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Yakugaku Zasshi : Journal of the... 2023This review introduces two sets of research results, one regarding patients' and consumers' perceptions of the pharmacist profession and pharmacy function, and the other... (Review)
Review
This review introduces two sets of research results, one regarding patients' and consumers' perceptions of the pharmacist profession and pharmacy function, and the other regarding factors that influence patients' medication-taking behavior. First, as an example of what was examined from patients' perspectives regarding the pharmacist profession and pharmacy function, an analysis of patient response data before the introduction of the family pharmacist/pharmacy system is presented. The results clarified that the quality of medication instruction influences patients' evaluations of pharmacists and further affects their evaluation of pharmacies, and that the main factor influencing patients' evaluation of pharmacies is their evaluation of the pharmacists. In particular, patients who continuously used the same pharmacist and the same pharmacy were highly statistically related, demonstrating the significance of recommending a family pharmacist/pharmacy. Next, regarding patients' medication-taking behavior, an empirical study of Japanese patients regarding the two-dimensional influencing factors was conducted. These factors, which have been the focus of recent overseas studies, included intentional nonadherence, such as skipping a dose, and unintentional nonadherence, such as forgetting to take a dose. The main influences were found to be from unintentional nonadherence and intentional non-adherence, with excessive information seeking and motivation to acquire knowledge potentially exacerbating intentional nonadherence in particular, as well as differences across diseases. These findings may contribute to supporting medication adherence in patients. In collaboration with graduate and postgraduate research students, future studies will continue to examine patients' and consumers' perspectives on medication adherence.
Topics: Humans; Community Pharmacy Services; Pharmacists; Education, Pharmacy; Pharmacies; Medication Adherence
PubMed: 36596533
DOI: 10.1248/yakushi.22-00126 -
PloS One 2020To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate... (Observational Study)
Observational Study
OBJECTIVE
To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate (DER).
METHOD
This was an observational study in northern and southern Taiwan's two largest medical centers, from 2012 to 2018. We calculated monthly PDW as number of prescriptions divided by number of pharmacist working days. We used monthly PSR and DER as outcome indicators for pharmacists' review and dispensing services, respectively. We used Poisson regression model with generalized estimation equation methods to evaluate the influence of PDW on PSR and DER.
RESULTS
The monthly mean of 463,587 (SD 32,898) prescriptions yielded mean PDW, PSR and DER of 52 (SD 3) prescriptions per pharmacist working days, 30 (SD 7) and 8 (SD 2) per 10,000 prescriptions monthly, respectively. There was significant negative impact of PDW on PSR (adjusted rate ratio, aRR: 0.9786; 95%CI: 0.9744-0.9829) and DER (aRR: 0.9567; 95%CI: 0.9477-0.9658). Stratified analyses by time periods (2012-2015 and 2016-2018) revealed the impact of PDW on PSR to be similar in both periods; but with positive association between PDW and DER in the more recent one (aRR: 1.0086, 95%CI: 1.0003-1.0169).
CONCLUSIONS
Reduced pharmacist workload was associated with re-allocation of pharmacy time to provide prescription suggestions and, more recently, decrease dispensing errors. Continuous efforts to maintain appropriate workload for pharmacists are recommended to ensure prescription quality.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists; Pharmacy Technicians; Prescriptions; Taiwan; Workload
PubMed: 32315319
DOI: 10.1371/journal.pone.0231482 -
International Journal of Clinical... Jun 2022Pharmacy professionals are increasingly moving into advanced roles, including in primary care. In England, the publicly funded Pharmacy Integration Fund (PhIF) enabled...
