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Obstetrics and Gynecology Dec 2021To assess pharmacy participation in and accessibility of pharmacist-prescribed contraception after legislation effective in the state of Utah in 2019.
OBJECTIVE
To assess pharmacy participation in and accessibility of pharmacist-prescribed contraception after legislation effective in the state of Utah in 2019.
METHODS
A secret-shopper telephone survey was used to assess participation in pharmacist-prescribed contraception. Geospatial analysis was used to map the distribution of participating pharmacies by population characteristics.
RESULTS
Of all operating Class A retail pharmacies in Utah, 127 (27%) were providing pharmacist-prescribed contraception 1 year after implementation of the Utah standing order. Oral contraceptive pills were widely accessible (100%); however, other allowed methods were not (vaginal ring 14%; contraceptive patch 2%). Consultation fees and medication costs varied widely. Participating pharmacies were mainly concentrated in population centers. Assuming access to a personal vehicle, urban areas with a high percentage of Hispanic people (Utah's largest minority race or ethnicity group) have access to a participating pharmacy within a 20-minute driving distance. However, access in rural areas with a high percentage Hispanic or other minority were limited. We identified 235 (40%) census tracts with a high proportion of Utah's residents living below the poverty line or of minority race or ethnicity who also had low access to pharmacist-prescribed contraception.
CONCLUSIONS
Although the pharmacy-based model is intended to increase access to contraception, practical availability 1 year after the authorization of pharmacist-prescribed contraception in Utah suggests that this service does not adequately serve rural areas, particularly rural areas with a high proportion of minorities and those living below the federal poverty line.
Topics: Adolescent; Adult; Contraception; Drug Costs; Female; Health Plan Implementation; Health Services Accessibility; Hispanic or Latino; Humans; Male; Middle Aged; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy; Poverty; Referral and Consultation; Rural Population; Utah; Young Adult
PubMed: 34735383
DOI: 10.1097/AOG.0000000000004594 -
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 -
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 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 -
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 -
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 -
BMC Health Services Research Nov 2022Pharmacists in Canada are assuming an increasingly important role in the provision of primary care services. This raises questions about access to pharmacy services...
BACKGROUND
Pharmacists in Canada are assuming an increasingly important role in the provision of primary care services. This raises questions about access to pharmacy services among those with medical care needs. While there is evidence on proximity of residents of Ontario and Nova Scotia to community pharmacies, there is little evidence for the rest of Canada. I thus measured the availability of pharmacist services, both the number of community pharmacies and their hours of operation, at both the provincial and sub-provincial level in Canada. Next, I measured associations of indicators of medical need and the availability of pharmacist services across sub-provincial units.
METHODS
I collected data, for each Forward Sortation Area (FSA), on medical need, measured using the fraction of residents aged 65 + and median household income, and pharmacist service availability (the number of community pharmacies and their hours of operation, divided by the FSA population). Linear regression methods were used to assess associations of FSA-level service availability and medical need.
RESULTS
There are between 2.0 and 3.3 community pharmacies per 10,000 population, depending on the province. There are also provincial variations in the number of hours that pharmacies are open. Quebec pharmacies were open a median of 75 h a week. In Manitoba, pharmacies were open a median of 53 h a week. The per capita number of pharmacies and their total hours of operation at the FSA level tend to be higher in less affluent regions and in which the share of residents is aged 65 or older. Provincial differences in pharmacy availability were still evident after controlling for medical need.
CONCLUSION
Community pharmacies in Canada tend to locate where indicators of health needs are greatest. The impact on patient health outcomes of these pharmacy locational patterns remains an area for future research.
Topics: Humans; Pharmacies; Community Pharmacy Services; Pharmacists; Pharmacy; Nova Scotia
PubMed: 36329439
DOI: 10.1186/s12913-022-08709-5 -
PloS One 2022Conducting high quality investigator-initiated trials (IITs) is challenging and costly. The costs of investigational medicinal products (IMPs) in IITs and the role of...
BACKGROUND
Conducting high quality investigator-initiated trials (IITs) is challenging and costly. The costs of investigational medicinal products (IMPs) in IITs and the role of hospital pharmacies in the planning of IITs are unclear. We conducted a mixed-methods study to compare planned and actual costs of IMPs in Swiss IITs, to examine potential reasons for differences, and to gather stakeholder views about hospital services for IITs.
METHODS
We included all IITs with IMP services from the Basel hospital pharmacy invoiced between January 2014 and June 2020 (n = 24). We documented trial and IMP characteristics including planned and actual IMP costs. Our working definition for a substantial cost difference was that the actual IMP costs were more than 10% higher than the planned IMP costs in a trial. We conducted semi-structured interviews with investigators, clinical trials unit and hospital pharmacy staff, and qualitatively analyzed transcribed interviews.
RESULTS
For 13 IITs we observed no differences between planned and actual costs of IMPs (median, 11'000 US$; interquartile range [IQR], 8'882-16'302 US$), but for 11 IITs we found cost increases from a median of 11'000 US$ (IQR, 8'922-36'166 US$) to a median over 28'000 US$ (IQR, 13'004-49'777 US$). All multicenter trials and 10 of 11 IITs with patients experienced substantial cost differences. From the interviews we identified four main themes: 1) Patient recruitment and organizational problems were identified as main reasons for cost differences, 2) higher actual IMP costs were bearable for most investigators, 3) IMP services for IITs were not a priority for the hospital pharmacy, and 4) closer collaboration between clinical trial unit and hospital pharmacy staff, and sufficient staff for IITs at the hospital pharmacy could improve IMP services.
CONCLUSIONS
Multicenter IITs enrolling patients are particularly at risk for higher IMP costs than planned. These trials are more difficult to plan and logistically challenging, which leads to delays and expiring IMP shelf-lives. IMP services of hospital pharmacies are important for IITs in Switzerland, but need to be further developed.
Topics: Humans; Organizations; Pharmacies; Pharmacy Service, Hospital; Research Personnel
PubMed: 35245312
DOI: 10.1371/journal.pone.0264427 -
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