bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical services in community pharmacies: a scoping review of policy and social implications
Authors: Campeau Calfat Alexandre , Duval Cécile , Laberge Maude , Savard Anne-Marie , Sirois Caroline 
Published: January 2021

Abstract

Objectives
Clinical services have allowed pharmacists to shift from product-oriented to patient-oriented services. However, the policy and social implications of clinical services in community pharmacies are not well described. The purpose of this scoping review was to identify these implications.

Key findings
We searched Pubmed and Embase, from inception to March 2019, as well as grey literature for publications that discussed policy (e.g. pharmacy model and pharmacist status) or social (e.g. role of pharmacists and interprofessional collaboration) implications of clinical services. Publications had to address clinical services provided by pharmacists in community settings that target the global long-term care of patients. We extracted data related to the implications and classified them into themes thereafter. The search process identified 73 relevant publications, of which 13 were included in regard to policy implications and 60 relative to social implications. Two themes emerged from policy implications: implementation and characteristics of policies, and professional status. Pharmacists’ independence from distribution, financial coverage of clinical services and innovative models of practice were addressed. Social implications involved three themes: roles and interprofessional collaboration, changes in practice and barriers and model of practices and services. Perceptions of pharmacists’ skills, organisational barriers, time constraints, lack of self-confidence and cultural shifts required to implement clinical services were included in these themes.

Summary
Our review demonstrates the changing role of community pharmacists in provision of clinical services within the healthcare system. The range of clinical services varies widely from one setting to another. The context of community pharmacy is not well suited to these changes in practice.
Analysis of the demographics and characteristics of the Australian pharmacist workforce 2013–2018: decreasing supply points to the need for a workforce strategy
Authors: Jackson John K , Liang Jenifer , Page Amy T 
Published: January 2021

Abstract

Objectives
An adequate workforce is necessary for health care delivery. The last official analysis of the Australian pharmacist workforce was in 2014 and the results of recent studies are contradictory. The objective of this work was to determine current demographic details and recent trends of the pharmacy workforce and assess the impact of changes in student numbers and migration policy.

Methods
Longitudinal and descriptive analysis was undertaken of National Health Workforce Datasets and registrant data available from the Australian Health Practitioner Regulation Agency and the Pharmacy Board of Australia from 2013 to 2018.

Key findings
There was an increase in females and a trend towards hospital practice but no change in the geographic distribution of pharmacists over the period. However, the pharmacist workforce grew more slowly than comparable health professions and while the youngest pharmacist cohort (20–34 years) remains the largest, the next oldest cohort increased at a greater rate. The youngest cohort reported a decrease in intention to remain working in pharmacy.

Conclusions
A fall in student numbers and changes to immigration policy have contributed to a low growth rate and ageing of the pharmacist workforce compared with other professions. Whether these factors along with the intentions of young pharmacists will result in a shortage is dependent on developments in demand for pharmacists and a workforce strategy is required to monitor these developments.
Antibiotics and toothache: a social media review
Authors: Emmott Rachel , Barber Sophy K , Thompson Wendy 
Published: January 2021

Abstract

Objectives
Antibiotics are inappropriate for the treatment of toothache, yet many seek them. Social media allows users to express their opinions, share experiences and offer support. This study used social media to investigate the public’s experiences of, and attitudes towards, antibiotics for toothache.

Methods
A systematic search of posts on Facebook and Twitter was undertaken. Eligibility criteria were applied to select relevant social media posts for thematic analysis of word content. An inductive descriptive coding system was developed from the data and exemplary quotes were identified to illustrate the themes and subthemes identified.
Key findings Searches identified 174 posts, of which 144 were selected for analysis. Five themes were identified: experience and expectations, self-care and professional treatment, access to dental care, quality of life and coping strategies. The belief that antibiotics are an appropriate treatment for a toothache was widespread. Antibiotic-seeking behaviour was related to access to professional dental care, including avoiding dental appointments due to dental anxiety and the perceived affordability of dentistry. A range of strategies to cope with the severe impact toothache was having on people’s quality of life were identified, from prayer to antibiotics.

