Journal of Pharmaceutical Policy and Practice
ISSN / EISSN: 20523211 / 20523211
Published by: Springer Nature
Total articles ≅ 585
Latest articles in this journal
Published: 30 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-10; https://doi.org/10.1186/s40545-022-00496-y
Background: Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points. Objectives: This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania. Methodology: A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices. Results: The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Liquefied Petroleum Gas (LPG), respectively. Besides, 27 (35%) health facilities have an alternative energy source as a backup. In general, healthcare workers had a good knowledge of cold chain management, including the World Health Organization recommended storage temperatures for vaccines. Furthermore, vaccine stockout was found in 12 (15.6%) health facilities for at least one antigen and 4 (5.1%) health facilities for all five antigens under observation. This current study also revealed that the average calculated vaccine wastage rates for DTP, Measles–Rubella and Rotavirus vaccines were 7%, 19%, and 15%, respectively. More than half of health workers did not perform monthly temperature data reviews. In addition, poor performance led to high wastage rates, including the Rotavirus vaccines, and a change in VVM to discard points. Finally, a small number of 5 (6.5%) health facilities consecutively reported temperature exposure beyond + 8 Celsius (between 5.9 and 281 h). Conclusions: Healthcare workers’ vaccine and cold chain management knowledge were good for temperature data reading and documentation. However, the practices were poor for some health facilities. The gaps observed in this study inform health managers and policymakers toward establishing interventions to improve health workers' knowledge and practice, including mentorships, supervision, and training to guarantee that each child in all communities reaps the benefits of immunisation services.
Published: 28 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-14; https://doi.org/10.1186/s40545-022-00482-4
Background: Globally accepted roles of pharmacists are described in the Good Pharmacy Practice (GPP) standards, published by the World Health Organization (WHO) and the International Pharmaceutical Federation (FIP) in 2011. These standards provide a wide-ranging description of four main roles pharmacists fulfil. The global platform, where pertinent discussions around excellence and innovation in various pharmacy roles take place, is the annual congress of the pharmacy organisation representing the profession globally, FIP. Objectives: Given the world pharmacy congresses present and reflect on the most topical and contemporary matters, this longitudinal study aimed at creating a historical overview of the frequency of appearance of the different GPP roles in the programmes of the past 17 congresses (2003–2019). This is to distinguish the dominance of different roles over time and thus their relevance for the profession. Methods: The GPP standards served as a framework to create a set of keywords that were analysed for their frequencies of appearance in the programmes through text analysis. Trends in the four overarching GPP roles and at individual keyword level were analysed descriptively over time. Results: The study found that all four GPP roles appeared in the programme each year and none of them was significantly missing, neither in the decade preceding the publication of the GPP standards nor in the decade thereafter. Role 3 “Maintain and improve professional performance” was most frequently represented, also demonstrating an upward trend in appearance, together with Role 4: “Contribute to improve effectiveness of the health-care system and public health”. Trends emerged towards patient-centred clinical focus and positioning pharmacy as an important player in the health-care system—observed also at individual keywords level in areas such as health promotion—away from the more traditional product-centred practice roles such as compounding. Conclusions: GPP roles have been already covered by the FIP annual congresses (long) before 2011, when the GPP roles were formally adopted, and they stayed relevant in the decade after. The more pronounced dominance toward the roles related to improving professional performance and positioning pharmacy are in line with the trend that the rather technical topics in pharmacy are increasingly covered by specialised meetings and that the FIP annual congresses have moved toward more general, scholarly platforms for dialogue and conversation.
