A Literature Review: Pharmaceutical Care an Evolving Role at Community Pharmacies in Pakistan

The aim of this paper is to highlight the role of pharmaceutical care at community pharmacies in Pakistan. The paper draws on the literature related to current dispensing practices at community pharmacies in developing countries as well as in Pakistan. There are approximately 63,000 community pharmacies in Pakistan, and according to an estimate, 80% of the medicines are being distributed through this channel to majority of the population. They often lack adequate facilities, staffing and equipments. Absence of pharmacists and their roles being performed by the non-qualified personnel working at community pharmacies are a common practice. There are 8102 pharmacists who are categorized as a category, 31,000 pharmacy technicians categorized in B & C category in the country. There is a shortage of pharmacists who could be engaged for ensuring good pharmacy practices. There are only ten percent of the total pharmacists who work at community pharmacies in the country according to the Pharmacy Council of Pakistan. All kind of medicines are freely available irrespective of their status as prescription or over the counter drugs. The paper highlights that the professional role of pharmacist in hospitals and community pharmacies is switching from dispensing and sale of drugs, to patient counselling. But, the concept of pharmaceutical care at community pharmacies has not been acknowledged yet in Pakistan. The process of prescription handling is poor and patients are often treated without a proper prescription. Prescription validation, drug labeling and patient counseling are the missing components in effective patient management at the community pharmacies. The paper concludes that although laws exist, but due to lack of accountability and weak regulatory framework their proper implementation is not witnessed. Moreover, due to lack of research and evidence related to problems in dispensing practices in healthcare system of Pakistan, the counteractive actions for resolving these problems are limited.

Adherence of Community Pharmacies in Riyadh, Saudi Arabia, to Optimal Conditions for Keeping and Selling Good-Quality Medicines

Exposure to excessive temperature during distribution or storage has unfavorable consequences on the quality of medicines, particularly in hot climates. This could be one of the possible reasons behind the existence of substandard amoxicillin in community pharmacies in Riyadh, Saudi Arabia. This study explored the conditions under which medicines were kept in a random sample of 181 community pharmacies in Riyadh. The pharmacist in charge in each pharmacy was interviewed and our observations about the quality of storage were recorded. The inspection revealed that in 9% of the sample the readings of the existing room thermometers were >25℃, and that 13% of the sample lacked thermometers. Also in 33% of the sample the readings of the refrigerator thermometers were outside the accepted range, and 7% of the sample lacked refrigerator thermometers. About 15% of pharmacists were not informed about the local regulations of community pharmacy practice, neither before nor after taking up their current positions. Surprisingly, incorrect answers to simple questions about the system were frequently given by the informed pharmacists. Certain aspects of substandard storage conditions existed, in varying degrees, in significant percentages of pharmacies regardless of the pharmacists’ qualifications, experience, or awareness about the local regulations of community pharmacy practice. Stricter monitoring by the authorities regarding the adherence of community pharmacies to optimal conditions of storing medicines is recommended. Continuing education of community pharmacists must also be improved.

The Pharmacists Attributes in Advising Patients in Independently Owned Maltese Pharmacies

Objectives: To determine the influence of pharmacists on customers who have to decide between Over the Counter products in independently owned Maltese pharmacies. Methods: 20 managing pharmacists in independently owned Maltese pharmacies were interviewed. The interviews were recorded, transcribed verbatim and the data were coded. The main categories and subcategories were extracted and interrelated by using the grounded theory of action approach. Key findings Pharmacists dedicate time to ensure the right OTC is received by their patients. Before recommending an OTC medication the pharmacists ask key questions, which help them determine if an OTC is appropriate for the patient. The Maltese pharmacists engage their patients in a discussion before recommending an OTC product. In order to ensure that the patients are following their advice, pharmacists use different techniques. Whenever the patient might want to purchase an OTC, which could interfere with their medication regimen or might not be appropriate from the age point of view, then pharmacist intervenes accordingly. Each pharmacist offered specific examples how they convince their patients to purchase the correct medication. The pharmacists provided specific examples how they decide to select a specific OTC medicine and what type of questions were asked before taking a decision. In order to ensure their patients have the best access to the health care, many pharmacists embraced other roles and services, such as measuring and monitoring the blood pressure and glucose levels, determining the correct weight management product. Conclusions: The analyzed data highlight that Maltese community pharmacists play an important role in counseling patients on their choice of OTC products. The analysis has also identified some useful counseling techniques, which has been used by pharmacists for prescription medications. However, the Maltese pharmacists use these counseling techniques on a larger scale. It seems likely that many pharmacists are embracing more additional roles to ensure their population receives the best clinical services. Before dispensing an OTC medication, pharmacists use their clinical knowledge.

