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BMC Veterinary Research Jun 2022Veterinary medicines have been widely used for the prevention and treatment of animal diseases. Globally, the veterinary medicine industry is growing. However, there is...
BACKGROUND
Veterinary medicines have been widely used for the prevention and treatment of animal diseases. Globally, the veterinary medicine industry is growing. However, there is a significant increase of concern on the quality of veterinary medicines in various developing countries' legal markets. Poor-quality medicines are associated with treatment failure, development of drug resistance, increased healthcare cost, and death. These reasons warrant a need for monitoring the quality of the medicines circulating in the Tanzania Mainland.
METHODS
This was a survey study and veterinary medicines samples were collected from 9 out of 26 regions of Tanzania mainland between 2014 and 2017. Veterinary medicines were sampled from wholesale pharmacies, retail pharmacies, veterinary clinics and Veterinary Accredited Drug Dispensing Outlets (ADDO-vet). All sampled medicines were subjected to product information review and full quality control testing at the Tanzania Medicines and Medical Devices Authority-World Health Organization prequalified laboratory.
RESULTS
A total of 238 samples of veterinary medicines were collected. Out of these, 97.1% (231/238) were subjected to full quality control testing and product information review. All sampled veterinary medicines conformed to visual appearance, clarity, pH, solubility and sterility tests. Also, of the sampled veterinary medicines 97.8% (226/231) and 89.2% (206/231) passed identification and assay tests, respectively. As well as, the majority of the collected samples 92% (219/238) failed to comply with product information requirements. The most observed deficiencies on product information were inadequate information on the package insert 94.1% (224/238), inappropriate storage conditions 55.5% (132/238) and lack of Tanzania registration number 27% (64/238).
CONCLUSION
Veterinary medicines with poor quality were found circulating in the legal markets of Tanzania. This can potentiate treatment failure and the development of drug resistance in animals and humans. Post marketing surveillance program will continue to be implemented to ensure that only good quality, safe and efficacious medicines are circulating in the Tanzania Mainland market.
Topics: Animals; Drug Industry; Marketing; Pharmacies; Product Surveillance, Postmarketing; Tanzania
PubMed: 35681204
DOI: 10.1186/s12917-022-03329-x -
Health Research Policy and Systems Feb 2021Licences to operate pharmacy premises are issued by statutory regulatory bodies. The Health Institutions and Facilities Act (Act 829) and Health Professions Regulatory...
BACKGROUND
Licences to operate pharmacy premises are issued by statutory regulatory bodies. The Health Institutions and Facilities Act (Act 829) and Health Professions Regulatory Bodies Act (Act 857) regulate pharmacy premises and the business of supplying restricted medicines by retail, respectively, and this could create a potential regulatory overlap for pharmacy practice in Ghana. We theorise that the potential overlap of regulation duties stems from how law-makers framed issues and narratives during the formulation of these Acts.
OBJECTIVE
To describe the policy actors involved, framing of narratives and decision-making processes relating to pharmacy premises licensing policy formulation.
METHODS
A qualitative study was conducted and data gathered through interviewing eight key informants and reviewing Hansards, reports, bills, memoranda and Acts 829 and 857. Data were analysed to map decision-making venues, processes, actors and narratives.
RESULTS
The Ministry of Health drafted the bills in July 2010 with the consensus of internal stakeholders. These were interrogated by the Parliament Select Committee on Health (with legislative power) during separate periods, and decisions made in Parliament to alter propositions of pharmacy premises regulations. Parliamentarians framed pharmacies as health facilities and reassigned their regulation from the Pharmacy Council to a new agency. The Pharmacy Council and the Pharmaceutical Society of Ghana could not participate in the decision-making processes in Parliament to oppose these alterations. The laws' contents rested with parliamentarians as they made decisions in venues restricted to others. Legislative procedure limited participation, although non-legislative actors had some level of influence on the initial content.
CONCLUSION
Implementation of these laws would have implications for policy and practice and therefore understanding how the laws were framed and formulated is important for further reforms. We recommend additional research to investigate the impact of the implementation of these Acts on pharmacy practice and business in Ghana and the findings can serve as bargaining information for reforms.
Topics: Ghana; Health Policy; Humans; Licensure; Pharmacies; Pharmacy
PubMed: 33557856
DOI: 10.1186/s12961-021-00680-7 -
BMJ Open Nov 2021The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health...