Pharmacy professionals are increasingly moving into advanced roles, including in primary care. In England, the publicly funded Pharmacy Integration Fund (PhIF) enabled employment and training of pharmacy professionals in new patient-facing roles, including general practice and care homes. In recognition of the need for support and supervision during work-based learning and building on established support structures in medicine and nursing, one of the providers of PhIF funded learning developed a supervision structure which mirrors arrangements for postgraduate medical specialty training. This paper describes what informed this supervision model, with a particular focus on educational supervision, its delivery, and the training which was developed to support supervisors. This supervision enabled pharmacy professionals moving into primary care to practise safely, manage workplace challenges, extend their roles and make progress with their education. This model illustrates the benefits of supervision in supporting post-registration learning to facilitate the development of advanced patient-facing clinical roles.
Topics: England; Humans; Pharmaceutical Services; Pharmacies; Pharmacy; Workplace
PubMed: 35575956
DOI: 10.1007/s11096-022-01421-8 -
BMC Medicine Dec 2016New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in... (Review)
Review
BACKGROUND
New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?"
METHODS
This is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases. We supplemented this with additional papers: studies that had been excluded from the quantitative review but which provided rigorous and relevant additional data for realist theorising; citation chaining (pursuing reference lists and Google Scholar forward tracking of key papers); the 'search similar citations' function on PubMed. After mapping what research questions had been addressed by these studies and how, we undertook a realist analysis to identify and refine candidate theories about context-mechanism-outcome configurations.
RESULTS
Our final sample consisted of 66 papers describing 74 studies (12 systematic reviews, 6 narrative reviews, 18 RCTs, 1 process detail of a RCT, 1 cost-effectiveness study, 12 evaluations of training, 10 surveys, 8 qualitative studies, 2 case studies, 2 business models, 1 development of complex intervention). Most studies had been undertaken in the field of pharmacy practice (pharmacists studying what pharmacists do) and demonstrated the success of pharmacist training in improving confidence, knowledge and (in many but not all studies) patient outcomes. Whilst a few empirical studies had applied psychological theories to account for behaviour change in pharmacists or people attempting to quit, we found no studies that had either developed or tested specific theoretical models to explore how pharmacists' behaviour may be affected by organisational context. Because of the nature of the empirical data, only a provisional realist analysis was possible, consisting of five mechanisms (pharmacist identity, pharmacist capability, pharmacist motivation and clinician confidence and public trust). We offer hypotheses about how these mechanisms might play out differently in different contexts to account for the success, failure or partial success of pharmacy-based smoking cessation efforts.
CONCLUSION
Smoking cessation support from community pharmacists and their staff has been extensively studied, but few policy-relevant conclusions are possible. We recommend that further research should avoid duplicating existing literature on individual behaviour change; seek to study the organisational and system context and how this may shape, enable and constrain pharmacists' extended role; and develop and test theory.
Topics: Humans; Pharmacies; Pharmacists; Qualitative Research; Smoking Cessation
PubMed: 27978837
DOI: 10.1186/s12916-016-0749-5 -
The American Journal of Managed Care Apr 2023The share of Medicare stand-alone prescription drug plans with a preferred pharmacy network has grown from less than 9% in 2011 to 98% in 2021. This article assesses the...
OBJECTIVES
The share of Medicare stand-alone prescription drug plans with a preferred pharmacy network has grown from less than 9% in 2011 to 98% in 2021. This article assesses the financial incentives that such networks created for unsubsidized and subsidized beneficiaries and their pharmacy switching.
STUDY DESIGN
We analyzed prescription drug claims data for a nationally representative 20% sample of Medicare beneficiaries from 2010 through 2016.
METHODS
We evaluated the financial incentives for using preferred pharmacies by simulating unsubsidized and subsidized beneficiaries' annual out-of-pocket spending differentials between using nonpreferred and preferred pharmacies for all their prescriptions. We then compared beneficiaries' use of pharmacies before and after their plans adopted preferred networks. We also examined the amount of money that beneficiaries left on the table under such networks, based on their pharmacy use.
RESULTS
Unsubsidized beneficiaries faced substantial incentives-on average, $147 annually in out-of-pocket spending-and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated from the incentives and demonstrated little switching. Among those who continued to mainly use nonpreferred pharmacies (half of the unsubsidized and about two-thirds of the subsidized), on average, the unsubsidized paid more out of pocket ($94) relative to if they had used preferred pharmacies, whereas Medicare bore the extra spending ($170) for the subsidized through cost-sharing subsidies.
