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Disaster Medicine and Public Health... Feb 2020The aim of this study was to analyze pharmacy functionality, or the volume of operational pharmacies, among areas in North Carolina and South Carolina affected by...
OBJECTIVES
The aim of this study was to analyze pharmacy functionality, or the volume of operational pharmacies, among areas in North Carolina and South Carolina affected by Hurricane Florence.
METHODS
Using geographic information system software and data from the Federal Emergency Management Agency and Healthcare Ready, we computed, mapped, and analyzed pharmacy functionality measures for the period of September 12, 2018, through September 20, 2018, among counties in North Carolina and South Carolina to examine health-care-related disaster readiness for and response to Hurricane Florence.
RESULTS
In the Hurricane Florence-impacted region, counties located along the coast had the most suboptimal pharmacy functionality, whereas counties located more centrally within North Carolina and South Carolina had more optimal pharmacy functionality throughout the disaster. Generally, functionality was high at Hurricane Florence's landfall on September 14, 2018, for which operating pharmacy capacity was reported at 85% in North Carolina and 88% in South Carolina. Both states had the lowest functionality on September 16, 2018, at 71% for North Carolina and 62% for South Carolina.
CONCLUSIONS
During the Hurricane Florence event, suboptimal pharmacy functionality was detected for coastal areas and during the disaster response period. Hurricane readiness plans and infrastructure strengthening should be emphasized for community pharmacies in hurricane-prone areas.
Topics: Cyclonic Storms; Humans; North Carolina; Pharmacies; South Carolina; Surge Capacity
PubMed: 31791439
DOI: 10.1017/dmp.2019.114 -
Cannabis and Cannabinoid Research Apr 2022Different countries have employed a variety of methods for their populace to access medical cannabis. The purpose of this literature review was to assess the... (Review)
Review
Different countries have employed a variety of methods for their populace to access medical cannabis. The purpose of this literature review was to assess the international literature on pharmacists' beliefs and attitudes towards medical cannabis. This literature review summarized the various countries that utilize pharmacies and pharmacists to dispense medical cannabis. The countries included in this review were: Australia, Canada, Denmark, Finland, Germany, Israel, Italy, Netherlands, Poland, Serbia, Switzerland, USA, and Uruguay. The pharmacist perspective has been of key importance within the medical landscape, as they are the ones who not only dispense medication but also counsel and monitor patients and it is this perspective that is lacking. Overall, this review found that even though pharmacists are generally comfortable with dispensing medical cannabis; they still require further education to do so as safely and effectively as possible.
Topics: Attitude; Germany; Humans; Medical Marijuana; Pharmacies; Pharmacists
PubMed: 33998897
DOI: 10.1089/can.2020.0144 -
PloS One 2022The burden of mental health problems continues to grow worldwide. Community pharmacists', as part of the primary care team, optimise care for people living with mental...
The burden of mental health problems continues to grow worldwide. Community pharmacists', as part of the primary care team, optimise care for people living with mental illness. This study aims to examine the factors that support or hinder the delivery of mental health services delivered in Australian community pharmacies and proposes ideas for improvement. A qualitative study was conducted comprising focus groups with community pharmacists and pharmacy staff across metropolitan, regional, and rural areas of New South Wales, Australia. Data were collected in eight focus groups between December 2020 and June 2021. Qualitative data were analysed using thematic analysis. Thirty-three community pharmacists and pharmacy staff participated in an initial round of focus groups. Eleven community pharmacists and pharmacy staff participated in a second round of focus groups. Twenty-four factors that enable or hinder the delivery of mental health services in community pharmacy were identified. Participant's perception of a lack of recognition and integration of community pharmacy within primary care were identified as major barriers, in addition to consumers' stigma and lack of awareness regarding service offering. Suggestions for improvement to mental health care delivery in community pharmacy included standardised practice through the use of protocols, remuneration and public awareness. A framework detailing the factors moderating pharmacists, pharmacy staff and consumers' empowerment in mental health care delivery in community pharmacy is proposed. This study has highlighted that policy and funding support for mental health services is needed that complement and expand integrated models, promote access to services led by or are conducted in collaboration with pharmacists and recognise the professional contribution and competencies of community pharmacists in mental health care. The framework proposed may be a step to strengthening mental health support delivered in community pharmacies.
