-
Journal of the American Pharmacists... 2024Community pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel...
BACKGROUND
Community pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel to reach these services.
OBJECTIVES
This study compared spatial accessibility and actual travel to different types of pharmacies among selected neighborhoods in the Detroit region.
METHODS
Three types of neighborhoods were selected and compared, including two lower income Black urban neighborhoods of high-density and four upper income White suburbs (two of low density and two of high density). Spatial accessibility was computed by pharmacy type and compared among neighborhoods using ANOVA. Pharmacy trips reported in a travel survey were geocoded and linked with community pharmacies in a list generated from ReferenceUSA business data. Destination choices were mapped and the relationship between spatial accessibility and actual distance traveled was examined using ordinary least squares regressions.
RESULTS
On average, urban residents in Detroit had higher access to local independent pharmacies (0.74 miles to the nearest one) but relatively lower access to national chains (1.35 miles to the nearest one), which most residents relied on. Urban residents also tended to shop around more for services even among national chains. In fact, they bypassed nearby local independent pharmacies and traveled long distances to use farther pharmacies, primarily national chains. The average trip distance to pharmacy was 2.1 miles for urban residents, but only 1.1 miles and 1.5 miles for residents in high-density suburbs and low-density suburbs, respectively.
CONCLUSION
Supposedly good spatial access considering all pharmacies together may mask excessive burden in reaching the pharmacy services needed in low-income minority urban communities, as shown in the case of Detroit. Thus, when mapping pharmacy deserts, it is important to distinguish spatial accessibility among different pharmacy types.
Topics: Humans; Michigan; Health Services Accessibility; Travel; Community Pharmacy Services; Pharmacies; Residence Characteristics; Urban Population; Poverty; Black or African American; White People
PubMed: 38401841
DOI: 10.1016/j.japh.2024.102052 -
The American Journal of Managed Care Jun 2023To estimate neighborhood income differences between the locations of 340B-covered entities and their contract pharmacies (CPs) and examine whether these differences vary...
OBJECTIVES
To estimate neighborhood income differences between the locations of 340B-covered entities and their contract pharmacies (CPs) and examine whether these differences vary between hospitals and grantees.
STUDY DESIGN
Cross-sectional study.
METHODS
Using Health Resources and Services Administration 340B Office of Pharmacy Affairs Information System and zip code tabulation area (ZCTA)-level US Census Bureau databases, we created a unique data set that contains covered entities' characteristics, CP use, and ZCTA-level median household income in 2019 for more than 90,000 pairs of covered entities and CPs. We computed income differences between each pair and for a subset of pairs in which the pharmacy is within 100 miles of the covered entity for both hospitals and federal grantees.
RESULTS
On average, median income in the pharmacy's ZCTA is about 35% higher than in the covered entity's ZCTA, with little difference between hospitals (36%) and grantees (33%). Roughly 72% of arrangements cover less than 100 miles; in that subset, income is about 27% higher for pharmacy ZCTAs, with little difference between hospitals (28%) and grantees (25%). In more than 50% of arrangements, the median income in the pharmacy's ZCTA is more than 20% higher than in the covered entity's ZCTA.
CONCLUSIONS
CPs serve at least 2 purposes: They can increase low-income patients' access to medicines directly when a CP is closer to where a covered entity's patients live, and they can increase profits for covered entities (some of which are potentially passed on to patients) and CPs. We find that in 2019, both hospitals and grantees used CPs to generate income but generally they do not appear to contract with pharmacies located in neighborhoods where low-income patients are likeliest to live. Prior research findings have suggested that hospitals and grantees behave differently from each other with respect to CP use, but results of our analysis suggest the opposite.
Topics: Humans; Pharmacies; Cross-Sectional Studies; Income; Residence Characteristics; Pharmaceutical Services
PubMed: 37341983
DOI: 10.37765/ajmc.2023.89377 -
Journal of the American Pharmacists... 2021Community pharmacists also play a vital public health role in increasing access to health care services and information during times of public health crisis. To examine...
OBJECTIVES
Community pharmacists also play a vital public health role in increasing access to health care services and information during times of public health crisis. To examine access to community pharmacies in Wisconsin and the relationship between pharmacy locations and primary care health professional shortage areas (HPSAs).
METHODS
A list of licensed pharmacies in Wisconsin was screened to identify community pharmacies. Rural-urban commuting area codes were used to classify the rurality of pharmacy locations. Descriptive measures and pharmacy location maps were used to assess access to community pharmacies in the state as well as the relationship between pharmacy locations and primary care HPSAs. Spatial analysis was conducted to estimate the percentage of the population that lives within 10-, 20-, and 30-minute drive times of each community pharmacy.
