scholarly journals Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications

2021 ◽  
Vol 11 ◽  
Author(s):  
Israel Abebrese Sefah ◽  
Olayinka O. Ogunleye ◽  
Darius Obeng Essah ◽  
Sylvia A. Opanga ◽  
Nadia Butt ◽  
...  
Keyword(s):  
Rapid Assessment ◽  
Inappropriate Prescribing ◽  
Data Gathering ◽  
Herbal Medicines ◽  
Community Pharmacists ◽  
Unintended Consequences ◽  
Stock Management ◽  
Patient Organisations ◽  
Price Increases ◽  
Considerable Controversy

Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic.Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients.Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic.

scholarly journals Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future

2020 ◽  
Vol 8 ◽  
Author(s):  
Brian Godman ◽  
Mainul Haque ◽  
Salequl Islam ◽  
Samiul Iqbal ◽  
Umme Laila Urmi ◽  
...  
Keyword(s):  
Rapid Assessment ◽  
Community Pharmacists ◽  
Unintended Consequences ◽  
Asian Countries ◽  
Price Increases ◽  
Appreciable Increase ◽  
Narrative Literature ◽  
Considerable Controversy ◽  
Narrative Literature Review ◽  
Price Instability

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further.Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries.Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries.Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

scholarly journals Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications

2021 ◽  
Author(s):  
AISDL
Keyword(s):  
Developing Countries ◽  
Personal Protective Equipment ◽  
Rapid Assessment ◽  
Protective Equipment ◽  
Price Increases ◽  
Considerable Controversy

Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high copayment levels. Consequently, there is a need to investigate this further.

scholarly journals Availability and price changes of potential medicines and equipment for the prevention and treatment of COVID-19 among pharmacy and drug stores in Bangladesh; findings and implications

2020 ◽  
Author(s):  
Mainul Haque ◽  
Salequl Islam ◽  
Samiul Iqbal ◽  
Umme Laila Urmi ◽  
Zubair Mahmood Kamal ◽  
...  
Keyword(s):  
Disease Management ◽  
Response Rate ◽  
Medical Science ◽  
Community Pharmacists ◽  
Protective Equipment ◽  
Local Production ◽  
Stakeholder Groups ◽  
Price Increases ◽  
Prevention And Treatment ◽  
Multiple Approach

Objective: There are concerns with increased prices and drug shortages for pertinent medicines and personal protective equipment (PPE) to prevent and treat COVID-19 enhanced by misinformation. Community pharmacists and drug stores play a significant role in disease management in Bangladesh due to high co-payments. Consequently, a need to review prices and availability in the pandemic. Materials and Methods: Multiple approach involving a review and questionnaire among pharmacies and stores early March to end May 2020. Results and Discussion: 170 pharmacies and drug stores took part, giving a response rate of 63.9%. Encouragingly, no change in utilization of antimalarial medicines in 51.2% of stores despite global endorsements. However, increased utilisation of antibiotics (70.6%), analgesics (97.6%), vitamins (90.6%) and PPE (over 95%). Encouragingly, increases in purchasing of PPE. No increase in prices among 50% of the stores for antimalarials, with a similar situation for antibiotics (65.3%), analgesics (54.7%), and vitamins (51.8%). However, price increases typically for PPE (over 90% of stores). Shortages also seen for medicines and PPE, again greater for PPE. Conclusions: The pandemic has impacted on the supply and prices of medicines and PPE in Bangladesh. Key stakeholder groups can play a role addressing misinformation, with enhanced local production helping address future shortages and prices. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 36-S 50

scholarly journals Safe use of the EHR by medical scribes: a qualitative study

2020 ◽  
Author(s):  
Joan S Ash ◽  
Sky Corby ◽  
Vishnu Mohan ◽  
Nicholas Solberg ◽  
James Becton ◽  
...  
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Clinical Training ◽  
Rapid Assessment ◽  
Data Gathering ◽  
Assessment Process ◽  
Healthcare Organizations ◽  
Safety Risks ◽  
The Us ◽  
Medical Scribes