Topics: Attitude of Health Personnel; Australia; Community Pharmacy Services; Humans; Mental Health Services; Pharmacies; Pharmacists; Professional Role
PubMed: 35551556
DOI: 10.1371/journal.pone.0268259 -
Research in Social & Administrative... Jul 2021Longitudinal placements are defined as involving "a regular, recurrent placement in the same setting with the same supervisor over a period of time". "Continuity" is the...
BACKGROUND
Longitudinal placements are defined as involving "a regular, recurrent placement in the same setting with the same supervisor over a period of time". "Continuity" is the organising principle for promoting learning through continuity of care, curriculum and supervision. Longitudinal placements are widely used in medicine, but less is known about their use in pharmacy and whether the educational principles translate to community pharmacy practice.
OBJECTIVE
This study sought to explore if a longitudinal community pharmacy placement (LCPP) for Year 2 pharmacy students promoted learning through student patient-centeredness, curricular integration, and growing professional engagement.
METHODS
An explanatory mixed methods study design was used. Quantitative data for the study was collected prior to and after the LCPP using a questionnaire incorporating a validated measure of professional engagement and items relating to patient-centeredness and curriculum integration. Pre and post-responses were compared using the Wilcoxon-signed rank test. To further understand the quantitative findings, semi-structured interviews were conducted with students, supervisors and practice-educators and thematically analysed through a constructivist lens.
RESULTS
There was a 78% response rate (47/60 paired responses) to the questionnaire and 25 interviews were conducted. There was quantitative and qualitative evidence of patient connection during LCPPs, yet some students had limited opportunities to connect with people. Curriculum integration was enhanced by the longitudinal nature of the placement. There was a significant increase in the sum scores of the S-PIPE instrument indicating enhanced professional engagement. Qualitatively there was evidence that engagement was promoted through role modelling and supervision, but continuity was compromised with changing supervisors.
CONCLUSIONS
An early LCPP promotes learning by providing opportunities for curriculum integration and professional engagement. It may be worth considering as a way to enhance integration through experiential learning in curriculum design. The placement needs to be of a sufficient length to enable repeated patient interaction and ideally provide continuity of supervision for maximum benefit.
Topics: Curriculum; Humans; Learning; Pharmacies; Students, Pharmacy
PubMed: 33060020
DOI: 10.1016/j.sapharm.2020.10.001 -
Human Resources For Health Jan 2022The Portuguese Pharmaceutical Society (PPS) implemented a system of Continuous Professional Development (CPD) for pharmacists in 2004. This system has evolved throughout... (Review)
Review
BACKGROUND
The Portuguese Pharmaceutical Society (PPS) implemented a system of Continuous Professional Development (CPD) for pharmacists in 2004. This system has evolved throughout the years, and currently all active pharmacists in Portugal are required to participate in the CPD program. Each CPD cycle takes 5 years. In each cycle, pharmacists must collect 15 CPD points, through participation in educational activities. The PPS accreditation process is managed via an online platform, where education/training providers, as well as pharmacists themselves, can submit educational activities for accreditation. Pharmacists may access their CPD status and assess their development at any point. The objective of this study was to analyze and review the educational activities submitted by providers over a 11-year period (2009-2019).
METHODS
Data from activities were retrieved from the PPS CPD online platform. All educational activities were labeled according to the area of pharmaceutical professional focus, type of promoter, and activity type.
RESULTS
During the study 3685 activities were analyzed. Over the last decade, submitted activities for accreditation increased in 52.6%. A significantly high proportion (98.9%) of these activities has been accredited. Promoters of activities were mostly pharmacies sectoral associations (29.6%), consultancy/training companies (19.6%), the PPS (18.5%), pharmaceutical industry (17.7%) and wholesalers' consortia (9.0%). Academia represented only 2.3% of the total amount of educational activities. The most frequent topics were related to "pharmacology & pharmacotherapy" (9.9%), followed by "counselling" (9.8%) and "management & administration" (7.2%). The most accredited type of activities was face-to-face (68.9%) and e-learning trainings (13.1%).
CONCLUSIONS
This study shows increasing interest in submitting CPD activities for accreditation between 2009 and 2019, but it also demonstrates that Academia could play a more interventive role in the lifelong learning education of Portuguese pharmacists.
