Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates

Pharmacy professionals' perceptions of their professional duties in the Ethiopian health care system: a mixed methods study

BACKGROUND

Pharmacy professionals are experts in therapeutic knowledge, experience, and skills that are used to ensure desired patient outcomes, utilizing the best available clinical evidence and interventions in collaboration with the health care team. They perceive themselves as a provider of technical, standardized, and individualized advice. The objective of this study was thus to assess the perception of pharmacy professionals towards their current professional roles in the health care system in Dessie, a city in the north-east Ethiopian region.

METHODS

A mixed-methods sequential explanatory study was used to assess the perception of pharmacy professionals towards their professional roles in Dessie city administration from December 15-30, 2019. The study participants were all pharmacy professionals working at health facilities in Dessie. Self-administered questionnaires were used to collect quantitative data, and face-to-face key informant interviews were used for qualitative data collection. Data were entered, processed, and analyzed using SPSS 25.0 statistical software, and thematic analysis was used for the qualitative exploration using QDA Miner Lite software (v2.0.7, free edition version).

RESULT

The study had a 97.7% response rate. Of the 301 participants, 173 (57.5%) were male. Most of the participants had a positive perception, while 38 (12.6%) had a poor perception of their current professional roles. Lack of physical access, poor initiatives, poor communication skills, and a lack of administrative support for pharmaceutical care were statistically significant at a p value of 0.05 and a 95% confidence interval. From the qualitative data, two major themes emerged: perceived roles and determinants (perceived facilitators and barriers).

CONCLUSION

Pharmacy professionals' roles were found to be influenced by a lack of physical access, poor initiatives, poor communication skills, and poor administrator support. Pharmaceutical care requires everyone's involvement in addressing these factors for successful performance and a better outcome and in considering perceived facilitators and barriers.

The role of community pharmacy in wound care: a scoping review

OBJECTIVE

To scope the literature describing the role of pharmacy in wound care in the community setting.

METHOD

A systematic scoping review was conducted including peer-reviewed and grey literature. A search was undertaken using CINAHL, Embase, Informit, International Pharmaceutical Abstracts and MEDLINE, and a Google search of the top 200 results via three virtual private networks were used to identify relevant grey literature. Keywords relating to pharmacy, pharmacist, wound, wound management and wound care were used. Descriptions of wound care activities were extracted, grouped by similarity, and mapped to the International Pharmaceutical Federation's (FIP) Global Competency Framework Version 2 (GbCFv2).

RESULTS

Of 2928 potentially relevant articles and 600 web search results, 55 articles from the database search and 11 results from the Google search met the eligibility criteria. After mapping 14 identified roles to the FIP GbCFv2, it was apparent that the scope of practice for wound care spanned across all four competency domains: pharmaceutical public health; pharmaceutical care; professional/personal; and organisational and management.

CONCLUSION

The role of community pharmacy in wound care is multifaceted and within the scope of entry-level competency for pharmacists. These roles comprise wound related and non-wound-specific, clinical and non-clinical activities.

Attitudes, awareness, and perceptions of general public and pharmacists toward the extended community pharmacy services and drive-thru pharmacy services: a systematic review

BACKGROUND

Several extended and newly added pharmacy services were evaluated in different countries. This review aims to provide a summary of studies on attitudes, awareness, or perceptions toward various extended and drive-thru pharmacy services at community settings among pharmacists and the general public.

METHODS

To find qualitative and descriptive quantitative studies, that reported on the attitudes, awareness, or perceptions of the general public and pharmacists toward the practice of any extended community pharmacy service and drive-thru pharmacy services in a community setting and conducted from March 2012 to March 2022. Researchers used databases such as Embase, Medline PubMed, Scopus, Web of Science, and Science Direct. The reviewers extracted data independently using the PRISMA checklist.