RESULTS
Of the 837 community pharmacies in Wisconsin, 73 (68.5%) were located in metropolitan areas, 95 (11.4%) in micropolitan areas, 112 (13.4%) in small towns, and 57 (6.8%) in rural areas. A total of 265 (31.7%) community pharmacies were located in a primary care HPSA. The drive-time analysis found that 99.7% of the population lives within 30 minutes of a pharmacy, 98.7% within 20 minutes of a pharmacy, and 89.3% within 10 minutes of a pharmacy.
CONCLUSIONS
Nearly the entire Wisconsin population has convenient access to community pharmacies. Community pharmacies are ideally located in underserved areas with shortages of other health professionals, which may provide an opportunity for pharmacists to take on additional clinical roles to support health care providers and facilities in these areas.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists; Rural Population; Wisconsin
PubMed: 33707122
DOI: 10.1016/j.japh.2021.02.004 -
Frontiers in Public Health 2023Primary care is an essential component of any health system, but building high-quality primary care has proven to be a challenge for most developing countries. Among the...
INTRODUCTION
Primary care is an essential component of any health system, but building high-quality primary care has proven to be a challenge for most developing countries. Among the multiplicity of providers in South Asia, one of the most ubiquitous channels through which not only medicines are obtained but also primary care advice is sought is the neighborhood pharmacy. There are widespread availability of pharmacies in South Asia. There is also good evidence that working with pharmacies in this way is a globally accepted idea, and there are several examples of countries, such as France and Nigeria, that have integrated pharmacies into their primary care systems and entrusted them with significant responsibilities.
METHODS
In this paper, we explore the potential of this channel as a formal primary care provider, with a particular focus on the South Asian context, by examining how pharmacies perform against the seven of (i) first contact care, (ii) continuity of care, (iii) comprehensiveness, (iv) coordination, (v) family centredness, (vi) cultural competency, and (vii) community orientation. In the paper, we use data on pharmacies from four pharmacy-related interventions, one from Bangladesh and three from India, to carry out our analysis using the Qualitative Comparative Analysis (QCA) framework.
RESULTS
We find that even in the South Asian context, pharmacies provide several components of good primary care. As expected, they demonstrate a strong orientation toward the community in which they are located and are able to provide first-contact care. However, we find no direct evidence that they are able to offer continuity of care or bring to bear family-centredness and cultural competency when dealing with their patients. It is encouraging, however, that while there is no formal evidence of this in any of the interventions, multiple anecdotal examples suggest that pharmacists do indeed do much of this, but perhaps in an informal and inconsistent manner.
DISCUSSION
The evidence from these studies provides support for the view that pharmacies have many of the inherent characteristics needed to become an effective primary care channel and already play an important role in providing access to health information and care. However, it is also clear from the research that without additional training and access to tools, pharmacies will not have the competency or knowledge necessary to provide these services or even act as an effective gateway to other healthcare providers. To fully unlock this opportunity, therefore, any organization that wishes to engage with them will need to have the vision and patience to work with this network for an extended period of time and not merely aspire for incremental improvements but have a strategy in place that fundamentally changes the capabilities and the roles that pharmacies can play.
Topics: Humans; Pharmacies; Pharmacy; Pharmacists; Asia, Southern; Primary Health Care
PubMed: 37693714
DOI: 10.3389/fpubh.2023.1221439 -
Die Pharmazie Jun 2021This paper describes research about a historical bottle found in the Polish town of Skarszewy in 2004. Upon discovery, the find was labeled "In Nazareth Aechter...
This paper describes research about a historical bottle found in the Polish town of Skarszewy in 2004. Upon discovery, the find was labeled "In Nazareth Aechter Jerusalemer Balsam im goldnen Engel", sealed and ⅓ filled with liquid. The Jerusalem Balsam mentioned on the label was a popular medicament in Europe in the 18th century. From 1719 it was produced by Father Antonio Menzani da Cuna in the Franciscan Pharmacy at the convent of Saint Savior in Jerusalem. In the 19th century, the Balsam became extremely popular in Silesia thanks to the hermit Johannes Treutler from Mariańska Hill near Kłodzko. It's fame spread north to Prussia and south to Bohemia (Czechia). After the hermit's death, the license for production was obtained by the owner of the Mohren-Apotheke pharmacy, but he had to deal with unfair competition from other pharmacies counterfeiting the Balsam. An attempt was made to determine where the found bottle came from. In the course of the research, it was found that the medicine certainly does not come from authorized production sources, as evidenced by accurate label comparisons.