Conclusions
Social media is used extensively to seek antibiotics, avoid dental treatment and provide support to people with toothache. A general belief that antibiotics are an appropriate and necessary treatment for toothache exists. This improved understanding about the factors driving antibiotic-seeking behaviour provides new targets for the development of approaches to tackling antibiotic resistance, by reducing unnecessary antibiotic use in dental clinics and beyond.
The Selectivity of Aesthetic Explanation
Authors: Song Moonyoung 
Published: January 2021

Abstract
It is widely agreed that an artwork having certain non-aesthetic properties explains its having a certain aesthetic property. One interesting feature of such an explanation is its selectivity—it cites only some of the non-aesthetic properties on which the presence of the aesthetic property depends. Hence a question arises as to what distinguishes the selected non-aesthetic properties from the unselected ones. I answer this question by proposing a selection principle modeled on Laura Franklin-Hall’s selection principle for causal explanation, according to which an explanation selects a package of factors that maximizes the ratio of delivery (the degree to which the factors cited in an explanation make what is explained modally robust) to cost (the amount of information an explanation contains).
Spectrophotometric Determination of Polyvinyl Pyrrolidone in Pure and Pharmaceutical Dosage Form
Authors: Al-Afify Nourhan Kh , Trabik Yossra A , El-Kosasy Amira M , Magdy N 
Published: January 2021

Abstract

Background
Recently, functional polymers have attracted significant attention in the areas of pharmaceuticals and biomedical applications, so it is important to develop simple techniques to analyze functional polymers in their pharmaceutical dosage forms.

Objective
Three simple, accurate, and sensitive UV spectrophotometric methods have been developed and validated for determination of polyvinyl pyrrolidone (PVP) in the presence of benzalkonium chloride (BZ) and sodium lactate in ternary mixtures.

Method
Method A is a derivative ratio spectra zero-crossing (DRSZ) method which measures PVP peak amplitude at 303.1 nm. Method B is a double divisor ratio derivative (DDRD), used for determination of both PVP and BZ in the presence of sodium lactate at 272.6 and 271.5 nm, respectively. Method C is a double divisor ratio derivative-ratio difference spectrophotometric method (DDRD-RDSM), a new and hybrid method of double divisor and ratio difference that hasn't been applied before. It measures peak amplitude difference of the ratio spectra at ΔP278 – 252.4 and ΔP260.9 – 213 for PVP and BZ, respectively.

Results
Linear ranges for PVP (5.00–35.00, 10.00–40.00, and 10.00–40.00 µg/mL) was obtained by using DRSZ, DDRD, and DDRD-RDSM, respectively. While the linear range for BZ (5.00–60 µg/mL) was obtained by using both DDRD and DDRD-RDSM.

Conclusions
All results were statistically compared with reported methods. No significant differences were observed. The developed methods were applied to the analysis of the investigated drugs in pure and pharmaceutical dosage forms.

Highlights
The proposed methods are of great value, improving the efficiency of routine analysis of PVP and BZ in their pharmaceutical dosage forms.
Prescribing patterns and cost-utility analysis of management of childhood asthma in Saudi Arabia: a retrospective cross-sectional study
Authors: Ali Mohammad Daud , Ahmad Ayaz , Banu Nuzhat , Patel Munfis , Ghosn Sherihan Ahmad , Eltrafi Zainab 
Published: January 2021

Abstract

Objective
This study is based on a retrospective cross-sectional study to assess the prescribing patterns and cost-utility analysis of management of childhood asthma in Saudi Arabia.

Methods
Prescription data were collected for 1 year from electronic records of pharmacy. The unit dose price was retrieved from pharmacy database and compared with daily price based on WHO Defined Daily Dose (DDD) and Saudi Initiative for Asthma (SINA). The cost of each drug is calculated from average prices of each unit dose of each prescription.

Key findings
In male children (57.98%), asthma was more common in comparison to female children (41.02%) at the studied hospital. Salbutamol (44.55%) was the most commonly prescribed medication followed by budesonide (30.97%) and montelukast (12.82%), whereas prednisolone (0.15%) was the least prescribed medication for the management of childhood asthma. It was found that fixed-dose combination of budesonide and formetrol prescribed for the longest duration of therapy (30 days) and imposed highest cost as well [197.10 SR (52.53 USD)] among all the prescribed medicine.