Topics: Accreditation; Education, Pharmacy, Continuing; Humans; Pharmacies; Pharmacists; Pharmacy
PubMed: 34991616
DOI: 10.1186/s12960-021-00700-1 -
JAMA Health Forum Nov 2023Pharmacy benefit managers (PBMs) play a major role in the provision of pharmacy services by acting as intermediaries between pharmacies, plan sponsors (insurance...
IMPORTANCE
Pharmacy benefit managers (PBMs) play a major role in the provision of pharmacy services by acting as intermediaries between pharmacies, plan sponsors (insurance companies and employers), pharmaceutical manufacturers, and drug wholesalers. As their role and visibility have increased, PBMs have come under increased scrutiny from policymakers. However, no prior literature has systematically described the history, business practices, and policymaking of PBMs.
OBJECTIVE
To provide an overview of the PBM industry, including its history, the evolution of services provided by PBMs, an assessment of the current policy landscape, and analysis of how proposed policies could affect PBM practices and patient care.
EVIDENCE
This work reviews historical events; previous and current industry practices and publications; prior academic literature, existing statutes, regulations, and court cases; and recent legislative reforms and agency actions regarding PBMs.
FINDINGS
Pharmacy benefit managers evolved in parallel with the pharmaceutical manufacturing and health insurance industries. The evolution of the PBM industry has been characterized by horizontal and vertical integration and market concentration. The PBM provides 5 key functions: formulary design, utilization management, price negotiation, pharmacy network formation, and mail order pharmacy services. Criticism of the PBM industry centers around the lack of competition, pricing, agency problems, and lack of transparency. Legislation to address these concerns has been introduced at the state and federal levels, but the potential for these policies to address concerns about PBMs is unknown and may be eclipsed by private sector responses.
CONCLUSIONS AND RELEVANCE
Pharmacy benefit managers are intermediaries in the pharmaceutical supply chain and perform multiple roles in the management and distribution of pharmaceuticals to patients. When regulating PBMs, it is important to adopt policies that address market failure problems by improving PBM competition as opposed to policies designed to serve the narrow financial interests of other market participants (eg, pharmacies, pharmaceutical manufacturers) without meeting the needs of consumers.
Topics: Humans; Pharmacies; Insurance, Pharmaceutical Services; Pharmaceutical Services; Policy; Pharmacy; Pharmaceutical Preparations
PubMed: 37921745
DOI: 10.1001/jamahealthforum.2023.3804 -
BMC Medical Informatics and Decision... Nov 2022Drug closed-loop management reflects the level of hospital management and pharmacist service. It is a challenge for hospital pharmacists to realize the whole-process...
BACKGROUND
Drug closed-loop management reflects the level of hospital management and pharmacist service. It is a challenge for hospital pharmacists to realize the whole-process closed-loop management of drugs in hospital pharmacies. Therefore, this study aimed to evaluate the operational effect of using mobile technology to build a closed-loop drug management system.
METHODS
Using mobile technology, replacing the traditional paper dispensing model and constructing a multinode information collection system according to the Healthcare Information and Management Systems Society Standard, we reformed the hospital information system and inpatient pharmacy workflow and then evaluated the new approach using statistical methods.
RESULTS
After the transformation, the entire process of drug data can be traced. Closed-loop management, as well as real-time data verification and control, thereby improves the work efficiency and reduces the drug dispensing time. By reducing the work error rate, the number of dispensing errors decreased from 5 to 1 case/month. The comprehensive dispensing process can achieve the whole workflow of paperless operation and reduce the use of paper A4 by 180,000 pieces per year.
CONCLUSIONS
Mobile technology can improve the service level of pharmacies, enhance the level of drug management and hospital quality management, ensure the safety of medication for inpatients, and significantly reduce the amount of paper used.
Topics: Humans; Health Facilities; Hospital Information Systems; Hospital Units; Pharmacies; Technology; Pharmacy Service, Hospital; Workflow
PubMed: 36443815
DOI: 10.1186/s12911-022-02067-2 -
Frontiers in Public Health 2020To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty... (Review)
Review
To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was "frequency of telephone follow-up to monitor adverse drug reactions (ADRs), "followed by "mode of drug delivery," "provider of medication guidance services," and "availability of medical insurance consultation"; the least important attribute was "business hours." A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (β = -0.23, < 0.001) and business hours [8:30-20:00 (Monday to Friday), 8:30-17:30 (weekend)] (β = -0.12, < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Preference measurements showed that "frequency of telephone follow-up to monitor ADRs" had the most critical impact on decisions, followed by "mode of drug delivery." Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.