Use of Spatial Analysis to Assess Geographic Accessibility of Community Pharmacies in São Mateus

Pharmaceutical services contribute to the rational use of medicines by ensuring the provision of appropriate, safe and effective pharmacotherapies. Thus, it is important to investigate whether the geographical distribution of pharmacies causes inequalities in access in countries like Brazil, where there is no federal law regulating the opening of new establishments (in contrast to many European countries). This study analyzed the accessibility of community pharmacies in the city of Sao Mateus, Espírito Santo, Brazil. The authors obtained the geographical coordinates of pharmacies and healthfacilities, which scanned and georeferenced the study area. The 40 pharmacies included in the spatial analysis presented a heterogeneous distribution, with the existence of neighborhoods with an accumulation of pharmacies and others with no pharmacies. The authors found that only 43.7% of the study area received pharmaceutical service coverage, when buffer zones of 350 meters are incorporated, and that most of the districts have a minimum distance of 100 meters between health facilities and pharmacies. It was concluded that the use of GIS proved to be very suitable for analysis of pharmaceutical services, enabling knowledge of the local situation and serving as a stimulus for future studies.

Assessment of Counselling for Acute Diarrhoea in North-Eastern German Pharmacies—A Follow-Up Study Using the Simulated Patient Methodology

Aim: As the primary aim of this study, we analysed whether the quality of advice provided by pharmacies in the period between 2014 (baseline study) and 2017 (follow-up study) could actually be increased using a single written performance feedback given to each pharmacy in 2014. The secondary aim of the follow-up examination was to analyse whether the quality of advice differed depending on the professional group providing the advice. Methodology: To ensure the least possible distortion in the comparison between the baseline and the follow-up studies, the study design used for the follow-up examination in 2017 was not changed compared to the baseline examination in 2014. The data for the follow-up examination were therefore collected using the simulated patient method in all 21 pharmacies in a city in the north-east of Germany. Three female and two male test buyers used four different scenarios for self-medication of acute diarrhoea in all of the pharmacies (a total of 84 test purchases). Results: There were significant differences between the overall results from the baseline study (2014) and the follow-up study (2017) (Wilcoxon signed rank test;z = –2.065, p = 0.039, r = 0.225). In the overall average, the pharmacies in 2017 achieved only 2.7 (30%) of 9 possible points whereas in 2014 they achieved 3.3 (37%). The quality of advice between the professional groups did not show any significant differences (Kruskal-Wallis test: χ2(2) = 1.946;p = 0.378, r = 0.027). Conclusions: The quality of advice for acute diarrhoea in adults declined over time. A written performance feedback intended to improve the quality proved ineffective. Interventions with a far greater impact are required to achieve an improvement in the quality of advice provided.

Impact of Training of Dispensers on Case Management of Acute Respiratory Tract Infections at Community Pharmacies in Pakistan

Purpose: To evaluate the impact of training of dispensers on the process of case management of ARI at community pharmacies in context to history taking and provision of advice working at community pharmacies in Islamabad, Pakistan. Method: A randomized, controlled, blinded intervention study was designed and implemented. Before the implementation of intervention, a baseline study was performed to assess the process of case management for ARI at community pharmacies. The study population included all community pharmacy outlets in Islamabad. After data collection, data was analyzed. The result of the study revealed that the overall process of disease management of ARI at community pharmacies in Pakistan is not satisfactory. Pharmacies of Islamabad which were visited in pre intervention phase (118) were divided into two geographical regions A (intervention) and B (control). From which thirty pharmacies were selected randomly from each region. The targeted group of the interventions was drug sellers. Keeping in view the results of the base line study an educational intervention was designed to improve the case management of ARI at community pharmacies in Pakistan. Results: No significant difference (p ≤ 0.05) was seen in the process of history taking and advice provision in case of ARI management at community pharmacies between pre and post control groups. On the other hand significant difference in the process of history taking and provision of advice for ARI was observed in the intervention group before and after training. Conclusion: The study has highlighted that improvements in the current dispensing practices at community pharmacies are possible through appropriate educational interventions. The dispensers have the potential to provide fast and low cost healthcare to the masses in the country where the presence of doctors and qualified pharmacist is low;to date they are an untapped and underutilized source in the country.