RESULTS

There were 55 studies found according to the inclusion criteria. Various extended pharmacy services (EPS) and drive-thru pharmacy services were noted in the community setting. Pharmaceutical care services and healthcare promotion services were the noticeable performed extended services. There were positive perceptions and attitudes toward extended and drive-thru pharmacy services among pharmacists and the public. However, some factors, such as lack of time and shortage of staff, affect the practice of those services.

CONCLUSION

Understanding the major concerns toward the provision of extended and drive-thru community pharmacy services and improving pharmacists' skills through more training programs to provide such services efficiently. In the future, more reviews for EPS practice barriers are recommended to faceup all concerns and find standardized guidelines by stakeholders and organizations for efficient EPS practices.

A pseudo-customer cross-sectional study to evaluate the community pharmacist's management of migraine in pregnant women

Background

To the best of our knowledge few published studies have been conducted to evaluate customer's care services in community pharmacies in the United Arab Emirates (UAE) using the pseudo-customer model. This further indicates that there is a paucity of information available about the current care services provided by the community pharmacists particularly for pregnant women with migraine.

Objective

The main objective was to evaluate, the effectiveness of the pseudo-customer method on the care services (counseling, advice, and management) provided by the community pharmacists for migraine during pregnancy.

Methods

This was a cross-sectional study conducted in community pharmacies with a cluster sampling of pharmacists. A sample of 200 community pharmacists was recruited from three emirates in the United Arab Emirates. Pregnant woman-related migraine management was assessed using the pseudo-customer model. The used script is not of a real patient but a fake/scripted used to describe the study.

Results

No association was found between the gender and nationality of community pharmacists and the ability to be proactive (P =0.5, 0.568) and between the utilization of source of information and gender (P =0.31). The ability to prescribe by community pharmacists without probing or only after a probe was independent of job title (P =0.310); gender (P =0.44) and nationality (P =0.128). The community pharmacists who have offered written information have had significantly higher odds to dispense medication compared to those who have not (OR =45.547, 95% CI: 2.653 - 782.088, P =0.008). Furthermore, the pharmacists who have been reported to ask for precipitating factors of migraine had significantly higher odds to dispense medication compared to those who have not (OR =11.955, 95% CI: 1.083-131.948, P =0.043). The main outcome was the responses of the community pharmacists to the pseudo-customer visit (pregnant woman with migraine).

Conclusions

The community pharmacist's care services (counseling, advice, and management) offered to the pseudo-customer visits was effective for dealing with migraine during pregnancy.

Cross-sectional Study on the Impact of Discount Pricing and Price Competition on Community Pharmacy Practice

Background

Without stipulated legislation, a free pricing policy can lead to a disparity in prices among private healthcare setups. Competition is especially rampant among community pharmacies, especially in the Sabah state of Malaysia, where the recent years have witnessed the steady growth of pharmacy players from Peninsular Malaysia. Thus, this study aimed to examine the impact of price competition and discount pricing on the practice of community pharmacy in Sabah, Malaysia.

Methods

This was a cross-sectional study using an online questionnaire. Survey participants included community pharmacists practicing in Sabah. The validated and pilot-tested questionnaire consisted of three parts: background information of the pharmacy, attitudes and perception toward medicine prices, and practice of discount pricing. All required data were collected from community pharmacists practicing only in Sabah. Data were then analyzed by using descriptive, Chi-Square, and Kendall's tau-b tests.

Results

Of the 150 community pharmacists contacted, only 70 responded, providing a response rate of 47%. In terms of pharmacy type, 71% of the respondents were pharmacist-owned independent pharmacies, while 19% were pharmacy chains owned by community pharmacists. The remaining were pharmacies owned by non-pharmacists (10%). Sixty percent of the community pharmacies had been in existence for more than 10 years, with 12% in existence for less than two years, and 28% in existence for three to 10 years. More than 80% of the respondents stated that the business aspect of community pharmacy had overwhelmed the professional practice aspects and that community pharmacists have become providers of products instead of providers of care. In terms of professionalism, 87% also noted that they are being perceived as profiteering in the medicine business at the expense of patients.