Topics: Balsams; Europe; History, 18th Century; History, 19th Century; Pharmaceutical Services; Pharmacies
PubMed: 34078524
DOI: 10.1691/ph.2021.1024 -
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 -
BMJ Open Feb 2020Due to a high global incidence of unintended pregnancy, finding novel ways to increase the accessibility of contraceptive products and information is critical. One... (Review)
Review
INTRODUCTION
Due to a high global incidence of unintended pregnancy, finding novel ways to increase the accessibility of contraceptive products and information is critical. One proposed strategy is to use the accessibility of community pharmacies and expand the role of pharmacists to deliver these services. This protocol reports the methods of a proposed scoping review of pharmacy-based initiatives for preventing unintended pregnancy. We intend to identify the range of interventions employed by pharmacists worldwide and their outcomes and aim to infer the value of task sharing for reducing certain access and equity barriers to contraception.
METHODS AND ANALYSIS
This protocol was developed with guidance from the Joanna Briggs Institute Methodology for Scoping Reviews. Reporting is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The scoping review will be reported according to the PRISMA Extension for Scoping Reviews. Seven electronic databases (PubMed, Ovid Medline, Embase, Cochrane Library, Scopus and Cumulative Index to Nursing and Allied Health Literature) were systematically searched for relevant literature published in English from 2000, on 22 August 2019. Two authors will individually screen articles for eligibility in Covidence and data will be charted and reported using a tool developed for the purpose of this review.
ETHICS AND DISSEMINATION
Findings will be disseminated in publications and presentations with relevant stakeholders. Ethical approval is not required as we will be using data from publicly available literature sources. We will map available evidence across the breadth of studies that have been conducted and identify the effectiveness and acceptability of interventions.
Topics: Female; Humans; Pharmaceutical Services; Pharmacies; Pharmacists; Pregnancy; Pregnancy, Unplanned
PubMed: 32014873
DOI: 10.1136/bmjopen-2019-033002 -
Journal of the American Pharmacists... 2023
Topics: Humans; Professional Autonomy; Pharmacy; Pharmaceutical Services; Pharmacies; Awards and Prizes
PubMed: 37084810
DOI: 10.1016/j.japh.2023.04.012 -
Inquiry : a Journal of Medical Care... 2021Understanding models of pharmacy education and practice in low-to-middle income countries (LMIC) can drive best practices and resource utilization. However, there is a...
Understanding models of pharmacy education and practice in low-to-middle income countries (LMIC) can drive best practices and resource utilization. However, there is a paucity of literature in this setting. The purpose of this report is to describe the length and breadth of pharmacy education and training in Tanzania as well as pharmacy practice models at 3 institutions. Lessons learned and implications for global pharmacy practice described herein aim to advance the profession and pharmacists' impact in LMIC settings. The Muhimbili campus is located in Dar es Salaam, the largest city in Tanzania, a LMIC in East Africa, and is comprised of 3 institutes and a health professions school. Despite variance in patient populations, all Muhimbili institutions have developed pharmacy services in outpatient and inpatient pharmacies, central pharmacy stores, intensive care units, and operating theaters. Unique pharmacy practice areas result from a variance in patient populations serviced and include services in pharmacovigilence/drug information, compounding, oncology, nephrology, and emergency departments. Medication availability and the complexity and time commitment of patient billing are consistent challenges, and multidisciplinary collaboration a common strength across the 3 institutions. Pharmacists at Muhimbili perform innovative and critical functions to support optimal patient care tailored to specific patient populations. The detailed review of these services can serve as a model for pharmacy practice at other health systems in LMIC and beyond.
Topics: Education, Pharmacy; Humans; Pharmaceutical Services; Pharmacies; Pharmacy; Tanzania
PubMed: 33759604
DOI: 10.1177/0046958021999934 -
International Journal of Pharmaceutical... 2022In addition to the numerous physical, chemical, instrumental, and microbiological tests commonly utilized in the quality control of compounded medications, it also...
In addition to the numerous physical, chemical, instrumental, and microbiological tests commonly utilized in the quality control of compounded medications, it also seems appropriate to incorporate visual testing and photodocumentation to provide additional assurance supporting the quality of compounded medications. This article provides a brief listing of what is needed, along with a description of simple procedures, to establish photodocumentation in a compounding pharmacy.
Topics: Documentation; Drug Compounding; Pharmaceutical Services; Pharmacies; Photography; Quality Control
PubMed: 35413010
DOI: No ID Found