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all levels of society, with children under the age of five and pregnant women being most at risk of serious illness. The availability of antimalarial medicines is one of the key interventions of malaria management. This study assessed the availability of antimalarial medicines in community pharmacies in Lusaka district, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 210 community pharmacies from September to November 2022 using a well-structured checklist in selected areas of Lusaka district. The availability was verified by a physical check of the product. The checklist contained the medicines listed both in the guidelines for diagnosis and treatment of malaria in Zambia as well as in the World Health Organization (WHO) malaria treatment guidelines. Results: This study found that all antimalarials listed in the local treatment guidelines for malaria were available in community pharmacies, though with the varying distribution. Of the 210 community pharmacies, 209 (99.5%) had artemether/lumefantrine in stock. The lowest available antimalarial was quinine/clindamycin, which was only available in 3 (1.4%) of the outlets. Conversely, 3 out of 16 (18.8%) antimalarials that were available in community pharmacies were not listed in the local treatment guidelines of malaria in Zambia, despite being listed in the WHO malaria treatment guidelines. This translated into a compliance level of 81.2% based on the local malaria treatment guidelines. Conclusion: This study concluded that antimalarials were available for all categories of malaria management in community pharmacies, though with a varying distribution. The presence of antimalarials not listed in the Zambian treatment guidelines is of public health concern which may have an impact on antimicrobial resistance in the future.

The Quality of Medicines in Community Pharmacies in Riyadh, Saudi Arabia: A Lot Quality Assurance Sampling (LQAS)-Based Survey

Objectives: To classify community pharmacies (CPs) in Riyadh, Saudi Arabia, in terms of the quality of medicines sold by them, using?the lot quality assurance sampling (LQAS) technique with a predefined threshold. Methods: Riyadh CPs were divided into 2 categories (“lots” for the purpose of LQAS), i.e., chain and independent CPs. Upper and lower rate thresholds for CPs that sell low-quality medicines were predefined as 20% and 5%, respectively. Consumer and provider risks were predefined as 0.05 and 0.10, respectively. The calculated number of randomly selected CPs required in each lot was 36;then, sale of low-quality medicines in >3 CPs implies a prevalence of >20% of such CPs according to LQAS. A randomly selected brand of amoxicillin (selected as a quality indicator of medicines because it is both widely counterfeited and heat-sensitive) was purchased from each pharmacy by a “mystery shopper”, checked for authenticity, and analyzed for drug content and content uniformity using a validated HPLC method. Results: Substandard amoxicillin was purchased in 9 pharmacies (4 chains and 5 independent). Both lots were thus rejected as unacceptable, which may indicate that consumers in Riyadh are at risk of purchasing substandard medicines at CPs. Conclusions: The quality of medicines sold in CPs in Riyadh did not meet our acceptability criterion, and appropriate intervention by decision makers is recommended. LQAS proved to be a practical, economical, and statistically valid sampling method for surveying the quality of medicines. It should enable decision makers to allocate resources for improvement more efficiently.

Reducing the Error Rate of Drug Delivery in Hospital Pharmacies: From the Angle of Pharmacy Quality Control Circle

Objective To explore the effect of applying pharmacy quality control circle to reduce the error rate of drug delivery in inpatient pharmacy,and to improve the service quality of inpatient pharmacy staff.Methods According to the ten standardized steps of pharmaceutical product management and Gantt chart,fishbone diagram and Plato were used to analyze the causes of drug delivery errors in hospital pharmacies,to find countermeasures and confirm the implementation effect.Results and Conclusion The error rate was reduced from 52% before implementation to 27.8%,and the target achievement rate was 100%.The staff’s understanding and application ability of pharmaceutical product circle was further enhanced.The “Training Standard for Newcomers” has reference value for hospital inpatient pharmacies and it can be promoted continuously.Pharmaceutical quality control circle can improve the quality of pharmacy services in hospitals.

