Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies
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ABSTRACT:
SUBMITTER: Koster E
PROVIDER: S-EPMC7330552 | biostudies-literature | 2020 Jul
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn the wake of COVID-19, community pharmacists (CP) were called upon to free up healthcare providers to treat more serious conditions and alleviate overcrowded healthcare centers. CPs were placed under tremendous pressure, where many patients primarily sought their health advice. This situation raised concerns about the preparedness of CPs in facing these challenges. Therefore, this study aimed to assess the appropriateness of pharmaceutical care provided by CPs to patients with suspected COVID-19 and to investigate their communication skills.MethodsA simulated patient (SP) study was conducted among randomly selected community pharmacies in Beirut, Lebanon. Each pharmacy was visited by the SP who complained of fever and loss of smell sensation. Interactions between the attending pharmacist and the suspected COVID-19 patient were documented directly after each visit in a standardized data collection form.ResultsMore than half of the CPs (56%) did not retrieve any relevant information to assess the patient's condition. While pharmacists' responses were limited to one to two recommendations, with the majority recommending the patient to perform the PCR test (90%). Inappropriate recommendations made by the CPs included mainly the confirmation that the patient had COVID-19 without prior testing (9%), and prescribing either an antimicrobial drug (5%) or dietary supplements (20%), claiming that the latter are essential to boost the patient's immunity. As for the pharmacist-patient communication skills, the mean total score was 2.25 ± 0.79 (out of 4), displaying nonoptimal and ineffective communication.ConclusionAn unsatisfactory and suboptimal provision of pharmaceutical care to a suspected COVID-19 case was evident. This may be a public health threat, particularly for developing countries that lack an efficient and unified healthcare system. The findings should alert health authorities to support and guide community pharmacists in assisting suspected COVID-19 patients.
| S-EPMC8994087 | biostudies-literature
Project description:BackgroundCommunity pharmacists played an essential role in the control and management of the COVID-19 pandemic; both pharmaceutical care and community pharmacists were affected, given that, patients' needs and demands increased due to the fear of lockdowns and shortage of medication throughout the pandemic.ObjectivesThis study was based in Lebanon and aimed to assess the impact of the COVID-19 pandemic on (1) pharmacists, including infection rates, pay, and working hours, and (2) pharmacy practice, including medicine and personal protective equipment (PPE) shortages.DesignA cross-sectional study involving 120 community pharmacists was carried out between August and November 2021.MethodsData were collected using an online survey filled out by pharmacists working in Lebanon.ResultsMost participants (71.7%) reported an increase in their income during the pandemic, and 60% reduced their working hours. A significant association was noted between being previously infected and marital status, level of education, work position, and salary of the participants. Most participants (95.8%) encountered a shortage of medications during the pandemic leading to high home storage of medication, searching for other sources of medicines, and decreased patient/pharmacist interactions.ConclusionThe COVID-19 pandemic imposed new challenges on pharmacists and the provision of pharmaceutical care. It affected pharmacists' daily routines, putting them at risk of infection with limited availability of medicines and PPE. This study suggests that establishing effective crisis management plans to increase community pharmacists' resilience during similar outbreaks.
| S-EPMC10067468 | biostudies-literature
Project description:BACKGROUND:Community pharmacies provide an important healthcare service, which is broadly established, and constitutes the preferred and initial contact for members of the community. The significant value of community pharmacies was further highlighted during the COVID-19 pandemic crisis. OBJECTIVE:The assessment of community pharmacies preparedness for the COVID-19 pandemic. METHODS:A cross-sectional interview survey of 1018 community pharmacies working in four regions of Egypt (South, East, Centre, and North). Data collection was conducted from 8-19 April 2020. RESULTS:Availability of personal protective equipment (PPE) and medication was better than alcohol (70% conc.). Home delivery services were available in 49.1% of pharmacies. Infection control measures covering interactions between staff were in place in up to 99.5% of pharmacies. Conversely, there was less frequent availability of contactless payment (29.1%), hand sanitizers (62.1%) or masks (86.5%) for customer use, or a separate area for patients with suspected COVID-19 (64%). Verbal customer education (90.4%) was used preferably to written (81.3%). Despite high clinical knowledge and awareness (97.6%-99.2%), only 8.8% of pharmacists had reported suspected COVID-19 cases, however this varied significantly with pharmacist demographics (geographic region P < 0.001; pandemic training p < 0.001; position p = 0.019; age p = 0.046). CONCLUSIONS:Government and policymakers strive to mitigate the shortage of PPE and medication. More attention should be given to infection control measures around interactions between staff and customers to ensure community pharmacists are fit and able to provide continuity in their important role. Educating customers using regularly-updated posters, banners or signs will contribute to decreasing contact with patients, and reducing the number and duration of visits to the pharmacy. Pandemic preparedness of community pharmacists must also extend to reporting procedures. By avoiding under-reporting or over-reporting, community pharmacists will contribute to accurate monitoring of the national spread of infection.