OBJECTIVES
The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities.
DESIGN
Three databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Scholar) were systematically searched for articles published after 2000, reporting on the effectiveness of HEA. Title and abstracts were screened according to an eligibility criteria to identify studies which included a full audit cycle (eg, initial equity analysis, service changes and review). Data were extracted from studies meeting the eligibility criteria after full text review and risk of bias assessed using the ROBINS-I tool.
RESULTS
The search strategy identified 596 articles. Fifteen records were reviewed in full text and three records were included in final review. An additional HEA report was identified through contact with an author. Three different HEAs were included from one peer-reviewed journal article, two published reports and one unpublished report (n=4 records on n=3 HEAs). This included 102 851 participants and over 148 practices/pharmacies (information was not recorded for all records). One study reviewed health equity impacts of HEA implementation in key indicators for coronary heart disease, type 2 diabetes and chronic obstructive pulmonary disease. Two HEAs explored Stop Smoking Services on programme access and equity. All reported some degree of reduction in health inequalities compared with prior HEA implementation. However, impact of HEA implementation compared with other concurrent programmes and initiatives was unclear. All included studies were judged to have moderate to serious risk of bias.
CONCLUSIONS
There is an urgent need to identify effective interventions to address health inequalities. While HEAs are recommended, we only identified limited weak evidence to support their use. More evidence is needed to explore whether HEA implementation can reduce inequalities and which factors are influencing effectiveness.
TRIAL REGISTRATION NUMBER
The study was registered prior to its conduction in PROSPERO (CRD 42020218642).
Topics: Coronary Disease; Diabetes Mellitus, Type 2; Health Equity; Humans; Pharmacies
PubMed: 34764176
DOI: 10.1136/bmjopen-2021-053392 -
British Journal of Clinical Pharmacology Oct 2022Sixty-four million pharmacy-filled multicompartment medication compliance aids (MCAs) are dispensed by pharmacies in England each year. Despite the widespread use of...
AIMS
Sixty-four million pharmacy-filled multicompartment medication compliance aids (MCAs) are dispensed by pharmacies in England each year. Despite the widespread use of MCAs and evidence that their use may be associated with harm there is no national consensus regarding MCA provision by acute hospital Trusts in England. The aim was to determine current practice for initiation and supply of MCAs in acute hospital Trusts in England and the potential consequences for patients and hospitals.
METHODS
A 26-item survey was distributed to all acute hospital Trusts in England. The questionnaire covered: policy, initiation, supply and review of MCAs; alternatives offered; and pharmacy staffing and capacity related to MCAs.
RESULTS
Seventy-two out of 138 (52%) Trusts responded to the survey: 70 Trusts responded regarding policy for MCA provision, with 60 (86%) having a policy regarding this; 33/55 (60%) that supplied MCAs on discharge supplied a different prescription length for MCA vs. non-MCA prescriptions; 49/55 (89%) Trusts provided only 1 brand of MCA; 47/55 (85%) MCA-supplying Trusts identified frequent difficulties with MCAs and 13/55 (24%) reported employing staff specifically to complete MCAs; and 30/35 (86%) MCA-initiating Trusts had an assessment process for initiation, with care agency request reportedly the most common reason for initiation.
CONCLUSION
There is a lack of a national approach to MCA provision and initiation by acute hospital Trusts in England. This leads to significant variation in care and has the potential to put MCA users at an increased risk of medication-related harm.
Topics: England; Humans; Medication Adherence; Pharmacies; Surveys and Questionnaires
PubMed: 35510733
DOI: 10.1111/bcp.15386 -
International Journal of Clinical... Dec 2021Background Studies have demonstrated the potential for patient feedback to inform quality care as well as a direct relationship between patient experience and clinical...