Privacy Level in Private Community Pharmacies in Saudi Arabia: A Simulated Client Survey

Background: Maintaining privacy during patient counseling is critical, especially with respect to sensitive client issues. In general, community pharmacy practice in Saudi Arabia is considered substandard in several aspects, particularly with respect to the privacy it offers to pharmacy clients. However, to date, maintenance of privacy in Saudi Arabian community pharmacies has not been studied using a practical, measurable method. Objective: This study investigates the level and quality of privacy offered by community pharmacies in Madinah, Saudi Arabia. Methods: This study randomly selected 80 pharmacies, which were visited by a simulated client and a simulated customer who were instructed to engage in a standard scenario. During each pharmacy visit, the simulated client asked the on-duty pharmacist about the correct use of a medication intended for a vaginal disease. The simulated customer pretended to look for a nonmedical product on the shelf nearest to where the client-pharmacist consultation took place and observed whether the conversation was audible. Further, privacy facilities and pharmacist behaviors were documented. Results: A designated consultation area was found in only one pharmacy;however, it was not used and not designed as separate from the pharmacist’s counter. Although a designated waiting area was found in the same pharmacy, it was located too close for privacy to be maintained. Other physical measures of privacy were unavailable in all the other pharmacies. Regarding the simulated client-pharmacist consultation, the conversation was audible to the simulated customer in 63% of the pharmacies. Further, in most of the visited pharmacies, there was only one pharmacist on duty. Finally, a female pharmacist was found in only one pharmacy. Conclusions: The study concludes that a critical insufficiency in privacy exists in community pharmacies in Saudi Arabia. It reveals that most pharmacies must be infrastructurally redesigned to provide acceptable privacy levels. Further, the number of on-duty pharmacists should be increased, and pharmacies should employ more female pharmacists.

Factors Related to Medication Adherence of Cognitively Impaired Patients in Community Pharmacies

Objective: The objective of the study was to identify factors related to donepezil medication adherence ("adherence") of cognitively impaired patients in community pharmacies. Methods: One hundred and twenty community pharmacies in 28 regions in Japan were randomly selected. Questionnaires were mailed to these pharmacies. The pharmacists answered based on the medication profiles ("YAKUREKI") of the patients given donepezil at their pharmacies. The survey items were "adherence", "who is the key person" and ‘the key person’s understanding and awareness of donepazil and its symptoms. The χ2 test and decision tree modeling analysis were performed to examine factors affecting adherence. A 5% level of statistical significance was used in the χ2 test. Results: Questionnaires with data on 479 patients were returned. The most common level of adherence was “take as instructed” (81.2%), followed by “forget once or twice a week” (10.2%). The χ2 test revealed that adherence was good if "key person" was professional caretaker (P = 0.004). Also, adherence was better if key person understood medication about dosage, P < 0.001;effect, P = 0.002;and general side effects,, P < 0.001. According to decision tree analysis, the key person had the strongest relationship with adherence. Conclusions: It was confirmed that the key person’s understanding of the medication and symptoms of cognitive impairment are related to adherence. In particular, it was suggested that there is a strong relationship between the key person and adherence and that factors related to adherence differ according to who the key person is. It is essential in the treatment of cognitive impairment to accurately identify the "key person", in order to provide better pharmaceutical care in community pharmacies.

Do Community Pharmacies in Saudi Arabia Provide Medication-Related Information to Nonbuyers? A Mysterious Shopper Survey

Background: Patient counseling service is an integral component of pharmacy practice in the community pharmacy. Counseling services should be provided to patients regardless of whether the patient has the intention to buy a medication or not. Objective: The aim of this study is to investigate the effect of the conflict between ethics and business objectives in Saudi Arabian private community pharmacies on patient counseling. Methods: Eighty pharmacies were randomly selected in Madinah, Saudi Arabia, and visited by mysterious shoppers following a preplanned scenario. Clients requested information on the correct use of a dry powder inhaler for bronchial asthma. A survey form was filled in by the clients immediately after the visit. Results: seventy-five pharmacies were included in the study. Seventy-seven percent of the pharmacists gave a varying content of information although the client showed no intention to buy the medication. Only 5% of pharmacists gave the full instructions regarding the correct handling of the device and using it for taking the correct dose. Around 68% of the pharmacists focused only on how to take the dose. Four percent of the pharmacists provided insufficient information. Around 23% of the pharmacists refused to give any information and referred the shopper to other sources for obtaining the required information. Conclusions: Although most of the pharmacists provided free counseling, the amount and level of information provided were generally insufficient. This illustrates the need for introducing clear policies and guidelines for providing free professional counseling services to patients in the community pharmacy setting in Saudi Arabia.

