the populations most affected by a decreased access to pharmacies should be identified. We conducted a scoping review to assess the preparedness and accessibility of pharmacies post-EWCEs and to identify populations most affected by pharmacy deserts.
METHODS
We searched PubMed, Embase, and Web of Science from January 1, 2012 to September 30, 2022 and included all English-language, peer-reviewed primary literature that examined the preparedness and accessibility of community pharmacies in the United States post-EWCEs and addressed disparities within pharmacy deserts. Studies meeting these criteria were screened of their titles and abstracts by the first author and discrepancies were resolved with co-authors. We used Covidence for data extraction.
RESULTS
A total of 472 studies were identified (196 duplicates removed) and after screening, 53 studies were assessed for eligibility. The results of included publications (N = 26) showed that pharmacists and pharmacies are not equipped with the necessary emergency protocols which could lead to decreased access of pharmacies in the wake of EWCEs. Pharmacy deserts disproportionately affect residents living in rural, lower income, and Black/African American and Hispanic/Latino neighborhoods. The lack of preparedness of pharmacies post-EWCEs could worsen medication access.
CONCLUSION
This scoping review addresses challenges impacting pharmacies and patients post-EWCEs and within pharmacy deserts. In times of increased need, these challenges implicate the well-being of communities affected by EWCEs by breaking the continuum of care and access to medications. Here we offer suggestions for future research and directions for policy change.
Topics: Humans; Pharmacies; Extreme Weather; Pharmacy; Pharmaceutical Services; Pharmacists
PubMed: 37431885
DOI: 10.1177/21501319231186497 -
Health Services Research Jun 2022To characterize price trends and variation for US generic and branded drugs at the retail level as they relate to pharmacy acquisition costs and local market factors.
OBJECTIVE
To characterize price trends and variation for US generic and branded drugs at the retail level as they relate to pharmacy acquisition costs and local market factors.
DATA SOURCES
Drug pricing data consisting of US pharmacy claims from 2014 to 2019 collected and licensed by GoodRx, an online tool for comparing drug prices.
STUDY DESIGN
Time trends of median drug prices and coefficients of variation were measured for generic and branded drugs, including subgroups based on clinical condition (i.e., diabetes and cancer). Pharmacy competition was measured using the Herfindahl-Hirschman Index (HHI) at the zip-code level. Multivariable linear regression analysis assessed the impact of local market-level factors on drug prices and variation.
DATA COLLECTION
US drug pricing data consisting of claims filled through a mix of public and private insurance at 58,332 chain and independent pharmacies across 14,421 zip codes in all 50 states.
PRINCIPAL FINDINGS
From 2014 to 2019, pharmacy retail markets trended towards greater competition: average HHI by zip code decreased by 15.0% (p < 0.001). Median cash price increased significantly for both generic (6.58%, p < 0.001) and branded (84.10%, p < 0.001) drugs. When normalized to acquisition costs, cash prices for generic drugs rose 22.03% (p < 0.001) while those of branded drugs decreased by 2.31% (p < 0.001). Diabetes drugs showed higher baseline overall markup of cash prices relative to acquisition costs (10.54, Interquartile range (IQR) 3.28-18.43) than cancer drugs (1.88, IQR 1.36-3.08). Neither local pharmacy competition nor median income significantly predicted drug price or variation.
CONCLUSION
Measures of generic drug price and price variation are high despite decreased costs earlier in the pharmaceutical supply chain, defying expectations of what would happen in a competitive market. Efforts to bypass the pharmacy benefit model for generic drugs may offer consumers an opportunity for substantial savings.
Topics: Costs and Cost Analysis; Drug Costs; Drugs, Generic; Humans; Pharmacies; Prescription Drugs
PubMed: 35211965
DOI: 10.1111/1475-6773.13961 -
The American Journal of Managed Care Aug 2021After years of anticipation about Amazon's rumored entry into pharmacy, Amazon Pharmacy launched in November 2020. What is yet to be understood is whether this new...
After years of anticipation about Amazon's rumored entry into pharmacy, Amazon Pharmacy launched in November 2020. What is yet to be understood is whether this new Amazon offering is a true market disruption capable of upending the pharmacy industry. This commentary describes the epic rise of Amazon from bookseller to retail giant, leading to its entry into the retail pharmacy space. Amazon Pharmacy's business model is described and its potential for industry disruption discussed.
Topics: Commerce; Drug Industry; Humans; Pharmaceutical Services; Pharmacies; Pharmacy
PubMed: 34460178
DOI: 10.37765/ajmc.2021.88719 -
Indian Journal of Pharmacology 2022The recent worldwide pandemic has prompted several companies to turn to the online market. The pharmaceutical industry is one such significant and crucial in India.... (Review)
Review
The recent worldwide pandemic has prompted several companies to turn to the online market. The pharmaceutical industry is one such significant and crucial in India. There has been an upsurge in online pharmacies throughout the Indian subcontinent over the last 3-5 years. This unique development of online or "E-pharmacy" field has been carefully examined and presented in this article. The distinction between online and offline pharmacies, the advantages and challenges faced by E-pharmacies, the driving forces that led to the growth of the E-pharmacy sector in India, and the various emerging Indian E-pharmacy companies are covered. A comprehensive review of the legal system under which the E-pharmacy industry operates is also briefed. The reader will also learn about the various initiatives implemented by the Government in support of the E-pharmacy sector in India.
Topics: Drug Industry; India; Pharmaceutical Services, Online; Pharmacies; Pharmacy
PubMed: 36204812
DOI: 10.4103/ijp.ijp_445_21