scholarly journals Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8134
Author(s):  
Shaid Booth ◽  
Richard Parsons ◽  
Bruce Sunderland ◽  
Tin Fei Sim
Keyword(s):  
Community Pharmacists ◽  
Multivariate Regression Analysis ◽  
Warning Signs ◽  
Migraine Treatment ◽  
First Line ◽  
Over The Counter ◽  
Implementation Model ◽  
Timely Access ◽  
Current Guidelines ◽  
Western Australian

Background Down-scheduling one or more triptans to Schedule 3 (Pharmacist Only Medicine) from Schedule 4 (Prescription Only Medicine) has been debated in Australia for a decade. This study aimed to evaluate the perspectives and readiness of Western Australian (WA) community pharmacists to manage migraine including over-the-counter (OTC) provision of triptans. Methods Data were collected using a self-administered paper-based questionnaire, posted to a random sample of 178 metropolitan and 97 regional pharmacies in WA. Respondent pharmacists were surveyed regarding: knowledge of optimal migraine treatment as per current guidelines, resources required to appropriately recommend triptans and attitudes and perspective toward down-scheduling. Data were analysed using descriptive statistics and multivariate regression analysis. Pharmacist/pharmacy characteristics influencing readiness were evaluated by assigning respondents a score based on responses to Likert scale questions. These questions were assigned to five domains based on an implementation model and these scores were used in a general linear model to identify demographic characteristics associated with readiness across each domain. Results A total of 114 of the 275 pharmacies returned useable questionnaires (response rate: 41.5%). The two most commonly recommended first line OTC agents were a combined paracetamol/non-steroidal anti-inflammatory drugs and aspirin (44/104; 42.3% and 22/104; 21.2%, respectively) which provided context to the respondents’ knowledge of optimal migraine treatment. Responses to questions in relation to triptans and the warning signs requiring referral were in line with current guidelines, demonstrating respondents’ knowledge in these areas. Nevertheless, most respondents demonstrated uncertainty in relation to the pathogenesis of migraine. If triptans were available OTC, 66/107 (61.7%) would recommend them first-line. The majority (107/113; 94.7%) agreed that down-scheduling would improve timely access to effective migraine medication and 105/113 (92.9%) agreed that if triptans were down-scheduled, pharmacists may be better able to assist people in the treatment of migraine. Most respondents agreed that additional training and resources, including a guideline for OTC supply of triptans and the management of first-time and repeat migraine would be necessary if triptans were down-scheduled. No single demographic characteristic influenced readiness across all five domains. Discussion Pharmacists were knowledgeable regarding triptans and recognised symptoms requiring referral; migraine knowledge could be improved. Pharmacists supported down-scheduling of one or more triptans in Australia, however they highlighted a need for further training and resources to support migraine diagnosis and provision of OTC triptans. Professional pharmacy bodies should consider these findings when recommending drugs suitable for down-scheduling for pharmacist recommendation.

scholarly journals Public perception of community pharmacists in South Africa: a preliminary study

2006 ◽  
Vol 11 (3) ◽  
Author(s):  
Suzanne Bornman ◽  
Ilse Truter ◽  
Daniel JL Venter
Keyword(s):  
South Africa ◽  
Full Text ◽  
Public Perception ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Self Medication ◽  
Over The Counter ◽  
Preliminary Study

This survey forms part of a study undertaken to identify and quantify the community pharmacist’s involvement in the use of non-prescription/over-the-counter (OTC) medicine/self-medication in community pharmacies throughout South Africa. Opsomming Hierdie opname vorm deel van ‘n studie wat onderneem word om die gemeenskapsapteker se betrokkenheid in die gebruik van nie-voorskrif/oor-die-toonbank medikasie/ selfmedikasie in gemeenskapsapteke in Suid Afrika te identifiseer en te kwantifiseer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Interactive Web-Based Resource for Annotation of Genetic Variants Causing Hereditary Angioedema (HADA): Database Development, Implementation, and Validation (Preprint)

2020 ◽  
Author(s):  
Alejandro Mendoza-Alvarez ◽  
Adrián Muñoz-Barrera ◽  
Luis Alberto Rubio-Rodríguez ◽  
Itahisa Marcelino-Rodriguez ◽  
Almudena Corrales ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Genetic Condition ◽  
First Line ◽  
International Consensus ◽  
Web Based ◽  
Genetics And Genomics ◽  
User Friendly ◽  
Current Guidelines ◽  
Generation Sequencing ◽  
Esterase Inhibitor