Access to Antibiotics through Prescription and Non-Prescription Media in Private Pharmacies in Lomé, Togo

Objectives: The present study was conducted to describe and analyze antibiotic demands via prescription and non-prescription media received in private pharmacies in Lomé. Methods: A cross-sectional study was conducted in 26 private pharmacies in Lomé (Togo) from August to October 2013. The study was based on a survey conducted with a standardized questionnaire to collect data representing the daily activity of the pharmacies. Data on prescription documents, non-prescription media, patients’ and prescribers’ identification, and antibiotics requested were collected and analyzed. Key findings: During the study period, 596 antibiotic prescriptions were collected. Various prescription and non-prescription media permitted available antibiotic access in private pharmacies. Seventy-nine percent (79%) of the received orders contained one antibiotic. All categories of health care professionals were found among antibiotic prescribers. Prescribers were not identifiable in 40.2% of all prescription tools received for antibiotics demand. Forty-four percent (44%) of antibiotic orders were supported by a prescription. The study found that many people ordering antibiotic (61%) were not the direct users. Some elements of prescription compliance were mentioned at the rate of 82%, 44.7% and 59% (date, prescribers’ identity and qualification), 3/4 of the prescription material (patients’ identity and sex), more than 87% (accuracy of the dosage), 79.7% (oral route of administration) and less than 1/3 (duration of treatment). The results also indicated that Beta-lactams (41%), quinolones (17%), and 5-nitroimidazoles (15%) were the most prescribed classes of antibiotics. Conclusions: The study revealed that more than half of the antibiotics orders, received in pharmacies were non-compliant. This calls for an awareness of healthcare workers and populations on the rational use of antibiotics. Access to antibiotics should be further controlled (prescription dispensing), community should ban other media of obtaining antibiotics without a prescription and avoid particularly antimicrobial self-medication.

Methadone Maintenance Treatment Program in Portuguese Community Pharmacies

MMT （Methadone maintenance treatment） is an effective way to treat opioid dependence. In Portugal, an MMT program has been available in pharmacies since January 1998, when a formal agreement was signed by the IDT, I.P. （Institute on Drugs and Drug Addiction）, the PPS （Portuguese Pharmaceutical Society）, and the ANF （National Association of Pharmacies）. In January 2004, the INFARMED （National Authority of Medicine and Health Products） became a partner of the program. The possibility of continuing the treatment at a community pharmacy was restricted to patients receiving a stabilized dose of methadone at IDT, I.P. treatment centers. Pharmacists joining the MMT were given mandatory training. Patients on the MMT program received daily doses of methadone solution under directly observed therapy, and were followed up by trained pharmacists. From January 1998 to January 2013, 3,090 patients underwent MMT in Portuguese community pharmacies. The delivery of MMT at community pharmacy level is feasible. This strategy improves access and adherence to methadone treatment, thus helping to reduce the use of illegal opioids. Community pharmacists fully demonstrated their ability to perform extended roles in public health and harm-reduction strategies. Interaction and close cooperation between the different health professionals and organizations involved were crucial to achieve adequate support to the patients.

Emergency Money in Hungarian Pharmacies from World War l to the Hungarian Soviet Republic

All of the existing emergency notes of pharmacy in Hungary between 1914 and 1919 were collected, presented and studied. The concept of emergency money, the causes and circumstances leading to its development were defined. The historical backgrounds of these reasons were studied and presented in chronology order. The various issued emergency money of pharmacy was classified and demonstrated in pictures. When an economic crisis turns up in the life of mankind, special solutions will occur. World War I breaking out a hundred years ago and the Hungarian Soviet Republic created such a situation in Hungary. The official currency was replaced with a new one, the amount of which could not cover the daily purchase of people. The lack of change led to print numerous emergency notes in different fields of life. In this study, all of the so-far discovered pharmaceutical emergency money was collected and presented systematically. The paper is considered to be unique since in the field of the history of pharmacy similar ones have not been born recently. The released notes provide an instantaneous picture of the industry （art, typography, chemical industry etc.） of the given country as well. These pieces of paper are regarded to be valuable treasure among numismatics.

Study of Consistency of Needs and Attitudes of Pharmacists towards Consumers/Patients in Retail Pharmacies in Georgia