Conclusion
In this study, inhalation route is the most preferred one for management of asthma; this may be due to their fast therapeutic action. Salbutamol was the most popular drug for quick reliever therapy, while budesonide was the most favoured drug for childhood asthma management. Medication prescribed for the management of childhood asthma at the mentioned study centre adhere to SINA guideline.
Healthcare resource utilization and costs associated with hyperkalemia in a large managed care population
Authors: Sharma Ajay , Alvarez Paula J , Woods Steven D , Fogli Jeanene , Dai Dingwei 
Published: January 2021

Abstract

Background
Hyperkalemia is a serious metabolic condition and can lead to life-threatening cardiac arrhythmias and sudden death. Guideline-directed medications that affect the renin-angiotensin-aldosterone axis can increase serum potassium and may limit their use. Hyperkalemia has been shown to drive healthcare resource utilization (HRU) and costs for patients with cardiorenal conditions.

Objectives
To describe hyperkalemic patient characteristics and quantify patient HRU and costs relative to normokalemic patients from a large US health plan.

Methods
A retrospective cohort study that identified and evaluated a hyperkalemic patient population from a large administrative claims database. The observation period was 1 January 2015 to 31 May 2018, with a 1-year follow-up period after the index date (the earliest service/claim with evidence of hyperkalemia). Primary patient outcomes included inpatient admissions, emergency department (ED) visits, primary care physician (PCP)/specialist visits, length of stay (LOS) and associated medical and pharmacy costs. This hyperkalemic cohort was stratified by renin-angiotensin-aldosterone system inhibitor (RAASi) utilization and chronic kidney disease (CKD) stage for the economic analysis.

Key findings
86,129 adult patients with hyperkalemia were evaluated in the study cohort (median age: 69 years). There were more males [45,155 (52%)], with the majority of patients located in the Southern United States [45,541 (51%)] and a 70/30 split of Medicare to a commercial health plan. Most patients had CKD, hypertension and hyperlipidemia; ≥80% of the patients had ≥4 comorbidities. Over 40% of patients were not receiving RAASi therapy, and potassium binder use was low (&lt;5%). Patients using optimal-dose RAASi with proportion of days covered ≥80% were observed to have the lowest HRU for inpatient admissions, ED and PCP visits and LOS days.

Conclusions
Hyperkalemia is associated with substantial HRU and costs. The development of a quality improvement program structured around the management of hyperkalemia in individuals with heart failure, diabetes and/or CKD may be necessary.
Attitudes and appropriateness of pain management in cancer patients using pain management index
Authors: Ayoub Nehad M , Nuseir Khawla Q , Al-Shamali Yasmeen A , Al-Zoubi Ahmad 
Published: January 2021

AbstractObjectivesInadequate management of cancer pain (CP) remains a global medical problem. In this study, the aim was to assess attitudes of cancer patients towards their CP treatment and to evaluate effectiveness of pain management.MethodsA sample of 300 adult cancer patients admitted to a single hospital were face-to-face interviewed in a cross-sectional study design using a structured questionnaire. The short form of the Brief Pain Inventory was used to collect data on pain, and Pain Management Index (PMI) was calculated to assess adequacy of pain management.Key findingsMedian age of patients was 53 years (interquartile range, 43–63). Half of patients (50.5%) believed their pain therapy needs improvement. Almost half patients had severe pain at interview (49.8%). Pain interfered most with patient enjoyment of life with a mean interference score 6.13 ± 2.37. Majority of cancer patients (84.3%) received a non-opioid analgesic while a minority (15.7%) received opioid analgesic in which morphine was the most common drug. The use of non-opioid adjuvants was minimal. Mean PMI for patients was −1.15 ± 0.75 (range −2 to +1), and most patients (80.3%) had inadequate pain treatment. Gender and smoking status of patients were significantly associated with adequacy of pain management (P = 0.009 and P = 0.004, respectively). There were no associations between patient age, educational level or tumour characteristics and adequacy of pain management.ConclusionsCancer patients in this study present with severe pain and the rates of undertreatment are high. There is an urgent need to improve management plans to assure appropriate use of therapeutic modalities for treatment of cancer-related pain.
Examining community-managed drug outlets' failure in geographically isolated and disadvantaged areas: insights from the consumers' end
Authors: Collado Zaldy C , Rescober Angeli Ann S , Hipolito Imee G , Ulat Armand Patrick A , Tayfour Abubakr 
Published: January 2021

