Online prescribing for sexually transmitted infections – what’s on offer? An evaluation of internet pharmacies based in the United Kingdom

BackgroundOnline pharmacies offer an alternative approach for patients to manage their sexual health. Our aim was to determine the type of antimicrobials sold as treatment for sexually transmitted infections (STIs) by UK internet pharmacies and if providers were adhering to national guidelines.MethodsA search engine results page (SERP) generated a list of registered UK online pharmacies offering treatment for the following infections: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex and Trichomonas vaginalis. An initial audit in 2017 benchmarked each provider against the British Association of Sexual Health & HIV (BASHH guidelines. Results were fed back to each provider before re-audit in 2020. Websites selling antibiotics for non-gonococcal urethritis (NGU) and Mycoplasma genitalium were included at re-audit.ResultsThere were 30 pharmacies identified in 2017 of which, five were excluded. Treatment could be obtained for Neisseria gonorrhoeae from five pharmacies without providing a culture result; three (60%) pharmacies sold BASHH approved antibiotics for Neisseria gonorrhoeae. All 25 pharmacies sold Chlamydia trachomatis treatment; 22 (88%) offered first line treatment options but no website assessed for proctitis. Herpes simplex treatment was sold on 22 websites of which, 13 (59%) offered treatment recommended by BASHH. Trichomonas vaginalis treatment was sold by four websites in line with BASHH. Results at re-audit showed an improvement in standards, although advice before, during and after treatment remained variable.DiscussionOur work has allowed us to engage with providers to improve prescribing within the UK online pharmacy industry. However, tougher regulation is needed in order to embed sustainable change for patients who choose to access treatment online.

Effect of Infodemic Regarding the Illegal Sale of Medications on the Internet: Evaluation of Demand and Online Availability of Ivermectin during the COVID-19 Pandemic

The COVID-19 pandemic and the related infodemic generated confusion and increased demand of various pharmaceuticals, ushering in the opportunity for illicit online vendors to fill a gap in the marketplace using potentially dangerous products. The aim of our study is to provide evidence regarding increased demand, online availability and consumer accessibility of ivermectin, an anthelmintic agent, without substantiated indications in reference to SARS-CoV-2. In our study, we combined infodemiology methodology aligned with search engine result assessment and website analytics to evaluate patient safety risks. Users’ Google queries regarding ivermectin were trending and peaked during the last week of November 2020 and March 2021. Consumers more likely found links leading directly or indirectly (via redirection) to illegal online retailers representing nearly half (53.3%) of search engine result links regarding the first three result pages in December 2020 and topped off at 73.3% by March 2021. Illicit medicine retailers outnumbered and outranked their legitimate counterparts and dominated the first search engine results page. A vast majority (77.7%) of the identified online pharmacies were characteristically rogue; more than half (55.5%) offered prescription-only products without a valid medical prescription. Our results illustrate connection between infodemic and its consequences on the illicit online pharmacy market

Online medication purchasing during the Covid-19 pandemic: potential risks to patient safety and the urgent need to develop more rigorous controls for purchasing online medications, a pilot study from the United Arab Emirates

Background Since the WHO announced that Covid-19 had become a global pandemic, online pharmacies have emerged as an extremely popular way to purchase medication due to the quarantine measures introduced by numerous countries to prevent the virus's spread. Aim The aim of this study was to collect information regarding the extent of online medication purchasing in the UAE and to assess the factors that motivating the purchase of medications from the internet. Method A convenience sampling of people living in the UAE was used to conduct an online descriptive cross-sectional study. Respondents were solicited using the social media platforms WhatsApp and Facebook, whereby they were asked to fill in a validated web-based questionnaire. The number of people buying medications from online pharmacies was calculated using a percentage with 95% CIs. Results 131 respondents (31.2%) [95% CI: 26.7–35.6] stated that they purchased medication via the Internet after Covid-19 was classed as a pandemic. It was found that those respondents most likely to have purchased medication via the Internet were male, single, and older and with a high school education. Conclusion More research should be conducted to investigate and compare the self-medication and associated risk factors between online pharmacies and community pharmacies. Moreover, regulatory bodies need to make and implement changes to the regulations that govern the sale and use of medications during COVID-19.

Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

Digital Marketing: Problems of Internet Pharmacies Legal Regulation

Digitalisation of pharmaceutical activities is creating a new type of pharmaceutical market, a more flexible and less costly; yet it has become more dangerous for patients and the economic stability. The reason is the imperfection of the legal regulation and online sales of pharmaceutical products, in particular. It is necessary to clarify that digitalisation of pharmaceutical activities is not only about online sales of pharmaceutical products. It is also digital marketing, which includes promoting pharmaceutical products via the Internet, including advertising such products. Research shows that prescription drugs are sold to such patients by both illegal online pharmacies and legal ones. Most counterfeit medicines are sold through illegal online pharmacies. The purpose of the article is to draw attention to the need for legal support for the activities of Internet pharmacies using more efficient technologies, including limiting their activities. Carrying out the research, several scientific methods were used. The methods of system-structural analysis, induction and deduction were used at all stages of the research in the study of the legal regulation of the sale of medicines in various countries through Internet pharmacies, the practice of its use, the state of illegal behavior in this area, analytical materials and scientific sources. The formal-logical method was used to study regulatory acts and international documents, the comparative-legal method was used to perform comparative analysis of the legal regulation of Internet pharmacies’ activity, as well as the practice of its application in the countries of the European Union, the USA, Turkey, Ukraine, and some Arab states. It should be noted that in the EU member countries, due to single European economic and customs area and general regulation, the problems of Internet pharmacies are of the same nature. The content analysis method was implemented for studying journalistic materials and researching websites that offer distance selling, online ordering, and delivery of pharmaceutical products to a consumer in various ways. Keywords: online pharmacies, digital marketing, digitalisation of pharmacy.

Factors Influencing the Adaption of Online Pharmacy in Oman: Literature Review (Preprint)

BACKGROUND There is low level of adoption and acceptance of online pharmacies in Oman; only very limited Omani Citizens are aware of the existence of online pharmacies and even fewer number of Omanis accessed and bought medicines using online pharmacy systems. Therefore, online pharmacy business is facing great challenge in adaption in Oman; despite many attempts on using web applications that mimic the actual pharmacy operations; such attempts still preliminary and need more theoretical modelling and practical enhancements to trust, reliability, efficacy, and other factors of success. OBJECTIVE the primary objective of the present study is to investigate the factors influencing on the adoption of online pharmacy in Oman. This study carries out under Unified Theory of Acceptance and Usage of Technology – 2 (UTAUT-2) to examine the perception of customers on adapting online pharmacy. METHODS The study has presented extensive review of existing books, journals, reports, newspapers, articles, and reputable online information on the issue at hand. The review of relevant literature is closely linked to UTAUT-2 variables and the adoption of online pharmacy in Oman RESULTS The most important factors such as performance expectancy, effort expectancy, and social influence, facilitating condition, habit, hedonic motivation, and price value were observed their influence on adoption of online pharmacy among Omanis. CONCLUSIONS The study addresses issues relevant in the context that help to examines all variables being investigated. Furthermore, it also focused on the review of related theories that support the relationship among the variables and the utilization of online digital pharmacy in the Oman. Finally, issues of relative importance were also discussed that could help broader the study.