Published: 28 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-11; https://doi.org/10.1186/s40545-022-00498-w
Background: Lebanon has been recognized as a center for high-quality healthcare services in the Middle East because of its prestigious facilities certified by international bodies, competent health workers, and credible pharmaceutical sector. This study assessed the professional situation of the Lebanese pharmaceutical workforce upon graduation and entry to the job market. It also evaluated the satisfaction of pharmacists with the financial, physical, and psychological aspects of their job and the effect of the current socioeconomic crisis on their profession. Methods: A cross-sectional study was performed between January and May 2021 among 114 Lebanese pharmacists from all pharmaceutical sectors across Lebanon. A self-administered questionnaire was elaborated to assess the pharmaceutical workforce in Lebanon. The online questionnaire was built using Google Forms and disseminated via emails and social platforms. Results: Fresh graduates seemed more oriented toward community pharmacies, and 78.1% of the participants worked at least once in their lifetime in a community pharmacy. Pharmacists from the public university worked predominantly in the community pharmacy sector, while those who graduated from private universities worked mainly as medical representatives. Hospital pharmacy comprised significantly more PharmD graduates than other sectors; medical representatives had mainly a BS pharmacy, while those working as industrial pharmacists had a Master’s degree. A low percentage (31.6%) of participants found it easy to get hold of a job across different pharmaceutical sectors while 64.0% considered the internships experience insufficient to get employed. Nearly half (48.2%) of the respondents were poorly satisfied with their job, and 54.0% of community pharmacists reported not working in their preferred field compared to 39.1% of pharmacists from other sectors. Also, 65.79% felt that the economic crisis and the consequent medication shortages affected their credibility and how society perceived them. About half (45.61%) of the participants reported that their employment status was not affected by the crisis; the rest got a second job to cover their expenses (15.79%) or changed jobs (14.91%). Conclusion: Our study findings revealed that most Lebanese fresh graduates worked as community pharmacists, which does not correspond to their preference, the available job market, and the modern pharmacy wingspan. Most pharmacists were also financially, physically, and emotionally dissatisfied due to the Lebanese economic crisis that added heavy workloads and responsibilities without any financial raise.
Published: 24 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-6; https://doi.org/10.1186/s40545-022-00488-y
Background: Family planning involves the use of traditional or modern methods to prevent maternal and infant mortality associated with unintended pregnancies and negative economic outcomes. In sub-Saharan Africa, the unmet need for modern family planning is approximately 66%. However, information on factors affecting utilization of female family planning commodities is limited. Therefore, this research was conducted to bridge this gap. Methods: Health facility-based descriptive cross-sectional research design was conducted and involved the public health facilities offering family planning, targeting respondents who handle the commodities and service providers themselves. A semi-structured questionnaire was used to collect data about availability of the commodities, knowledge of service providers and barriers affecting provision of the service. Data were coded and analyzed via Microsoft Excel 2019 and SPSS version 20. Results: The study showed that shorter term methods were more readily available, 60–75% than the long-term methods, 20–60%. Approximately 60% of the service providers did not comprehensively utilize the recommended World Health Organization Medicine Eligibility Criteria (WHO MEC) during service provision. Stock outs, myths and misconceptions, male interference and culture were the major barriers identified. Conclusion: Provision of family planning commodities in public health facilities in Kajiado county is affected by stock levels at the national program, and provider knowledge on WHO MEC. The key factors affecting provision of family planning were stock outs, myths and misconceptions on the contraceptives, inadequate male involvement and inadequate community engagement on potential benefits of the service. These challenges need to be part of the solutions to bridging the gap identified.
Published: 24 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-8; https://doi.org/10.1186/s40545-022-00492-2
Background: Access to quality medicines is a global initiative to ensure universal health coverage. However, the limited capacity of National Medicines Regulatory Authorities (NMRAs) to prevent and detect the supply of poor-quality medicines led to the predominance of sub-standard and falsified (SF) medicines in the supply chains of many countries. Therefore, this study was designed to assess the capacity of a young NMRA to ensure the quality of medicines with Rwanda as a case study. Objective: This study aimed to assess the capacity of the Rwanda FDA, a young NMRA, to identify gaps and existing opportunities for improving regulatory capacity and ensuring the quality of medicines. Methods: This study used a descriptive cross-sectional design with both quantitative and qualitative approaches. The quantitative approach used a self-administered questionnaire to collect data from employees of Rwanda FDA who are involved in medicine regulatory practices based on their positions while the qualitative research approach covered a desk review of key regulatory documents. The data collection tool was developed from the World Health Organization (WHO) Global Benchmarking Tool (GBT) for “Evaluation of National Regulatory System of Medical Products Revision VI”. Results: Of the 251 WHO sub-indicators assessed, 179 sub-indicators (71%) were fully implemented, 17 sub-indicators (7%) were partially implemented, 9 sub-indicators (4%) were ongoing and 46 sub-indicators (18%) were not implemented by the time of the study. The results of the study showed that the estimated maturity level at which Rwanda FDA operates is maturity level 2. The study reported the challenges hindering the implementation of key regulatory functions that need to be addressed. Challenges reported include but are not limited to understaffing, lack of automation system, poor implementation of the quality management system, lack of screening technologies for SF medicines, low capacity of the quality control laboratory to test all sampled medicines and lack of regulatory inspection tools/equipment. Conclusion: Findings indicated that all key regulatory functions were operating and supported by the legal framework. However, the implementation of key regulatory functions faced challenges that need to be addressed for better organizational effectiveness and compliance with the requirements of a higher maturity level.