Abstract

Objectives
The article aimed to examine the impact of poor purchasing power, perceptions on the physical structure, and medicine demand to community-managed drug outlets or Botika ng Barangay (BnB) in the Philippines. The study investigated what contributes to program resiliency or failure in so far as the consumers in geographically isolated and disadvantaged area (GIDA) are concerned.

Methods
Findings were drawn from five sets of focus-group discussion (FGD) among residents, four in-depth interviews (IDIs) with former operators of BnB and three IDI with former members of the village council specifically assigned in health sector.

Key findings
The study found out that all our study variables namely; poor purchasing power, perceptions on BnBs' physical image, and limited medicines that do not match the consumers' medicine demand did not contribute to the failure of the program in their communities. However, the study found out that informal arrangements in the community which allowed people to just loan medicines without actually paying in return was intimately connected to BnBs' closure in the communities.

Conclusion
The study suggests that, in the context of GIDAs, the failure of community-managed drug outlets rests as well on financially unsustainable practices in the community. This, we believe, can be negated through provisions for medicine subsidy.
Perception and attitude of the public on vaccine practices and pharmacists as immunizers in Jordan
Authors: Batarseh Yazan S , Darwish ElHajji Feras W , Shammas Samira , Darwish Rula M , Fakhoury Rula , Al Haj Ahmad Maram , Al Rusasi Ahmed , Jarrar Laila 
Published: January 2021

Abstract

Objective
To assess general perception and attitude of the public on vaccines current practices and pharmacists as immunizers in Jordan

Methods
In this study, computer-assisted personal interviews technique was utilized using a quantitative approach of a structured questionnaire. The survey instrument was completed with random telephonic interviews covering different geographic areas in the country of Jordan with a total sample size of 366.

Key findings
Majority of respondents had a positive perception of vaccines in general. Regarding the respondents’ perception of current vaccination status, the majority felt it is good as is or requires some enhancements. Furthermore, 53% believe pharmacists should administer vaccines. Majority strongly agree (76%) that pharmacists should be trained and certified to do so. However, 57% strongly disagree that current pharmacies in Jordan have the facilities allowing them to administer vaccines. Finally, a significant increase of 26% in public willingness to have a pharmacist immunizer after certification was observed compared to without being certified (52%).

Conclusions
Respondents support the role of vaccination as a preventative tool. However, to their opinion, contrary to the high effectiveness in paediatric vaccination in Jordan, current adult vaccination systems need to be revised and improved to increase its adult coverage. Additionally, respondents highly support the idea of allowing pharmacists to become immunizers under certain conditions regarding proper training, accredited certification and licensed administration facilities.
Medical staff perspective on factors influencing their prescribing decisions: a cross-sectional study in Mekong Delta, Vietnam
Authors: Tran Van De , Cao Nguyen Thi Tai , Le Minh Hoang , Pham Duy Toan , Nguyen Kien Trung , Dorofeeva Valeria Valeryevna , Loskutova Ekaterina Efimovna 
Published: January 2021