Conclusions

The free market situation in Malaysia for medicine pricing has brought a detrimental consequence for community pharmacists with each one trying to undercut prices. Differing pricing mechanisms of medicines based on the quantity ordered contribute to the problem of discount pricing and price competition. Most community pharmacists, as indicated by this study, want the problem to be addressed.

Quantum Diffie-Hellman Extended to Dynamic Quantum Group Key Agreement for e-Healthcare Multi-Agent Systems in Smart Cities

Multi-Agent Systems can support e-Healthcare applications for improving quality of life of citizens. In this direction, we propose a healthcare system architecture named smart healthcare city. First, we divide a given city into various zones and then we propose a zonal level three-layered system architecture. Further, for effectiveness we introduce a Multi-Agent System (MAS) in this three-layered architecture. Protecting sensitive health information of citizens is a major security concern. Group key agreement (GKA) is the corner stone for securely sharing the healthcare data among the healthcare stakeholders of the city. For establishing GKA, many efficient cryptosystems are available in the classical field. However, they are yet dependent on the supposition that some computational problems are infeasible. In light of quantum mechanics, a new field emerges to share a secret key among two or more members. The unbreakable and highly secure features of key agreement based on fundamental laws of physics allow us to propose a Quantum GKA (QGKA) technique based on renowned Quantum Diffie-Hellman (QDH). In this, a node acts as a Group Controller (GC) and forms 2-party groups with remaining nodes, establishing a QDH-style shared key per each two-party. It then joins these keys into a single group key by means of a XOR-operation, acting as a usual group node. Furthermore, we extend the QGKA to Dynamic QGKA (DQGKA) by adding join and leave protocol. Our protocol performance was compared with existing QGKA protocols in terms of Qubit efficiency (QE), unitary operation (UO), unitary operation efficiency (UOE), key consistency check (KCC), security against participants attack (SAP) and satisfactory results were obtained. The security analysis of the proposed technique is based on unconditional security of QDH. Moreover, it is secured against internal and external attack. In this way, e-healthcare Multi-Agent System can be robust against future quantum-based attacks.

Community pharmacist's knowledge, attitude, roles and practices towards patient-centred care in Saudi Arabia: a systematic review of the literature

Objectives

This study aimed to evaluate published original studies in Saudi Arabia about knowledge, attitude, roles and practices of community pharmacists in providing patient-centred care services.

Methods

Systematic searching of original studies published between 1 January 2007 and 31 December 2017 using electronic databases: PubMed, International Pharmaceutical Abstracts, Scopus, Science Direct, Cochrane Library, TRiP database, Springer Link and Google Scholar. Studies were included if they outlined community pharmacist's knowledge, role, attitude and professional practice behaviours towards patient-centred care provided by pharmacists alone or in collaboration with other healthcare professional (s). The studies were identified, and data were extracted independently by two reviewers. The modified Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of each study.

Key findings

Twenty-four original studies conducted in Saudi Arabia were included. Majority of studies were questionnaire-based surveys (62.5%). One quarter of the studies investigated knowledge, roles and attitude of community pharmacists about irrational dispensing and prescribing of antibiotics and prescription only medicines. Included studies highlighted numerous gaps in knowledge, attitude, roles and practices of community pharmacists in Saudi Arabia in providing efficient patient-centred care services. Lack of knowledge and time, absence of pharmacy information database, deficiency of continued professional development training, unavailability of adverse drug reaction reporting forms and professional and cultural issues were some of the barriers in providing patient-centred care.

Conclusions

The studies showed that although community pharmacists in Saudi Arabia do provide medicine counselling and other patient-centred care services; however, these services need substantial improvement. This review may be useful for policy makers, regulators, pharmacy educators and researchers in understanding the work being performed in the community pharmacy setting in Saudi Arabia.