Background Studies have demonstrated the potential for patient feedback to inform quality care as well as a direct relationship between patient experience and clinical outcomes. Over recent years, there has been increasing use of online patient feedback platforms, however, there has been little study of the content of patient feedback relating to pharmacy and pharmacy services. Objective This study explores the content of online feedback provided by patients from across the UK in relation to their experiences of their interaction with pharmacy staff and pharmacy services. Main outcome measure Content of online patient feedback relating to pharmacy. Method Patient stories published on Care Opinion, a national online patient feedback platform, for a one-year period were searched for all content relating to patients' pharmacy experiences. A thematic and sentiment analysis was conducted on 237 patient stories. Results Patient stories related to supply, staff attitudes, services, accessibility, systems, and errors. Patient sentiment depended on pharmacy setting, but staff attitudes, services, and accessibility were generally positive across all settings. Waiting time was the most common complaint in both hospital and community pharmacies with stories relaying experiences of slow discharge, stock shortages and poor communication and collaboration between pharmacies and GP surgeries. Conclusions Online patient feedback highlighted factors important to patients when interacting with pharmacies and their staff. Medication supply was the primary topic of patient stories with waiting times and stock shortages being clear areas for improvement; however, accessibility, pharmacy services and advice were key strengths of the profession. Further research is needed to understand how online patient feedback can be used effectively to inform improvements in pharmacy services.
Topics: Community Pharmacy Services; Feedback; Humans; Pharmacies; Pharmacists; Pharmacy; Sentiment Analysis
PubMed: 34146233
DOI: 10.1007/s11096-021-01287-2 -
Journal of Medical Internet Research Feb 2022There is much public debate regarding the high cost of insulin. With 1-in-4 patients in the United States with type 1 diabetes reporting difficulties affording insulin,...
BACKGROUND
There is much public debate regarding the high cost of insulin. With 1-in-4 patients in the United States with type 1 diabetes reporting difficulties affording insulin, there is concern that some of these patients might look for cost savings on the internet, unaware that 96% of internet pharmacies are illegitimate. Patients who purchase insulin from illegitimate internet pharmacies remove themselves from traditional health care systems that ensure safe, quality-assured, and effective medication use.
OBJECTIVE
This study aims to determine the accessibility of Humalog and NovoLog insulin from internet pharmacies and characterize how these sites approached patient safety, and priced as well as marketed their products.
METHODS
From September to December 2019, we queried the phrases buy insulin online, buy Humalog online, and buy NovoLog online in common search engines. The first 100 search results from Google and Bing, and the first 50 search results from Yahoo! and DuckDuckGo were screened. Websites were included if they claimed to sell Humalog or NovoLog insulin, were active, free access, in the English language, and had a unique URL. The legitimacy of websites was classified using LegitScript. Safety and marketing characteristics were compared across the legitimacy of internet pharmacies. Internet pharmacy prices were compared with the prices offered through brick-and-mortar pharmacies using GoodRx.
RESULTS
We found that 59% (n=29) of the 49 internet pharmacies in our analysis were illegitimate, whereas only 14% (n=7) were legitimate and 27% (n=13) were unclassified. Across illegitimate internet pharmacies, Humalog and NovoLog insulin were 2 to 5 times cheaper as compared with both legitimate internet pharmacies and brick-and-mortar stores. Risks associated with the use of illegitimate internet pharmacies by American consumers were evident: 57% (8/14) did not require a prescription, 43% (6/14) did not display medication information or warnings, and only 21% (3/14) offered access to purported pharmacists. This included 9 rogue internet pharmacies that sold Humalog and NovoLog insulin within the United States, where 11% (1/9) required a prescription, 11% (1/9) placed quantity limits per purchase, and none offered pharmacist services. Rogue internet pharmacies often offered bulk discounts (11/18, 61%), assured privacy (14/18, 78%), and promoted other products alongside insulin (13/18, 72%). The marketing language of illegitimate internet pharmacies appealed more to quality, safety, and customer service as compared with legitimate sites.
CONCLUSIONS
The ease of access to low-cost insulin through illegitimate internet pharmacies calls for urgent attention. Illegitimate internet pharmacies place patients at risk of poor-quality medications and subpar pharmacy services, resulting in adverse events and poor diabetes control. A multifaceted approach is needed to close illegitimate internet pharmacies through legal and regulatory measures, develop better search engine filters, raise public awareness of the dangers of illegitimate internet pharmacies, and address the high costs of insulin.
Topics: Cross-Sectional Studies; Humans; Insulins; Internet; Marketing; Pharmacies; United States
PubMed: 35156937
DOI: 10.2196/25855 -
Tidsskrift For Den Norske Laegeforening... Sep 2020The summary care record receives a copy of all electronic prescriptions and their dispensing by Norwegian pharmacies. Some electronic prescriptions expire without being...