AbstractObjectivesUnderstanding medical staff’s prescription behaviors helps improve the quality of prescriptions and the rationality of medication use. Although factors affecting the prescribing decisions were discussed in various studies worldwide, limited knowledge of these issues has been reported in Vietnam. This paper aims to examine factors that influence prescribing behavior concerning medical staff’s demographics and characteristic differences.MethodsQuantitative descriptive cross-sectional study, using adapted questionnaire consisting of 27 factors divided into 9 factor categories, was conducted with medical staff in Mekong Delta during June–July, 2019. Rasch analysis was performed to assess the questionnaire psychometric properties. Descriptive analysis, parametric tests and non-parametric tests were utilized to address the study objectives.Key findingsA total of 201 participants completed the questionnaire. A majority of participants (&gt;90%) agreed that their own decision to prescribe a drug was influenced by several factors such as drug safety and efficacy (92.5%), patient history (92.0%), patient income (92.0%) and patient disease status (91.0%). There were significant age differences in influences on prescribing decision. Medical staff aged under 30 appreciated the role of pharmacists higher than whose aged 31–40 (P-value = 0.010) and over 40 (P-value = 0.013). Additionally, they were more concerned with ‘patient characteristics’ including patient request, expectations, and disease status when making prescribing decisions compared with whose aged over 40 (P-value = 0.005).ConclusionsThe study revealed various factors influencing medical staff prescription decision-making processes. These findings could be useful for pharmaceutical companies in Vietnam in developing marketing strategies, and for policy-makers in timely improvement of prescription quality.
A comparison study between public and private healthcare sector medicine prices in South Africa
Authors: Thaver Tarryn , Padayachee Neelaveni , Bangalee Varsha 
Published: January 2021

Abstract

Objectives
The objectives of the study were to compare price trends, determine price differentials, and equate the average price index of a basket of medicines between the public and private healthcare sectors in South Africa.

Methods
A price list consisting of 32 essential medicines available in both the public and private healthcare systems of South Africa was chosen for this study. The price of medicines for the private sector were obtained from the Medicine Price Registry-Open Up website for the period 2014–2018. Public sector medicine prices were obtained from the Department of Health website for the corresponding period. Observations and price trends were identified and analyzed using Microsoft Excel version 2016.

Key findings
A total of 74 medicine brands were analyzed in the study. It was found that the prices across both sectors had increased over time, however, the majority of brands (87%) displayed higher prices in the private sector in comparison to the public sector. On average, the price differential between the private and public sector medicines were 395.47%.

Conclusions
The study found varying price differences between medicines in the public and private sectors because of the different methodologies used in each. The reasons for changes in medicine prices across the years in both sectors, could not always be clearly determined as both sectors lacked complete transparency in the processes applied to establish medicine prices. Therefore, more transparent medicine price systems need to be considered for the future of South Africa’s healthcare system as the country transitions toward universal health coverage.
Impact of pharmacist-led interventions on asthma patients’ knowledge, attitudes and self-efficacy: single-blind randomised controlled trial
Authors: Amorha Kosisochi C , Okonta Mathew J , Ukwe Chinwe V 
Published: January 2021

Abstract

Objectives
Asthma is a common chronic disease and education is a critical component of chronic disease management. This study assessed the impact of pharmacist-led educational interventions on asthma patients' knowledge, attitudes and self-efficacy.

Methods
This single-blind, three-arm, prospective, randomized, controlled and parallel group study was conducted in the Respiratory Units of University of Nigeria Teaching Hospital, Enugu State and the Lagos University Teaching Hospital, Lagos State between March 2016 and September 2017. The three arms, in a 1 : 1 : 1 ratio, were: Usual Care, Individual Intervention and Caregiver-assisted Intervention. The Intervention arms received education, to varying degrees, for six months. The Usual Care arm received no education. The Knowledge, Attitude and Self-Efficacy-Asthma Questionnaire was filled at baseline, three months and six months. Data were analysed using the IBM SPSS Version 25.0 with statistical significance set as P &lt; 0.05.

Key findings
Seventy-eight (78) asthma patients participated; 39 per hospital; 13 in each arm. Patients in both Intervention arms possessed significantly better asthma knowledge compared to Usual Care at three months (13.73 versus 5.88, P &lt; 0.001/12.81 versus 5.88, P &lt; 0.001) and six months (14.31 versus 5.77, P &lt; 0.001/13.23 versus 5.77, P &lt; 0.001). Only the Individual Intervention arm demonstrated significantly better attitudes (84.92 versus 79.77; P = 0.047) and self-efficacy (86.12 versus 80.73, P = 0.006) compared to Usual Care at three months and six months, respectively.

Conclusions
These findings highlight the importance of educating patients directly, as much as possible.