Background:The demand for the pharmaceutical services in retail pharmacies has increased over the last decade.The aim of the study is to study the requirements of patients/customers in a modern changing environment to ensure that appropriate pharmaceutical care is provided to increase customer loyalty while taking into account the concept of pharmaceutical care.The study also examined the competence and attitudes of pharmacists in pharmaceutical care to meet the patient’s requirements.Methods:The study was conducted in December 2020.526 patients/pharmacy customers and 1,309 pharmacists participated in the study,via the online questionnaire.Participants were presented with questions such as“I visit pharmacy to buy products”and used 3 or 5-point scale to indicate their response.Results:When choosing a pharmacy,the costumers/patients prioritize:the quality of pharmaceutical services,speed of service,assortment,competence of the pharmacist and the price of the products;while receiving pharmaceutical care,customers want pharmacists to be oriented on them,to be professional and communicate in an understandable language.In pharmaceutical care,the pharmacists’visions and attitudes are consistent and meet with costumers’requirements.Conclusions:In Georgia,the pharmacy is no longer perceived as just a place to buy a medication,but 50%of customers go to the pharmacy to purchase cosmetic and hygiene products.Modern patient/costumer expectations tend to increase the speed and quality of pharmaceutical services.Considering the risks of the patients,it is recommended to expand the modern approaches-new technologies and online services to improve/accelerate the processes in retail pharmacies.

Empirical Study on Improving Customer Satisfaction of Retail Pharmacies by Using Quality Control Circle

Objective To study the effect of quality control circle(QCC)activities on customer satisfaction of retail pharmacies so as to improve the level of customer management.Methods After choosing the theme of improving customer satisfaction research(CSR)in pharmacies,Gantt chart,questionnaire,fishbone diagram and other tools were applied in the“endeavor circle”to find out the factors affecting the theme.Then corresponding countermeasures were made and implemented to verify them in different stages.Meanwhile,the radar map and other technologies were used to compare the changes of CSR and circle members’growth before and after the activities.Results and Conclusion Sales clerk’s lack of drug knowledge,serious shortage of drugs,incapability of establishing a good relationship with customers and the lack of after-sales service were identified as the main factors.After implementing corresponding countermeasures,the target achievement rate was 116.12%,and the progress rate was 19.02%.Besides,customer satisfaction increased from 79.54%to 94.67%and the team growth value of circle members increased from 3.29 to 5.83,with significant tangible and intangible effects.QCC activities in retail pharmacies can not only standardize pharmaceutical service mode,but also improve the overall competence of sales clerks.The key factors and management methods for CSR improvement obtained from QCC activities will provide reference for the customer management of retail pharmacies.

Design of Pharmaceutical Care Process for Retail Pharmacies Based on Pareto Analysis

Objective To study the problems of pharmaceutical care in retail pharmacies and provide reference for the standardized development of pharmaceutical care in China.Methods Based on the literature of CNKI database,Pareto analysis was used to study the present situation of pharmaceutical care in retail pharmacies.Then the following problems in pharmaceutical care were found such as low personnel professional quality,inadequate attention,imperfect laws and regulations,and lack of standard service process.As to the first three problems,there were more research references.But there was less literature on the standard care process.Results and Conclusion Focusing on the customer demand,taking drug sales process as the basic framework of pharmaceutical care standardized process,and combining with the collaboration,the service process including prescription drugs review and OTC drugs purchase consultation is established.This process elaborates the division of staff services as well as the service standards in pre-sale,on-sale,and after-sale stages.Besides,it also puts forward some advice for the previous three problems,which will ensure the smooth implementation of pharmaceutical care in drugstores.

The Problems and Countermeasures of Four Community Pharmacies on Drug Quality Management in Kangping County

Objective To study the drug quality management of four community pharmacies and provide countermeasures and suggestions for improving the drug management level in Kangping County.Methods Literature research and investigation research were adopted in this paper to analyze the current situation and problems of drug management in four community pharmacies in a town of Kangping County.Results and Conclusion The problems of four community pharmacies in a town of Kangping County are low level of drug quality management,insufficient quality and capability of the practitioners and physician’s illegal act such as some licensed pharmacists paid from the linked pharmacies.There are also problems in facilities and equipment,drug display and storage,and document management,which reflects the lack of local drug supervision.Based on the above problems,some countermeasures and suggestions are put forward to strengthen the drug quality management of four community pharmacies in Kangping County.

Research on Development Strategy of Online Pharmacies Based on Blockchain Technology

Objective To study the problems that restrict the development of online pharmacies,and put forward some suggestions for the development of online pharmacies with the help of blockchain technology.Methods Literature review method was used to understand consumers’psychology of online drug purchase.Besides,some experts in related fields were consulted.The specific path of applying blockchain technology to online pharmacies was analyzed based on the unique characteristics of blockchain technology.Results and Conclusion From the perspective of the characteristics of blockchain technology,this paper analyzes the factors restricting the development of online pharmacies,and proposes targeted solutions to the problems of selling counterfeit drugs,leaking consumer information,and government supervision difficulties in the online pharmacies trading platform.This will break through its bottleneck and help the development of online pharmacies.