scholarly journals Policy and vision for community pharmacies in Finland: A roadmap towards enhanced integration and reduced costs

2021 ◽  
Vol 19 (1) ◽  
pp. 2288
Author(s):  
Marja Airaksinen ◽  
Terhi Toivo ◽  
Lenita Jokinen ◽  
Eeva Savela ◽  
Stina Parkkamäki ◽  
...  

Finland’s community pharmacy system provides an example of a privately-owned regulated system being proactively developed by the profession and its stakeholders. Community pharmacists have a legal duty to promote safe and rational medicine use in outpatient care. The development of professionally oriented practice has been nationally coordinated since the 1990s with the support of a national steering group consisting of professional bodies, authorities, pharmacy schools and continuing education centers. The primary focus has been in patient counseling services and public health programs. The services have extended towards prospective medication risk management applying evidence-based tools, databases and digitalization. Research has been essential in informing progress by indicating high-risk patients, medications, practices and processes needing improvement. Despite the commitment of the profession and pharmacy owners, large-scale implementation of services has been challenging because of lack of remuneration, the pharmacy income still consisting primarily of sale of prescription and nonprescription medicines. Policy documents by the Ministry of Social Affairs and Health have supported the extension of the community pharmacists’ role beyond traditional dispensing to promote rational pharmacotherapy. The current roadmap by the Ministry of Social Affairs and Health emphasizes ensuring adequate regional availability and accessibility of medicines, regardless of the future pharmacy system. It also emphasizes the importance of strong regulation on pharmacy business operations and sale of medicines to ensure medication safety. At the same time, the roadmap requires that the regulation must enable implementation of new patient-oriented services and procedures, and further promote digitalization in service provision. Competition and balance of funding should be enhanced, e.g., through price competition, but the risk of pharmaceutical market concentration should be managed. The regulation should also consider influence of the new social and health care system on drug delivery. Year 2021 will be crucial for making long-term political decisions on the future direction of tasks and finances of Finnish community pharmacies in this framework. Government-funded studies are underway to guide decision making. Ongoing Covid-19 crisis has demonstrated the readiness of Finnish community pharmacies to adapt fast to meet the changing societal needs.

Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.


2002 ◽  
Vol 36 (5) ◽  
pp. 781-786 ◽  
Author(s):  
Kirsti K Vainio ◽  
Marja SA Airaksinen ◽  
Tarja T Hyykky ◽  
K Hannes Enlund

OBJECTIVE: To assess the effect and importance of the therapeutic class of a drug as a determinant for verbal counseling by community pharmacists. METHODS: Direct external observations (n = 1431) of pharmacist—customer interactions at the point of delivery of prescription medicines were conducted in 7 community pharmacies in Finland. Trained observers noted whether the pharmacist provided information on directions for use, mode of action, and adverse effects. To examine factors associated with counseling, a multiple logistic regression analysis was constructed, with the dependent variable being counseling of any of the 3 observed topics. In addition to therapeutic class, other independent variables were the pharmacy; pharmacist's age, gender, and degree; and the customer's age, gender, previous use of medicine, and question asking. RESULTS: Provision of counseling differed significantly according to therapeutic classes. Counseling on any of the 3 observed topics was most likely to be provided for customers with antibiotics (80%) and least likely for customers with gynecologic preparations (18%). Differences between therapeutic classes remained statistically significant when the effects of the other variables were controlled for. Other significant predictors for any verbal counseling were the pharmacy, customer's previous use of the medicine, and question asking. CONCLUSIONS: Therapeutic class is an important variable that should be included in further studies and considered when comparing studies on patient counseling in community pharmacies.


2021 ◽  
Vol 25 (3) ◽  
pp. 686-691
Author(s):  
Khanda Hamasalih ◽  
Walid Nitham

Background and objective: Community pharmacists play an important role in the best use of drugs and in improving patient outcomes. Evidence demonstrates that pharmacists' counseling improves the quality of life, clinical outcomes, and drug and disease knowledge and reduces the utilization of health services. This study aimed to investigate the nature and extent of counseling practices of community pharmacists in community pharmacies in Sulaimani region of Kurdistan, Iraq. Methods: A cross-sectional survey was conducted in community pharmacies in Sulaimani city, in a one-month duration from November to December 2020. The sample size was 100 community pharmacies, which were selected randomly. The data were stored and analyzed using Excel 2016 and expressed as frequencies and percentages. Results: According to the completed questionnaires, about 78.8% of pharmacists would do counseling spontaneously each time they dispense any drug. Only 61% of the pharmacists would ask the patients if they understood what was said during their communication to assess the understanding of advice given to their patients. The most common barrier observed during patient counseling was the patient's lack of time. Conclusion: This study indicates that community pharmacists counsel the patients in an appropriate way. They provide information orally and in written form. However, further research is needed to evaluate the quality of patient counseling by using different methods like pseudo-patient methodology to gain real counseling data. Keywords: Counselling; Community pharmacist; Community pharmacy; Counselling barriers.