BACKGROUND Hereditary angioedema is a rare genetic condition caused by C1 esterase inhibitor deficiency, dysfunction, or kinin cascade dysregulation, leading to an increased bradykinin plasma concentration. Hereditary angioedema is a poorly recognized clinical entity and is very often misdiagnosed as a histaminergic angioedema. Despite its genetic nature, first-line genetic screening is not integrated in routine diagnosis. Consequently, a delay in the diagnosis, and inaccurate or incomplete diagnosis and treatment of hereditary angioedema are common. OBJECTIVE In agreement with recent recommendations from the International Consensus on the Use of Genetics in the Management of Hereditary Angioedema, to facilitate the clinical diagnosis and adapt it to the paradigm of precision medicine and next-generation sequencing–based genetic tests, we aimed to develop a genetic annotation tool, termed Hereditary Angioedema Database Annotation (HADA). METHODS HADA is built on top of a database of known variants affecting function, including precomputed pathogenic assessment of each variant and a ranked classification according to the current guidelines from the American College of Medical Genetics and Genomics. RESULTS HADA is provided as a freely accessible, user-friendly web-based interface with versatility for the entry of genetic information. The underlying database can also be incorporated into automated command-line stand-alone annotation tools. CONCLUSIONS HADA can achieve the rapid detection of variants affecting function for different hereditary angioedema types, and further integrates useful information to reduce the diagnosis odyssey and improve its delay.

scholarly journals Community Pharmacists’ Perceptions towards the Misuse and Abuse of Pregabalin: A Cross-Sectional Study from Aseer Region, Saudi Arabia

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1281
Author(s):  
Sultan M. Alshahrani ◽  
Khalid Orayj ◽  
Ali M. Alqahtani ◽  
Mubarak A. Algahtany
Keyword(s):  
Saudi Arabia ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Male Dominance ◽  
Community Pharmacies ◽  
First Line ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
First Line Therapy ◽  
Structured Questionnaire

Pregabalin is a first-line therapy for neuropathic pain and for chronic pain. It has abuse potential. This study was conducted to assess community pharmacists’ perceptions towards pregabalin abuse and misuse in the Aseer region, Saudi Arabia, and identify predictors and associated factors. A cross-sectional survey using a structured questionnaire following a self-administrative study was conducted across community pharmacies in the Aseer region (Abha, Khamis Mushait, Mahayel, Sarat Abeeda, Ahad-Rufaida, and Bishah). A total of 206 respondents from community pharmacists participated in the study. Over the last six months, 136 respondents (66.0%) suspected pregabalin abuse in community pharmacies; male dominance in pregabalin abusers was also recorded (n = 165, 80.1%). Additionally, 40 (19.4%) respondents stated that a prescription was not issued for pregabalin demands. Over half (61.7%) of community pharmacists recorded an increased change in pregabalin abuse compared to the previous year. This is the first study to explore pharmacists’ perceptions in the community of the Aseer region towards customers’ misuse and abuse of pregabalin. Further monitoring and regulations on the prescribing and procurement of pregabalin are needed to avoid abuse.

scholarly journals How timely is access to palliative care medicines in the community? Amixed methods study in a UK city

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029016 ◽  
Author(s):  
Elizabeth Jane Miller ◽  
Julie D Morgan ◽  
Alison Blenkinsopp
Keyword(s):  
Palliative Care ◽  
Information Transfer ◽  
Care Service ◽  
Phase 1 ◽  
Palliative Care Service ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Inadequate Information ◽  
Timely Access ◽  
Palliative Patients

ObjectiveTo investigate timely access to palliative medicines/drugs (PMs) from community pharmacies to inform palliative care service delivery.DesignMixed methods in two sequential phases: (1) prospective audit of prescriptions and concurrent survey of patients/representatives collecting PMs from pharmacy and (2) interviews with community pharmacists (CPs) and other healthcare professionals (HCPs).SettingFive community pharmacies in Sheffield, UK and HCPs that deliver palliative care in that community.ParticipantsPhase 1: five CPs: two providing access to PMs within a locally commissioned service (LCS) and three not in the LCS; 55 patients/representatives who completed the survey when accessing PMs and phase 2: 16 HCPs, including five phase 1 CPs, were interviewed.ResultsThe prescription audit collected information on 75 prescriptions (75 patients) with 271 individual PMs; 55 patients/representatives (73%) completed the survey. Patients/representatives reported 73% of PMs were needed urgently. In 80% of cases, patients/representatives received all PMs on the first pharmacy visit. One in five had to travel to more than one pharmacy to access PMs. The range of PMs stocked by pharmacies was the key facilitating factor. CPs reported practical issues causing difficulty keeping PMs in stock and playing a reactive role with palliative prescriptions. Confidentiality concerns were cited by other HCPs who were reluctant to share key patient information proactively with pharmacy teams. Inadequate information transfer, lack of CP integration into the care of palliative patients and poor HCP knowledge of which pharmacies stock PMs meant patients and their families were not always able to access PMs promptly.ConclusionsConsistent routine information transfer and integration of pharmacy teams in the care of palliative patients are needed to achieve timely access to PMs. Commissioners of PM access schemes should review and monitor access. HCPs need to be routinely made aware and reminded about the service and its locations.

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