Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

Practices, perceptions and trust of the public regarding online drug purchasing: a web-based survey from Jordan

OBJECTIVES

Online purchasing, including drugs, increased dramatically in the last decade especially through the COVID-19 pandemic. The aim of this study was to investigate the frequency and attitudes of consumers concerning online drug purchasing and assess their perceptions regarding the benefits and disadvantages.

DESIGN

A web-based survey conducted through a self-administered questionnaire that was approved by the Institutional Review Board (IRB) committee, ethical approval number: IRB/Al-Ahliyya Amman University/3/13/2021-2022. Cronbach's alpha for the attributes of benefits and disadvantages was 0.608 and 0.744, respectively. Primary outcome measures were extent of trust of the public in online drug purchasing using Likert scale. Multivariate linear regression was used to assess predictors of the trust score.

SETTINGS

Hashemite Kingdom of Jordan.

PARTICIPANTS

Inclusion criteria; residents of the Hashemite Kingdom of Jordan 18 years or older. The questionnaire was distributed through snowball effect via different social media.

RESULTS

A total of 428 participants filled the questionnaire, their average age was 29.7±11.2. Almost all participants, 419 (98.6%) use the internet daily but only 79 (18.6%) participants shop online regularly. Fifty participants (11.8%) purchased drugs online and they had higher benefits score of online purchasing compared with those who did not buy drugs online, 12.5±3.7 and 10.9±3.1, respectively, p=0.002. Participant who purchased drugs online had an increase in trust score of 0.847 compared with those who did not purchase drugs online, p<0.001. In the multivariate model, participants with education level of high school or higher than high school, compared with those with education lower than high school had an increase in trust score of 1.336 (p=0.026) and 1.137 (p=0.039), respectively.

CONCLUSION

The public recognises the risks in buying drugs online. Awareness campaigns and regulations that control and monitor online drug purchasing should be implemented.

Illicit Online Pharmacies: A Scoping Review

This scoping review presents the extent and nature of the body of literature on illicit online pharmacies (IOPs) and identifies research gaps. Using the five-step framework developed by Arksey and O'Malley, we searched PubMed, Web of Science, EMBASE, CINAHL, Science Direct and PsycInfo to retrieve relevant studies published in English in peer-reviewed journals. The search strategy identified forty-three articles that met the inclusion criteria. Ten themes were identified and categorized into five clusters: patient risk, healthcare providers, marketing and supply chain, public health and society, and policy and regulation. Research into these clusters has evolved over time and has focused increasingly on issues related to specific drugs rather than the overall phenomenon. Data collection has been dominated by convenience sampling, online searches, content analysis and surveys. Data analysis remains primarily descriptive. Gaps within the extant literature suggest an agenda for future research into regulation and enforcement; public health awareness and education; healthcare services; risks to patients and public health; patient-, price- and product-related issues; website design; social media promotion; and supply chains and logistics. We conclude that IOPs are vastly understudied and suggest an urgent need for further empirical and conclusive research.

Pharmacy Student Perceptions and Knowledge of Online Pharmacy Use

Objective. Currently, there is no set of accreditation standards for integrating the dangers of illegal online pharmacies into Doctor of Pharmacy (PharmD) curricula. As a result, many pharmacists are unable to recognize the differences between a legal and illegal online pharmacy or educate patients on the dangers of online pharmacies. The objectives of this study were to assess gaps in student pharmacists' knowledge and to assess the impact of adding education regarding online pharmacies into PharmD programs.Methods. A pre- and postsurvey design was developed. Data were collected through an electronic questionnaire distributed to second-year pharmacy (P2) students to evaluate student knowledge gaps at baseline and after education on illegal online pharmacies.Results. A total of 102 students responded to the presurvey, with 93 (91%) consenting to participate. Out of 100 respondents to the postsurvey, 84 (84%) students consented. Approximately 87% (81/93) of respondents indicated some awareness of prescription medications being purchased online. Most students (89%, 77/86) stated that they do not believe the university has provided adequate curriculum on illegal online pharmacies and counterfeit medications. After receiving education on the relevant topics, 64% (55/85) stated they now felt their education was adequate.Conclusion. Although pharmacy students were aware of the existence of illegal online pharmacies, they were not aware of the significance of this patient safety issue or how to accurately identify suspicious websites. It is imperative that PharmD programs incorporate formal education on the risks that illegal online pharmacies pose to patient and medication safety.

A narrative review of illegal online pharmacies and contemporary issues with restricting FDA-approved medication access

The rapid growth of technology has transformed the way the public purchases many products, including medications. Online medication purchasing has become a convenient and confidential route for patients to access healthcare without leaving their homes. Online pharmacies have many benefits but also present an increased risk for patient harm caused by unintentionally purchasing from illegal online pharmacies. Illegal online pharmacies are those that operate online without the requisite valid licenses or supply drugs not approved by the Food and Drug Administration (FDA). As obtaining certain medications has become restricted, either due to policy or drug shortages, more patients are relying on services provided by Internet pharmacies. The overturning of Roe versus Wade has caused an emerging drug restriction that may coerce the public to turn to Internet pharmacies for purchasing medications. A narrative review was conducted to analyze both the past and present effects of medications sold by illegal online pharmacies to help recognize the implications of restricting access to FDA-approved medications. Several large science and health literature databases were searched to find relevant references. Resulting resources, which referenced the connection between restricting access to FDA-approved medications and the increase in illegal online sales, were included in this review. The information evaluated in this article will help inform healthcare providers and policymakers of the inadvertent effects of restricting access to FDA-approved medications.

Swedish community pharmacy employees' knowledge and experience of substandard and falsified medical products: a cross-sectional descriptive survey

OBJECTIVES

Substandard and falsified medical products are, according to the World Health Organization, a global threat to public health. To evaluate if community pharmacy employees can guide the public to safer medication purchases, their knowledge and experience about SF medical products was examined.

METHODS

A digital questionnaire was distributed to the five dominating pharmacy companies in Sweden, representing 97% of the community pharmacies (1391/1433), giving the theoretical possibility of reaching 6200 employees. Three companies published a link to the questionnaire on their intranets, one distributed the link via e-mail to the responsible pharmacist for quality and knowledge, respectively. The fifth company did not pass on, due to technical problems. Employees aged 18 years or older with customer contact were invited to participate.

KEY FINDINGS

The questionnaire was available for 74% of all community pharmacies (1067/1433), having approximately 4900 employees with customer contact. The response rate was 5% (228/4900). Of the respondents, 89% were pharmacists (203/228), 84% were women (191/228) and 43% were 35-49 years (98/228). The respondents worked in pharmacies of different size, located both in rural and urban areas. The definition of substandard and falsified medical products was known by 182 of the 228 respondents (80%) and the main source of knowledge was media (61%, 111/228). The common European logo for authorized online pharmacies was not recognized by 74% (169/228).

CONCLUSIONS

For pharmacy employees to guide the public to safer medication purchases, knowledge about substandard and falsified medical products needs to be enhanced specially about legal international e-commerce.