Abstract Objective Hiring medical scribes to document in the electronic health record (EHR) on behalf of providers could pose patient safety risks because scribes often have no clinical training. The aim of this study was to investigate the effect of scribes on patient safety. This included identification of best practices to assure that scribe use of the EHR is not a patient safety risk. Materials and Methods Using a sociotechnical framework and the Rapid Assessment Process, we conducted ethnographic data gathering at 5 purposively selected sites. Data were analyzed using a grounded inductive/hermeneutic approach. Results We conducted site visits at 12 clinics and emergency departments within 5 organizations in the US between 2017 and 2019. We did 76 interviews with 81 people and spent 80 person-hours observing scribes working with providers. Interviewees believe and observations indicate that scribes decrease patient safety risks. Analysis of the data yielded 12 themes within a 4-dimension sociotechnical framework. Results about the “technical” dimension indicated that the EHR is not considered overly problematic by either scribes or providers. The “environmental” dimension included the changing scribe industry and need for standards. Within the “personal” dimension, themes included the need for provider diligence and training when using scribes. Finally, the “organizational” dimension highlighted the positive effect scribes have on documentation efficiency, quality, and safety. Conclusion Participants perceived risks related to the EHR can be less with scribes. If healthcare organizations and scribe companies follow best practices and if providers as well as scribes receive training, safety can actually improve.

The impact of pharmaceutical industry salesperson regulations, guidance statements, and laws on their sales behaviours

2016 ◽  
Vol 10 (2) ◽  
pp. 161-191
Author(s):  
John F. Riggs ◽  
Scott Widmier ◽  
Richard E. Plank
Keyword(s):  
Pharmaceutical Industry ◽  
Data Gathering ◽  
Clinical Trial Data ◽  
Science Inquiry ◽  
Unintended Consequences ◽  
Cluster Solution ◽  
Content Type ◽  
The Usa ◽  
Taxonomic Approach ◽  
The Impact

Purpose The purpose of this research is to develop a taxonomy of the impact of sales process regulations, guidance statements and laws (henceforth, referred to as “regulations”) on sales behaviours within the pharmaceutical industry, particularly as it relates to those within the USA. Design/methodology/approach Given the large number of regulations, guidance statements and laws and sales behaviours that comprise the domain of this study, this research uses a “multicenter, parallel-arm clinical trial data gathering method”. This approach aggregated or “stacked” the responses from three individual questionnaires; 7,493 total observations generated by 381 respondents were analyzed. Findings The analysis produced a six-cluster solution of regulations, guidance statements and laws indicating distinct taxonomic structures of items that affect selling activities. Research limitations/implications The research was conducted with a single firm in the USA. Therefore, results may not be applicable to other geographical areas, firms and industries. Practical Implications The knowledge of which behaviours are perceived by the salespeople to be impacted by what regulations, guidance statements and laws provides managers with a useful tool to sort their own companies’ regulations on the basis of the classification scheme. Originality/value This paper provides a novel taxonomic approach to organize sales activities affected by regulations, guidance statements and laws which provides a look at the unintended consequences of the item not compliance. Additionally, it uses a research methodology relatively unknown to social science inquiry.

scholarly journals Electronic transmission of prescriptions in primary care: transformation, timing and teamwork

2021 ◽  
Vol 13 (4) ◽  
pp. 340
Author(s):  
Chloë Campbell ◽  
Caroline Morris ◽  
Lynn McBain
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
General Practitioners ◽  
Community Pharmacists ◽  
Unintended Consequences ◽  
Structured Interviews ◽  
Interprofessional Communication ◽  
Potential Benefits ◽  
Handwritten Signature ◽  
Purposive Sample

ABSTRACTINTRODUCTIONDuring the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy.AIMThe purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy.METHODSSemi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants’ perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach.RESULTSFour themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs).DISCUSSIONBoth general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners.

scholarly journals A multidisciplinary approach to treating low back pain in the ED: improving patient outcomes

2020 ◽  
Vol 43 (2) ◽  
pp. 2-3
Author(s):  
Lesley Beique ◽  
Jason Martyn
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multidisciplinary Approach ◽  
Rapid Assessment ◽  
Unintended Consequences ◽  
Lessons Learned ◽  
Low Back ◽  
Near Misses ◽  
Early Results ◽  
Time Required