CONCLUSIONS
Preferred networks have important implications for beneficiaries' out-of-pocket spending and the low-income subsidy program. Further research is needed about the impact on the quality of beneficiaries' decision-making and cost savings to fully evaluate preferred networks.
Topics: Aged; Humans; United States; Medicare Part D; Prescription Drugs; Pharmacies; Motivation; Pharmacy
PubMed: 37104832
DOI: 10.37765/ajmc.2023.89346 -
BMC Infectious Diseases Aug 2023Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial... (Review)
Review
BACKGROUND
Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial resistance, and economise use of healthcare resources. POCT implementation in private retail settings such as pharmacies and drug shops could lessen the burden on public healthcare. We performed a narrative review on studies of POCTs in low- and middle-income countries (LMICs), and explored uptake, impact on treatment, and feasibility of implementation.
METHODS
We searched MEDLINE/PubMed for interventional studies on the implementation of POCT for infectious diseases performed by personnel in private retail settings. Data were extracted and analysed by two independent reviewers.
RESULTS
Of the 848 studies retrieved, 23 were included in the review. Studies were on malaria (19/23), malaria and pneumonia (3/23) or respiratory tract infection (1/23). Nine randomised controlled studies, four controlled, non-randomised studies, five uncontrolled interventions, one interventional pre-post study, one cross-over interventional study and three retrospective analyses of RCTs were included. Study quality was poor. Overall, studies showed that POCT can be implemented successfully, leading to improvements in appropriate treatment as measured by outcomes like adherence to treatment guidelines. Despite some concerns by health workers, customers and shop providers were welcoming of POCT implementation in private retail settings. Main themes that arose from the review included the need for well-structured training with post-training certification covering guidelines for test-negative patients, integrated waste management, community sensitization and demand generation activities, financial remuneration and pricing schemes for providers, and formal linkage to healthcare and support.
CONCLUSION
Our review found evidence that POCT can be implemented successfully in private retail settings in LMICs, but comprehensive protocols are needed. High-quality randomised studies are needed to understand POCTs for infectious diseases other than malaria.
Topics: Humans; Health Facilities; Pharmacies; Pharmacy; Point-of-Care Testing; Retrospective Studies
PubMed: 37612636
DOI: 10.1186/s12879-023-08480-w -
Health Services Research Oct 2022To evaluate the effects of preferred pharmacy networks-a tool that Medicare Part D plans have recently adopted to steer patients to lower cost pharmacies-on the use of...
OBJECTIVE
To evaluate the effects of preferred pharmacy networks-a tool that Medicare Part D plans have recently adopted to steer patients to lower cost pharmacies-on the use of preferred pharmacies and factors underlying beneficiaries' decisions on whether to switch to preferred pharmacies.
DATA SOURCES
Medicare claims data were collected for a nationally representative 20% sample of beneficiaries during 2010-2016 and merged with annual Part D pharmacy network files.
STUDY DESIGN
We examined preferred networks' impact on pharmacy choice by estimating a difference-in-differences model comparing preferred pharmacies' claim share before and after implementation among unsubsidized and subsidized beneficiaries. Additionally, we evaluated the factors affecting whether a beneficiary switched from mainly using nonpreferred to preferred pharmacies.
DATA COLLECTION/EXTRACTION METHODS
We examined stand-alone drug plans that adopted a preferred network during 2011-2016. Our main sample included beneficiaries 65 years and older who stayed in their plan in both the first year of implementation and the year before and whose cost-sharing subsidy status and ZIP code remained unchanged during the 2-year period.