Published: 24 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-10; https://doi.org/10.1186/s40545-022-00491-3
Purpose: Despite its importance in ensuring sustainable healthcare, there are huge challenges with pharmaceutical research and development (R&D) especially for developing countries mainly due to the high investment costs naturally associated with such activities. In this regard, the pharmaceutical sector in Ethiopia, the most populous nation in East Africa, faces numerous challenges. The current study aimed at assessing the R&D capacity of the local pharmaceutical manufacturers from the perspectives of key informants working in the companies and supporting government offices and education institutions. Methods: A qualitative study design employing in-depth interviews using semi-structured interview guides with flexible probing techniques was used for data collection. The study involved purposively selected participants who represented major stakeholders such as managers in the R&D departments of pharmaceutical manufacturers, officers and leaders in concerned government agencies and researchers in a local university. All transcribed interviews were subjected to thematic analysis and the Qualitative Data Analysis software in family R (RQDA) was used for data analysis. Results: A total of 14 participants were involved in the study and three major themes were identified from the interviews. Current R&D capacity, opportunities and challenges for involvement in R&D were the major themes. Under current R&D capacity, the weak R&D status of local pharmaceutical plants and minimal university–industry linkage were identified. The challenges of pharmaceutical R&D in Ethiopia included weak governmental and managerial support; difficult procurement processes for R&D input; and the high cost of R&D. Availability of trainable human power and planned government incentives were identified as the opportunities. Conclusion: Overall, there is a low level of R&D capacity in local pharmaceutical industries and timely interventional strategies should be implemented through collaboration of academia, research institutions and pharmaceutical industries.
Published: 22 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-11; https://doi.org/10.1186/s40545-022-00487-z
Background: Yemen's health system has severely deteriorated due to the ongoing civil war accompanied by the COVID-19 pandemic which coincided with other outbreaks of endemic infections. Many health institutions closed due to insufficient equipment and supplies. Consequently, pharmacists became the available healthcare provider on the frontlines. This study aimed to evaluate the pattern of demand for prescription and nonprescription drugs during the pandemic based on the pharmacist's perspective in Yemen, a conflict zone country. Methods: An online survey was developed, validated, and distributed among pharmacists. The questionnaire was composed of two sections: (1) demographic characteristics of the participants and (2) changes in the demand for different drug categories. Chi-square test and Fisher's exact test were used to find statistical associations. Results: Responses (330) were received from pharmacists working in 12 out of 22 governorates in Yemen. During the pandemic, there was an increase in the demand for prescription drugs such as antibiotics, antimalarials, and sedatives (95%, 90%, and 71%, respectively) and an increase in the demand for nonprescription drugs such as vitamins (93%) and paracetamol (> 90%). Some of these drugs could have serious side effects if taken without medical advice, and others could result in severe effects if taken concomitantly. In addition, there was an increase in the demand for prescription drugs without a prescription, which was reported by 50% of the participants. No statistical difference was seen between the frontline districts and major cities in terms of requesting these drugs without a prescription. On the other hand, most participants (75.2%) did not attend any training or workshop during the last 6 months of conducting this survey. Conclusion: COVID-19 has increased the demand for many prescription and nonprescription drugs, where the irrational use of these drugs may lead to devastating health effects. In war zone areas hit by a pandemic, policymakers and public health organizations should focus on training and educating pharmacists as important health care and medicine providers for the public.