| S-EPMC7211678 | biostudies-literature
Project description:BackgroundIn the field of health, the year 2020 will be remembered for testing (stressing) all health institutions and their forms of management (centralised and decentralised). The everyday activity of primary and hospital care was significantly altered by the introduction of telephone consultations, which reduce the number of visits to health centres or hospitals and are still relevant today in the face of successive waves of the pandemic.ObjectiveTo analyse whether population confinement due to the COVID-19 pandemic had an impact on the dispensing of medications in community pharmacies and the associated spending during the period March-July 2020 in Andalusia (Spain).MethodsA time series analysis applying econometric model analysis techniques to confirm or rule out whether the lockdown caused by the COVID-19 pandemic had an impact on the dispensing of medications by community pharmacies and the associated expenditures. The variables used were the number of medication containers dispensed by community pharmacies (charged to the public funds of the Spanish National Health System) and the expenditure on prescription drugs, both in relation to the population. The analysis was performed within the region of Andalusia, which has 8,464,441 inhabitants.ResultsThe data obtained from the time series confirmed that there were no significant differences during the studied period between the number of medication containers actually dispensed and the number that would have been expected to be dispensed according to the trend in this variable for the sample period. The expenditure results followed the same pattern.ConclusionsThe health crisis produced by the COVID-19 lockdown had no impact on medication consumption in Andalusia.
| S-EPMC8234708 | biostudies-literature
Project description:Non-pharmaceutical interventions to combat COVID-19 transmission have worked to slow the spread of the epidemic but can have high socio-economic costs. It is critical we understand the efficacy of non-pharmaceutical interventions to choose a safe exit strategy. Many current models are not suitable for assessing exit strategies because they do not account for epidemic resurgence when social distancing ends prematurely (e.g., statistical curve fits) nor permit scenario exploration in specific locations. We developed an SEIR-type mechanistic epidemiological model of COVID-19 dynamics to explore temporally variable non-pharmaceutical interventions. We provide an interactive tool and code to estimate the transmission parameter, β, and the effective reproduction number, R eff . We fit the model to Santa Clara County, California, where an early epidemic start date and early shelter-in-place orders could provide a model for other regions. As of April 22, 2020, we estimate an R eff of 0.982 (95% CI: 0.849 - 1.107) in Santa Clara County. After June 1 (the end-date for Santa Clara County shelter-in-place as of April 27), we estimate a shift to partial social distancing, combined with rigorous testing and isolation of symptomatic individuals, is a viable alternative to indefinitely maintaining shelter-in-place. We also estimate that if Santa Clara County had waited one week longer before issuing shelter-in-place orders, 95 additional people would have died by April 22 (95% CI: 7 - 283). Given early life-saving shelter-in-place orders in Santa Clara County, longer-term moderate social distancing and testing and isolation of symptomatic individuals have the potential to contain the size and toll of the COVID-19 pandemic in Santa Clara County, and may be effective in other locations.
| S-EPMC7276010 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has overburdened the healthcare facilities, which demanded the use of alternative and effective methods for delivering healthcare services. The use of telehealth has become a necessity to provide initial health services.ObjectiveTo identify the pharmaceutical care provided by community pharmacists to suspected high-risk COVID-19 patients using telehealth.MethodsA simulated patient (SP) phoned 100 randomly-selected community pharmacies throughout Lebanon using a standard scenario of uncontrolled diabetes mellitus with typical symptoms of COVID-19. Pharmacists' responses were compared with pre-defined ideal recommendations using a special form.ResultsThe mean of the retrieved medical information score obtained by the pharmacists was 2.48 ± 2.79 (out of 21), with 34 % of the participants not retrieving any relevant medical data from the SP. The relative patient information, the exposure to COVID-19, and the possible COVID-19 symptoms were not retrieved by 61 %, 70 %, and 41 % of the pharmacists, respectively. Two percent of the pharmacists assured that the SP's symptoms were related to common cold, while 5 % confirmed that the SP is infected with COVID-19. Notably, 35 % of the pharmacists did not offer any recommendation. Among them, 14 % claimed that they were too busy to respond. Only 39 % of the pharmacists provided an appropriate recommendation by referring the SP to her physician to seek medical attention within 24 h since the SP is a high-risk patient, and 41 % recommended doing a PCR test. Antipyretics, antibiotics, and dietary supplements were recommended by 27 %, 7 %, and 16 % of the pharmacists, respectively. Less than 16 % of the pharmacists recommended using protective measures against COVID-19. In addition, the overall communication skills of the pharmacists were generally below expectations.ConclusionsThis study is the first to assess the quality of pharmaceutical care provided by community pharmacists in the Middle East via Telehealth. An unsatisfactory level of preparedness through means of telehealth technology was evident. This resulted in the quality of pharmaceutical-care services provided to high-risk patients via telehealth to be below expectations. Therefore, health authorities should encourage community pharmacists to effectively adopt telehealth, by providing appropriate training, as well as recognizing their extra efforts with financial compensations, aiming to optimize patients' health outcomes.