Topics: Adult; China; Community Pharmacy Services; Female; Humans; Male; Patient Preference; Pharmacies; Surveys and Questionnaires
PubMed: 33363089
DOI: 10.3389/fpubh.2020.597389 -
Research in Social & Administrative... Nov 2022Primary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being... (Review)
Review
BACKGROUND
Primary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being trained to deliver mental health care. However, there is still a gap in the literature exploring the characteristics of all available mental health training programs and their components and their influence on pharmacists, pharmacy staff and students' outcomes.
OBJECTIVES
To summarize the evidence evaluating mental health training programs completed by community pharmacists, pharmacy staff and students. More specifically, to explore the components of mental health training programs and identify those that facilitate significant improvements in outcomes.
METHODS
A systematic review was conducted following the Cochrane handbook and reported according to PRISMA guidelines. A search for published literature was conducted in three databases (PubMed, Scopus, and Web of Science) in July 2021. Eligible studies were included if they described and evaluated the impact of mental health training programs delivered to community pharmacists, pharmacy staff and pharmacy students regardless of design or comparator. The methodological quality of included studies was appraised using both the NIH quality assessment, to evaluate studies with an uncontrolled pre-post design, and the Cochrane EPOC risk of bias assessment, to evaluate studies with a controlled (randomized and non-randomized) study design.
RESULTS
Thirty-three studies were included. Most of the identified mental health training programs contained knowledge-based components and active learning activities. Changes in participants' attitudes, stigma, knowledge, confidence and skills were frequently assessed. An extensive range of self-assessment and observational instruments used to evaluate the impact of the training programs were identified. Positive improvements in participants' attitudes, knowledge and stigma were frequently identified following participation in training programs.
CONCLUSIONS
This systematic review highlights the importance of mental health training programs in increasing pharmacists', pharmacy staff and pharmacy students' skills and confidence to deliver mental health care in community pharmacy. Future research should build upon this basis and further focus on finding the most efficient measures to evaluate these training programs and assess their long-term effectiveness, allowing comparison between programs.
Topics: Humans; Mental Health; Pharmacies; Pharmacists; Pharmacy; Students, Pharmacy; Education, Pharmacy; Controlled Clinical Trials as Topic
PubMed: 35778317
DOI: 10.1016/j.sapharm.2022.06.006 -
The American Journal of Managed Care Mar 2022To estimate the association of 340B contract pharmacy growth between 2009 and 2019 with county-level characteristics, including availability of health care providers,... (Observational Study)
Observational Study
OBJECTIVES
To estimate the association of 340B contract pharmacy growth between 2009 and 2019 with county-level characteristics, including availability of health care providers, health care spending, population, and socioeconomic characteristics.
STUDY DESIGN
Observational study.
METHODS
We constructed county-level maps of 340B contract pharmacy penetration for the years 2009 and 2019 by 340B participant type (hospital or safety-net clinic). We then used a multivariable linear probability regression model to estimate the association of county-level characteristics in 2009 with the probability of gaining at least one 340B contract pharmacy within the county by 2019. We estimated separate regressions for safety-net clinics and hospitals.
RESULTS
We find that growth of contracts with 340B hospitals was uncorrelated with uninsured rates, poverty rates, or areas of medical underservice. By contrast, we find that growth of contracts with 340B safety-net clinics was positively correlated with poverty rates and metropolitan statistical status. These findings suggest different patterns of access for patients.
CONCLUSIONS
Our results add systematic evidence of a difference in how the 2 main types of 340B participants-hospitals and safety-net clinics-use the 340B program. Policy proposals to reform 340B should consider reforms for safety-net clinics and hospitals separately.
Topics: Drug Costs; Humans; Pharmaceutical Services; Pharmacies; Pharmacy; Prescription Drugs; Safety-net Providers; United States
PubMed: 35404549
DOI: 10.37765/ajmc.2022.88840