Published: 21 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-9; https://doi.org/10.1186/s40545-022-00476-2
Background: High-risk medications use at home entails an increased risk of significant harm to the patient. While interventions and strategies to improve medications care have been implemented in hospitals, it remains unclear how this type of medications care is provided in the home care setting. The objective was to describe home care nurses’ management of high-risk medications. Methods: A cross-sectional, descriptive design was set up in home care nurses in Flanders, Belgium. Participants were recruited through convenience sampling and could be included in the study if they provided medications care and worked as a home care nurses. Participants completed an online structured questionnaire. Questions were asked about demographic information, work experience, nurses’ general attitude regarding high-risk medications, contact with high-risk medications and the assessment of risk and severity of harm, specific initiatives undertaken to improve high-risk medications care and the use of additional measures when dealing with high-risk medications. Descriptive statistics were used. Results: A total of 2283 home care nurses participated in this study. In our study, 98% of the nurses reported dealing high-risk medications. Home care nurses dealt the most with anticoagulants (96%), insulin (94%) and hypnotics and sedatives (87%). Most nurses took additional measures with high-risk medications in less than 25% of the cases, with the individual double check being the most performed measure for all high-risk medications except lithium. Nurses employed by an organization received support mostly in the form of a procedure while self-employed nurses mostly look for support through external organizations and information sources. Conclusions: The study shows several gaps regarding high-risk medications care, which can imply safety risks. Implementation and evaluation of more standardized high-risk medications care, developing and implementing procedures or guidelines and providing continuous training for home care nurses are advised.
Published: 18 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-9; https://doi.org/10.1186/s40545-022-00481-5
Background: Regular measurement of the availability and use of key medicines for non-communicable diseases allows the tracking of progress to achieve equitable access to medicines. Using a country-level public sector monitoring system for medicine supply, we aim to evaluate the availability and use of losartan 50 mg tablets and metformin 850 mg tablets between 2015 and 2020 investigating the impact of different policy changes and the COVID-19 pandemic. Methods: Data from the Peruvian National System of Medicine Supply were analyzed using an interrupted time series analysis with known and unknown structural breaks. The outcomes assessed were medicine use (monthly doses dispensed at facilities over time) and medicine availability (proportion of facilities that reported having the medicine available). Results: The use of losartan and metformin at the primary level of care had a linear increasing trend over the period of analysis. In secondary and tertiary levels of care, there were no increases but some significant level and trend changes of doses dispensed at different times between 2017 to 2019, but none were related to the change of procurement procedures. At all levels of care, the COVID-19 onset in April 2020 caused an abrupt drop in doses dispensed especially at the primary level. Regarding availability, we found an increasing linear trend in the primary level of care for both medicines. In secondary and tertiary levels of care, the availability fluctuated between 40 and 95%. The onset of the COVID-19 pandemic did not significantly impact medicine availability, except for losartan in the tertiary level of care. Conclusion: The availability and proper dispensing of first-line medicines for hypertension and diabetes is an essential factor for sustainable and equitable treatment. Health care systems need to be prepared for forecasting the increasing demand of medicines for chronic diseases, but also to maintain effective medicine supply chains during humanitarian crisis like pandemics.
Published: 18 November 2022
Journal of Pharmaceutical Policy and Practice, Volume 15, pp 1-16; https://doi.org/10.1186/s40545-022-00480-6
Background: Currently in Greece, no formal organisation offers post-academic education to pharmacists. To improve the clinical practice of pharmacists, there is a need for training that will educate them on how to approach and consult their patients. The study aimed to evaluate the training required by pharmacists to offer a pharmacy-led weight management service in Greece. Methods: The study consisted of 3 phases. During the first phase educational needs of the participating pharmacists were identified. A pre-training quiz was given consisting of 14 questions to investigate the participating pharmacists’ knowledge on guidance, causes and facts of obesity. The second phase comprised the training design and delivery. The final phase dealt with training evaluation (27 questions in total), which included the perceived rating of knowledge and confidence levels pre- and post-training, and a post-training quiz (the same as the pre-training quiz). The post-evaluation questionnaire and the quiz (pre- and post-training) results were entered into SPSS Version 23 for statistical analysis. Results: The mean total quiz score was 6.38 (SD = 2.56) pre-training compared to 11.92 (SD = 1.20) post-training (P < 0.001). Nearly all community pharmacists, 96.2% (n = 25) stated that they had an excellent/good experience and 88.5% (n = 23) strongly agreed/agreed that their expectations were met. Conclusions: Training delivered was well received and it enhanced participants’ knowledge on the topic. Limitations include the small number of participating pharmacists and investigation of short-term training effects only. Due to the positive outcomes of the training, however, it has the potential to become a model for Greek pharmacists to offer different pharmacy-led public health services.