PRINCIPAL FINDINGS
Unsubsidized Part D beneficiaries faced an average difference of $129 per year in out-of-pocket spending between using nonpreferred and preferred pharmacies, while subsidized beneficiaries were insulated from these cost differences. The implementation of preferred networks resulted in a 3.7-percentage point (95% CI: 3.3, 4.2) increase in preferred pharmacies' claim share in the first year among the unsubsidized. Existing relationships with preferred pharmacies, the size of financial incentives, proximity to preferred pharmacies, and urban residence were positively associated with beneficiaries' decisions to switch to these pharmacies.
CONCLUSIONS
Preferred pharmacy networks caused a moderate shift on average towards preferred pharmacies among unsubsidized beneficiaries, although stronger financial incentives correlated with more switching. Researchers and policymakers should better understand plans' cost-sharing strategies and assess whether communities have equitable access to preferred pharmacies.
Topics: Aged; Cost Sharing; Humans; Medicare Part D; Pharmaceutical Services; Pharmacies; Pharmacy; United States
PubMed: 35297507
DOI: 10.1111/1475-6773.13973 -
BMC Medical Informatics and Decision... Aug 2020In recent years, online pharmacies have been accepted by increasingly more consumers, and the prospects for online pharmacies are optimistic. This article explores the...
BACKGROUND
In recent years, online pharmacies have been accepted by increasingly more consumers, and the prospects for online pharmacies are optimistic. This article explores the consumers' satisfaction factors addressed in Business to Customer (B2C) online pharmacy reviews and analyzes the sentiments expressed in the reviews. The goal of this work is to help B2C online pharmacy enterprises identify consumers' concerns, continuously improve the health services level.
METHODS
This article was based on the Latent Dirichlet Allocation (LDA) topic model. From a third-party platform-based B2C online pharmacy and a proprietary B2C online pharmacy (JD Pharmacy and J1.COM, respectively), 136,630 pieces of over-the-counter (OTC) drug review data posted from January 1, 2015 to December 31, 2018 were selected as samples and used to explore the satisfaction factors of B2C online pharmacy consumers regarding the entire drug purchasing process. Then, the sentiments expressed in the drug reviews were analyzed with SnowNLP.
RESULT
Categorization of the 12 factors identified by LDA showed that 5 factors were related to logistics; these 5 factors, which also included the most drug reviews, made up 38.5% of the reviews. The number of factors related to drug prices was second, with 3 factors, and reviews of drug prices made up 25.5% of the reviews. Customer service and drug effects each had two related factors, and a smaller percentage of these reviews (13.95%) were related to drug effects. Consumers still maintain positive opinions of JD Pharmacy and J1.COM. However, some opinions on logistics and drug prices are expressed.
CONCLUSION
The most important task for online pharmacies is to improve logistics. It is better to develop self-built logistics. Both types of B2C online pharmacies can improve consumer viscosity by implementing marketing strategies. With regard to customer service, focusing on improving employees' service attitudes is necessary.
Topics: Commerce; Consumer Behavior; Humans; Personal Satisfaction; Pharmaceutical Services, Online; Pharmacies
PubMed: 32807175
DOI: 10.1186/s12911-020-01214-x -
PloS One 2018Limited studies have investigated geographic accessibility to a nearby community pharmacy for elderly which is an essential determinant of the access to medications and...
OBJECTIVES
Limited studies have investigated geographic accessibility to a nearby community pharmacy for elderly which is an essential determinant of the access to medications and pharmacy services. This research identified pharmacy deserts and investigated availability of different types of community pharmacies and their services for elderly enrolled in a State Pharmaceutical Assistance Program (SPAP).
METHODS
The state of Pennsylvania in the US was used as a case to demonstrate the geographic accessibility to community pharmacy and services for elderly enrolled in SPAP. The locations of community pharmacies and households of elderly enrolled in SPAP were derived from Pharmaceutical Assistance Contract for the Elderly programs' database. The street addresses were geocoded and the distance to a nearby community pharmacy was calculated for study sample using the haversine formula. The demographic and geographic data were aggregated to Census Tracts and pharmacy deserts were identified using the predefined criteria. Descriptive statistical analysis was used to determine whether there are statistical differences in the socio-demographic profiles and distribution of different types of community pharmacies and their services in pharmacy deserts and non-deserts. This research used hot spot analyses at county level to identify clusters of pharmacy deserts, areas with high concentration of different racial/ethnic groups and clusters of high densities of chain and independent pharmacies.
