Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment

Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.

Community Pharmacist-Based Collaborative Disease Management Program for Patients with Poorly Controlled Diabetes

Objective： Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementation of an employer initiated community pharmacist-based disease management program for diabetic patients with poorly controlled diabetes. Methods： Employees with poorly controlled diabetes （glycosylated hemoglobin （A1 C） level 〉 7.5%） were identified fi＇om a large diabetes disease management program, in a rural setting in Texas, US. A longitudinal retrospective study was conducted, analyzing clinical indicators in the diabetes patients following the community pharmacist-based disease management program. The program involved a comprehensive drug therapy assessment and individualized disease management education. Primary outcome measured in the present study was A1C levels, assessed at the baseline visit and at the end of the intervention. Results： A total of 64 patients with poorly controlled diabetes were identified. Significant improvement in mean clinical outcome scores was achieved for A1C levels （p = 0.0011）. At the end of the 1 year longitudinal intervention, targeted body mass index and A1C goals were attained by 35.9% （p 〈 0.001） and 15.6% patients, respectively. The 10 patients reaching goal levels post intervention were in the group that had baseline A1C of 7.5 to 9%. However, patients with 〉 9% A1C levels at baseline had a significant reduction （mean 2.1, p 〈 0.001） post intervention. Conclusion： The community pharmacist-based diabetes disease management program improved A1C levels of patients with poorly controlled diabetes.

Rôles et vécus des pharmaciens d’officine dans les soins palliatifsàdomicile en France Role and Experience ofCommunity Pharmacists in Home Palliative Care in France

The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to understand how community pharmacists see their role in end-of-life home care in France,and to analyze their experiences of this care.An online questionnaire was distributed to community pharmacists working in France between December 2022 and March 2023.Of the 136 respondents to the questionnaire,87%had accompanied at least one patient at the end of life in the 3 months preceding the survey.Therapeutic education(88%of respondents),psychological support for caregivers(85%of respondents),securing treatment(82%of respondents)and monitoring therapeutic compliance(80%of respondents)are the behaviors validated by the greatest number of participants.The majority of professionals surveyed had a positive overall experience of managing patients at the end of life.These results pave the way for pharmacists to better support end-of-life patients at home.

Research on the construction of a pharmacist competency model in China

Based on the competency model building theory, a literature review, a behavioral event interview and statistical analysis were used in this study to build a competency model for pharmacists in China. The competency model framework for pharmacists included five dimensions of characteristics, consisting of 25 competency elements of pharmacists, such as the general competency elements that all pharmacists should possess and outstanding competency elements that community pharmacists and hospital pharmacists should possess. This newly constructed competency model for pharmacists helped develop and cultivate the abilities of future Chinese pharmacists.