2014 ◽  
Vol 27 (4) ◽  
pp. 364-368
Author(s):  
David W. Seal ◽  
Je'Laune Walton ◽  
Sherifa Williams ◽  
Robert Wilson ◽  
Joshua Smith-Benson

Objective: To evaluate the provisions made by pharmacists when dispensing an emergency supply of an antihypertensive medication to patients in a community setting. Participants: Pharmacists and nonpharmacists (pharmacy technicians or interns) who were employed with community pharmacies and have witnessed or dispensed an emergency supply of an antihypertensive medication. Those who agreed to participate in this study via informed consent. Intervention: A short questionnaire was used to assess the provisions made by community pharmacists from the perspectives of both the pharmacists and the nonpharmacists. Main outcome measures: Availability of blood pressure machines, evaluation of blood pressure readings, and patient counseling sessions or assessments prior to dispensing the emergency supply of an antihypertensive were the major outcome measures. Results Among the participants, 92% of the pharmacists and 79% of the nonpharmacists reported they have witnessed or dispensed an emergency supply of an antihypertensive medication. Of those, 82% of the pharmacists and 78% of the nonpharmacists recognized there were blood pressure machines available. However, 78% of the pharmacists and 72% of the nonpharmacists acknowledged the patient’s blood pressure was not checked. Conclusion/Implication: This observational study demonstrates that provisions when dispensing an emergency supply of an antihypertensive medication are inconsistent. Further evaluation is warranted.


2021 ◽  
Vol 8 ◽  
Author(s):  
Danladi C Husaini ◽  
Yusuf Abubakar ◽  
Lydia Harris-Thurton ◽  
David D. Mphuthi

Aim: In Belize, antibiotics are categorized as prescription-only drugs, and their sales over the counter without a prescription is prohibited. This study assessed the sales and dispensing of antibiotics in community pharmacies without a prescription. Methods: 36 community pharmacies in 4 districts of Belize were assessed for non-prescription sales of antibiotics using a simulated client method (SCM) approach from September to November 2019. Results: The majority (19; 52.8%) of the community pharmacies assessed refused to sell antibiotics without a prescription from a physician. Approximately 17 (47.2%) sold and dispensed antibiotics to simulated clients (SCs) without a prescription. Adequate patient counseling was provided by the pharmacists to the SCs. Conclusion: Some level of lack of compliance with the sales of antibiotics without prescription was observed among community pharmacists in this study. There is a need to reinforce stricter control on the sales and dispensing of antibiotics without prescription in the country of Belize.


2017 ◽  
pp. 75-80
Author(s):  
Quoc Duong Doan ◽  
Thi Ha Vo

Background: Community pharmacists play an important role in counseling of rational drug use for population. The study aimed to characterize counselling activities of drug use and demand of counselling tools at some community pharmacies at Hue City. Materials and method: A 17-question survey were asked to fill pharmacy staffs of a convenient sample of 100 community pharmacies at Hue City from 2/2017 to 7/2017. Results: There were 58 pharmacies (58.0%) answered this survey. Cough, headache, fever, high blood pressure and diabetes were the most popular symptoms/diseases presented in pharmacies. Patients often need counselling about dose (82.8%) and when to take medicine (79.3%). The main bariers for counselling were a lack of time (53.4%), and of skills/medthods for counseling (31.7%). About 96.6% pharmacies demanded counselling tools and favorite formats were book (32.9%) or pocket handbook (29.3%). Conclusion: Most pharmacies demanded counselling tools. Other studies should be conducted to develop supporting tools for counseling and to assess the quality of counseling in pharmacies. Key words: community pharmacy, counseling of drug use, pharmacist, Hue


Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 166
Author(s):  
Amina Abubakar ◽  
Jessica Sinclair

Remote physiologic monitoring (RPM) services involve the transmission of patient-collected physiologic data to the healthcare team. These data are then analyzed to determine what changes may be needed to enhance patient care. While pharmacists may not be recognized as billing providers through some payers, there are opportunities for pharmacist collaboration with providers to enhance patient access to RPM services. Community pharmacist services are traditionally tied to a product, but pharmacists are skilled in medication management, disease state evaluation, and patient counseling, which are skills that can contribute to an elevated RPM program.


2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i35-i35
Author(s):  
S S Alghamdi ◽  
R Deslandes ◽  
S White ◽  
K Hodson ◽  
A Mackridge ◽  
...  