RESULTS
The Spatial analysis revealed that 39% and 61% Census Tracts in Pennsylvania were pharmacy deserts and non-deserts respectively (p < 0.001). Pharmacy deserts were found to have significantly more females, married and white elderly and fewer blacks and Hispanics compared to pharmacy non-deserts. Pharmacy deserts had significantly fewer chain and independent pharmacies and less delivery and 24-hour services in pharmacies than pharmacy non-deserts. Hot spot analyses showed that clusters of pharmacy deserts were more concentrated in southcentral, northwest and northeast regions of the state which represent rural areas and overlapped with clusters of high concentration of white individuals.
CONCLUSIONS
The findings suggest that urban-rural inequality, racial/ethnic disparity and differences in availability of pharmacies and their services exist between pharmacy deserts and non-deserts. The methodological approach and analyses used in this study can also be applied to other public health programs to evaluate the coverage and breadth of public health services.
Topics: Aged; Aged, 80 and over; Community Pharmacy Services; Cross-Sectional Studies; Female; Health Services Accessibility; Humans; Male; Medical Assistance; National Health Programs; Pennsylvania; Pharmacies; Rural Population; Socioeconomic Factors; Spatial Analysis; United States
PubMed: 29864159
DOI: 10.1371/journal.pone.0198173 -
Medical Archives (Sarajevo, Bosnia and... Dec 2017After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period... (Review)
Review
After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period slowed down due to numerous unfavorable political-economic and other circumstances. Thanks to the Turks, Arabic culture and useful Islamic principles expanded to the territory of our homeland of Bosnia and Herzegovina (B&H). Significant role in the transfer of Arabic pharmaceutical knowledge was also attributed to the Sephardic Jews who, with their arrival, continued to perform their attar activities, which were largely based on Arab achievements. However, insufficiently elaborated, rich funds of oriental medical and pharmaceutical handwriting testify that Oriental science has nurtured in these areas as well, and that the Arabic component in a specific way was intertwined with other cultures and traditions of B&H. The Franciscan monasteries in Bosnia and Herzegovina have museums which contain important exhibits and libraries rich in books, among which many from the field of medicine and pharmacy. Muslim mosques, also, had small libraries with Arabic books used for spreading medical knowledge. The second category was folk doctors and practitioners who were on disposition to the people of any religion. Some of them listened to lectures in medicine during the studies of theology and philosophy. However, most did not have any medical education, but by reading books and teaching experience they made their own recipe collection. Special books, called "Ljekaruše" (Books of recipes) were also born during the study when they came into contact with an even larger number of health books. However, it should not be neglected that a lot of them contained folk medicines that were used in some environments depending on the habits and available herbs. Although it has been proven that many recipes from Ljekaruše are pharmacologically and medically justified, one should not ignore the knowledge and skill behind them. The true flowering of medicine in B&H happening thanks to graduate doctors in Italy, Austria, Hungary, Turkey, etc. Through their action, in a short time, they greatly improved health in B&H, educated the population. The Franciscans were important because they opened the first open-air clinics, the first pharmacies, and wrote the first pharmacopoeia and regulations for the work of health care institutions. Numerous works preserved in monasteries have mostly brought about the study in only one or two copies. Their contribution to the development of health care and the prevention of illness and treatment of the population in B&H during that period is very significant.
Topics: Bosnia and Herzegovina; Culture; Delivery of Health Care; History of Pharmacy; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, Medieval; Humans; Islam; Medicine, Arabic; Ottoman Empire; Pharmacies; Reference Books, Medical; Turkey
PubMed: 29416207
DOI: 10.5455/medarh.2017.71.439-448