BACKGROUND
The summary care record receives a copy of all electronic prescriptions and their dispensing by Norwegian pharmacies. Some electronic prescriptions expire without being dispensed, in whole or in part. The purpose of the study was to ascertain how many electronic prescriptions passed their expiry date without being dispensed, and what type of prescriptions these were.
MATERIAL AND METHOD
All electronic prescriptions and dispensations for the period 1 March 2016-1 March 2018 were extracted anonymously from the summary care record. The number of prescriptions that expired without being dispensed was added up and classified according to the drug prescribed. The percentage of uncollected prescriptions was calculated for each drug.
RESULTS
Of 47 771 233 registered electronic prescriptions in the period, 5 934 589 (12 %) expired without having been dispensed. The proportion of non-dispensed electronic prescriptions varied within the individual drug groups from 4 % for Z-hypnotics to 49 % for glucagon.
INTERPRETATION
The study indicates that several reasons exist for the non-dispensing of prescriptions.
Topics: Drug Prescriptions; Electronic Prescribing; Humans; Pharmacies; Prescription Drugs
PubMed: 32998490
DOI: 10.4045/tidsskr.19.0577 -
Journal of Managed Care & Specialty... Mar 2023The AMCP Abstract and Poster Program provides a forum for authors to share their research with the managed care pharmacy community. Authors submit their abstracts to... (Review)
Review
The AMCP Abstract and Poster Program provides a forum for authors to share their research with the managed care pharmacy community. Authors submit their abstracts to AMCP, and each abstract is reviewed by a team of peer reviewers and editors. All accepted abstracts are presented as posters at AMCP's Annual and Nexus meetings. These abstracts are also available through the AMCP meeting app. This JMCP supplement publishes all abstracts that were peer reviewed and accepted for presentation at AMCP 2023. Abstracts submitted in the Student and Encore categories did not undergo peer review; therefore, these abstracts are not included in the supplement.
Topics: Humans; Pharmacy; Publishing; Pharmacies; Managed Care Programs; Community Pharmacy Services
PubMed: 37877441
DOI: 10.18553/jmcp.2023.29.3-a.s1 -
PloS One 2023Adherence to antiretroviral therapy (ART) remains the main predictor of sustained HIV virologic suppression for people with HIV (PWH). Mail-order pharmacy services are...
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Topics: Humans; Male; Middle Aged; Female; Cohort Studies; Cross-Sectional Studies; Pharmaceutical Services; Pharmacy; Pharmacies; Anti-Retroviral Agents
PubMed: 37220118
DOI: 10.1371/journal.pone.0285694 -
Journal of the American Pharmacists... 2021The uptake of point-of-care testing (POCT) within community pharmacies at state and national levels is largely unknown despite the endorsement and advocacy efforts of...
BACKGROUND
The uptake of point-of-care testing (POCT) within community pharmacies at state and national levels is largely unknown despite the endorsement and advocacy efforts of pharmacy organizations, recent legislative advances, and numerous models for successful POCT implementation within individual pharmacy sites.
OBJECTIVES
The study aimed to describe the current landscape of POCT in Wisconsin community pharmacies and identify opportunities for the advancement of testing and the key factors influencing the realization of these opportunities.
METHODS
A survey was administered over the telephone to pharmacy managers of community pharmacies in Wisconsin. The sites were randomly selected from predefined geographic regions to mirror pharmacy distribution across Wisconsin. The survey items evaluated provision of POCT, future direction of POCT, barriers and motivators to offering POCT, and pharmacy demographics. Descriptive statistics and thematic analysis were used to analyze data.
RESULTS
Pharmacy managers from 147 of the 938 registered community pharmacies (15.7%) participated in the survey. Only 17.1% of the pharmacies were offering POCT; however, 48.3% of managers reported that their pharmacy would likely implement or expand POCT within the next 5 years. The most commonly reported barriers to initiating or expanding POCT were the limitations on pharmacist availability to oversee testing and workflow restrictions. Continuing to advance the pharmacy profession was a top reason for offering or expanding testing services.
DISCUSSION
While few pharmacies are offering POCT in Wisconsin, there is motivation for expansion in coming years. Understanding, anticipating and addressing common barriers can faciliate this process.
CONCLUSION
This needs analysis offers a blueprint for researchers, educators, and clinicians to shape POCT efforts by examining the landscape of pharmacy-based testing in their own states and communities.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists; Pharmacy; Point-of-Care Testing
PubMed: 33431252
DOI: 10.1016/j.japh.2020.12.013