Background:   In collaboration with emergency physicians, the physiotherapy and pharmacy teams at RGH implemented a novel multidisciplinary, evidence-based pathway, addressing a significant care gap in the management of low back pain (LBP) in urban emergency departments (EDs).   To accomplish this, the physiotherapist conducts a neuromusculoskeletal exam, prior to the physician. They provide treatment including manual therapy, mobilization, education, home-exercises and referral to community resources. The pharmacist then reviews medications, discusses pain management, prescribes analgesia and creates a plan for outpatient analgesia. This occurs while the patient awaits the physician, avoiding increases to length of stay (LOS) and reducing burden on physicians.   Implementation: At minimum, a site wishing to implement the pathway requires a team consisting of a physiotherapist (PT) and pharmacist dedicated to the ED, called the Rapid Assessment Back Team (RABT). To operationalize the RABT successfully, the selected PT and pharmacist must be confident practitioners and have a solid understanding of LBP, red-flags, and appropriate treatment. To avoid increasing LOS, patients are seen during the 2-hour average waiting time required to see a physician. The project team consisted of physiotherapists, pharmacists, nurses, physicians, managers, and QI leaders, formed to facilitate a collaborative approach to implementation. The Prosci® ADKAR model and Plan-Do-Study-Act (PDSA) cycles were used to implement the pathway and troubleshoot operational challenges.   Evaluation Methods: Front-line staff manually collected data on response time, treatments, adverse events, and resources provided. The investigators reviewed patient charts to record opioid prescriptions, DI referrals, and arrival/discharge times of the patients. We compared outcomes of patients seen by the RABT to historical site data of patients with a discharge diagnosis of LBP from the ED.   We actively sought feedback from physicians, nurses, and the leadership group to ensure that we identified unintended consequences or near-misses early on. We reviewed interim data such as LOS and average time-to-assessment, to identify areas for improvement. This data and feedback were addressed via bimonthly PDSA cycles. We also administered patient and staff satisfaction surveys before and after site implementation of the pathway to develop an understanding of patient and staff thoughts and experiences with the service model.   Results: We studied these outcomes in 44 patients exposed to our RABT implementation. Patients who saw a physiotherapist prior to the physician had shorter median ED LOS (3.2 vs. 4.0 hours), lower diagnostic imaging rates (36.4% vs. 49.4%) and less opioid prescribing (31.8% vs. 49.2%). No patients returned to the ED within 72 hours post evaluation, compared to the 7.6% historical recidivism. Not all patients were seen by a pharmacist. When performing a subgroup analysis of patients seen by both a pharmacist and physiotherapist prior to physician, opioid prescriptions were found to drop significantly from a baseline of 49.2% to 16.7%.   Advice and Lessons Learned: Valuable learnings from the pilot include: As described above, the physiotherapist and pharmacist must be experienced and confident to be successful in the ED setting. Selection of the appropriate clinicians is crucial to achieving results, and given this is a new area of practice for many physiotherapists, a proper orientation to the setting is required. The combination of a physiotherapist and pharmacist had the largest impact on study outcomes, further confirming the need for a multidisciplinary approach to ED patient care. An “ED toolkit” can greatly facilitate service implementation for future sites, and this was developed to facilitate implementation of the RABT at another ED within the city. The toolkit consisted of items such as resources, workflows, patient handouts, sample documentation and promotional materials to increase awareness. Service hours may need some realignment with patient demand and should be geared towards minimizing service disruptions. Ideally, the physiotherapist and pharmacist would work similar hours to maximize the amount of patients able to be seen. Regular PDSA cycles to review interim data and address operational issues increases the likelihood of success by ensuring the pathway evolves to fit the contextual needs of the site. Reviewing early results motivates the team to continue to utilize the pathway. Reviewing practice issues allows clinicians to improve the care provided. One significant unintended consequence was the increase in ED LOS for patients who were referred to PT/pharmacy following physician assessment. In addition, this subgroup did not show significant reductions in opioid prescriptions or DI referrals. RABT referrals were subsequently restricted to before the physician only.

scholarly journals Pharmacists’ Knowledge, Perceptions, and Practices Regarding Herbal Medicine