Abstract Introduction Since 2019, the role of independent pharmacist prescribers (IPPs) in primary care has extended to community pharmacies in Wales [1]. This was in response to a Welsh Pharmaceutical Committee report in 2019 that outlined a plan to include an IPP in each community pharmacy in Wales by 2030. This aimed to relieve pressure on general practices, enhance patient care and reduce referral and admission rates to secondary care [2]. As funding was provided by the Government, the number of community pharmacists completing the independent prescribing course increased and many have implemented their prescribing role. Aim To explore the views of community IPPs regarding their prescribing role within community pharmacies in Wales. Methods Semi-structured face-to-face and telephone interviews were conducted with community IPPs from all seven health boards (HBs) in Wales. Ethical approval was obtained from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University and the School of Pharmacy and Bioengineering at Keele University. Purposive sampling was used to identify potential participants. Gatekeepers (HB community pharmacy leads and directors of IPP courses in Wales) sent invitation emails, participant information sheet and consent form to potential participants. Written consent was obtained. Interviews were audio-recorded and transcribed ad verbatim. Thematic analysis was used to analyse the data. Results Thirteen community IPPs across Wales participated. Six themes were identified, including the utilisation of their role as community IPPs, their experiences with their independent prescribing training, motivation to obtain their prescribing qualification and utilise it, the impact, barriers and facilitators to implement and utilise their role. Participants practised as IPPs in the management of minor ailments and some other conditions, such as respiratory and sexual health. The course and training for community IPPs was helpful, but there was a need to focus more on therapeutic and clinical examination skills. The main impact of the role was that it helped to improve communication between community pharmacies and general practices and relieved some pressure on general practices. The main barriers were the lack of appropriate funding by the Government to develop the role, lack of access to patients’ medical records, lack of support and high workload. “One of the areas identified as high risk is for pharmacy prescribers is the lack of access to clinical records. How can you [as community IPPs] make any sensible decisions with half the information?” IPP6 Facilitators included that some services were already in place and the drive from the 2030 vision. Conclusion This is the first study that explored the views of community IPPs regarding their prescribing role in community pharmacies in Wales. It provided an insight into this new role that can be considered by the Welsh Government to achieve the 2030 vision for this role. A limitation to this study was that the role is still new in community pharmacies, which may affect the views of the community IPPs. Many of them have obtained their prescribing qualification but have not started to utilise it yet. Further work is needed to explore a wider population of community IPPs’ experiences as the role develops. References 1. Wickware, C. 2019. All community pharmacies in Wales to have an independent prescriber as part of long-term plan for Welsh pharmacy. Available at: https://www.pharmaceutical-journal.com/news-and-analysis/news/all-community-pharmacies. 2. Welsh Pharmaceutical Committee. 2019. Pharmacy: Delivering a Healthier Wales. Available at: https://www.rpharms.com/Portals/0/RPS%2.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047034
Author(s):  
Javiera Navarrete ◽  
Nese Yuksel ◽  
Theresa J Schindel ◽  
Christine A Hughes

ObjectivesPharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas.DesignScoping reviewData sourcesMedline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007–July 2020).Study selectionStudies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists.Data extractionTwo investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes.ResultsForty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists’ delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking.ConclusionThis scoping review highlights the expansion of pharmacists’ roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users’ acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.


Author(s):  
Jane J. Aggrey ◽  
Mirjam A. F. Ros-Tonen ◽  
Kwabena O. Asubonteng

AbstractArtisanal and small-scale mining (ASM) in sub-Saharan Africa creates considerable dynamics in rural landscapes. Many studies addressed the adverse effects of mining, but few studies use participatory spatial tools to assess the effects on land use. Hence, this paper takes an actor perspective to analyze how communities in a mixed farming-mining area in Ghana’s Eastern Region perceive the spatial dynamics of ASM and its effects on land for farming and food production from past (1986) to present (2018) and toward the future (2035). Participatory maps show how participants visualize the transformation of food-crop areas into small- and large-scale mining, tree crops, and settlement in all the communities between 1986 and 2018 and foresee these trends to continue in the future (2035). Participants also observe how a mosaic landscape shifts toward a segregated landscape, with simultaneous fragmentation of their farming land due to ASM. Further segregation is expected in the future, with attribution to the expansion of settlements being an unexpected outcome. Although participants expect adverse effects on the future availability of food-crop land, no firm conclusions can be drawn about the anticipated effect on food availability. The paper argues that, if responsibly applied and used to reveal community perspectives and concerns about landscape dynamics, participatory mapping can help raise awareness of the need for collective action and contribute to more inclusive landscape governance. These findings contribute to debates on the operationalization of integrated and inclusive landscape approaches and governance, particularly in areas with pervasive impacts of ASM.


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