2019 ◽  
Vol 10 (3) ◽  
pp. 15
Author(s):  
Catherine Santanello ◽  
Ashlyn Carr
Keyword(s):  
Side Effects ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Community Pharmacists ◽  
Reliable Information ◽  
Medicine Use ◽  
Article Type ◽  
Knowledge Survey ◽  
The Impact

Introduction: With the increase of herbal medicine sales and a lack of reliable information available to consumers, it is important for pharmacists to be knowledgeable about these products and have the ability to effectively counsel on their uses and risks. The purpose of this study was to: 1) assess community pharmacists’ knowledge, perceptions, and practices regarding herbal medicines, 2) understand the impact pharmacists may have on their patients’ herbal medicine use, and 3) gauge what practices could be improved. Methods: An anonymous survey was distributed to community pharmacists through email, social media, and in-person at local pharmacies. The survey consisted of general background questions, questions assessing perceptions and practices regarding herbal medicine, and a ten-question true/false quiz to assess knowledge. Survey data was collected and assessed using Qualtrics and Excel. Results: Of the 127 community pharmacists who completed the survey, only 34% were confident in their ability to effectively counsel patients on herbal medicines. Approximately 50% of pharmacists reported never or rarely asking patients about herbal medicine use and 80% reported never or rarely documenting herbal medicine use. Only 25% of pharmacists reported that they always discuss side effects and 19% reported that they always discuss herb-drug interactions when patients are using herbal medicines. The average quiz score assessing knowledge of herbal medicines was 6.06 out of 10. Conclusions: It is important for community pharmacists to be knowledgeable about herbal medicines and prepared to educate patients to ensure safe medication use. Pharmacists need to acknowledge the use of herbal medicine in their patients and always discuss potential side effects and herb-drug interactions. It is also important that pharmacists know where they can find reliable information on herbal medicines and use evidence-based resources when possible.   Article Type: Student Project

scholarly journals Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications

2021 ◽  
Vol 11 ◽  
Author(s):  
Mainul Haque ◽  
Santosh Kumar ◽  
Jaykaran Charan ◽  
Rohan Bhatt ◽  
Salequl Islam ◽  
...  
Keyword(s):  
Response Rate ◽  
Community Pharmacists ◽  
Protective Equipment ◽  
Price Changes ◽  
Stakeholder Groups ◽  
Early Stages ◽  
Price Increases ◽  
Multiple Approach ◽  
Future Direction ◽  
Evidenced Based

Background: COVID-19 has already claimed a considerable number of lives worldwide. However, there are concerns with treatment recommendations given the extent of conflicting results with suggested treatments and misinformation, some of which has resulted in increased prices and shortages alongside increasing use and prices of personal protective equipment (PPE). This is a concern in countries such as India where there have been high patient co-payments and an appreciable number of families going into poverty when members become ill. However, balanced against pricing controls. Community pharmacists play a significant role in disease management in India, and this will remain. Consequently, there is a need to review prices and availability of pertinent medicines during the early stages of the COVID-19 pandemic in India to provide future direction.Objective: Assess current utilisation and price changes as well as shortages of pertinent medicines and equipment during the early stages of the pandemic.Our Approach: Multiple approach involving a review of treatments and ongoing activities across India to reduce the spread of the virus alongside questioning pharmacies in selected cities from early March to end May 2020.Our Activities: 111 pharmacies took part, giving a response rate of 80%. Encouragingly, no change in utilisation of antimalarial medicines in 45% of pharmacies despite endorsements and for antibiotics in 57.7% of pharmacies, helped by increasing need for a prescription for dispensing. In addition, increased purchasing of PPE (over 98%). No price increases were seen for antimalarials and antibiotics in 83.8 and 91.9% of pharmacies respectively although shortages were seen for antimalarials in 70.3% of pharmacies, lower for antibiotics (9.9% of pharmacies). However, price increases were typically seen for PPE (over 90% of stores) as well as for analgesics (over 50% of pharmacies). Shortages were also seen for PPE (88.3%).Conclusion: The pandemic has impacted on utilisation and prices of pertinent medicines and PPE in India but moderated by increased scrutiny. Key stakeholder groups can play a role with enhancing evidenced-based approaches and reducing inappropriate purchasing in the future.

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