| S-EPMC8454989 | biostudies-literature
Project description:The coronavirus disease-19 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus that was first detected at the end of December 2019. The epidemic has affected various regions of China in different degrees. As the situations evolve, the COVID-19 had been confirmed in many countries, and made a assessment that it can be characterized as a pandemic by the World Health Organization on March 11, 2020. Drugs are the main treatment of COVID-19 patients. Pharmaceutical service offers drug safety ensurance for COVID-19 patients. According to COVID-19 prevention and control policy and requirements, combined with series of diagnosis and treatment plans, pharmacists in the first provincial-level COVID-19 diagnosis and treatment unit in Jilin Province in Northeast China have established the management practices of drug supply and pharmaceutical care from four aspects: personnel, drugs supply management, off-label drug use management and pharmaceutical care. During the outbreak, the pharmaceutical department of THJU completed its assigned workload to ensure drug supply. So far, no nosocomial infections and medication errors have occurred, which has stabilized the mood of the staff and boosted the pharmacists' confidence in fighting the epidemic. For the treatment of COVID-19, pharmacists conducted adverse reaction monitoring and participated in the multidisciplinary consultation of COVID-19. Up to now, the COVID-19 patients admitted to THJU have not shown any new serious adverse reactions and been cured finally. The hospital pharmacy department timely adjusted the work mode, and the formed management practices is a powerful guarantee for the prevention and control of the COVID-19 epidemic. This paper summarized the details and practices of drug supply and pharmaceutical services management to provide experience for the people who involving in COVID-19 prevention and contain in other abroad epidemic areas.
| S-EPMC7136878 | biostudies-literature
Project description:ObjectiveIn this study, we investigated the impact of COVID-19 NPIs in South Africa to understand their effectiveness in the reduction of transmission of COVID-19 in the South African population. This study also investigated the COVID-19 testing, reporting, hospitalised cases, excess deaths and COVID-19 modelling in the first wave of the COVID-19 epidemic in South Africa.MethodsA semi-reactive stochastic COVID-19 model, the ARI COVID-19 SEIR model, was used to investigate the impact of NPIs in South Africa to understand their effectiveness in the reduction of COVID-19 transmission in the South African population. COVID-19 testing, reporting, hospitalised cases and excess deaths in the first COVID-19 epidemic wave in South Africa were investigated using regressional analysis and descriptive statistics.FindingsThe general trend in population movement in South African locations shows that the COVID-19 NPIs (National Lockdown Alert Levels 5,4,3,2) were approximately 30% more effective in reducing population movement concerning each increase by 1 Alert Level. The translated reduction in the effective SARS-CoV-2 daily contact number (β) was 6.12% to 36.1% concerning increasing Alert Levels. Due to the implemented NPIs, the effective SARS-CoV-2 daily contact number in the first COVID-19 epidemic wave in South Africa was reduced by 58.1-71.1% while the peak was delayed by 84 days. The estimated COVID-19 reproductive number was between 1.98 to 0.40. During South Africa's first COVID-19 epidemic wave, the mean COVID-19 admission status in South African hospitals was 58.5%, 95% CI [58.1-59.0] in the general ward, 13.4%, 95% CI [13.1-13.7] in the intensive care unit, 13.3%, 95% CI [12.6-14.0] on oxygen, 6.37%, 95% CI [6.23-6.51] in high care, 6.29%, 95% CI [6.02-6.55] on ventilator and 2.13%, 95% CI [1.87-2.43] in isolation ward respectively. The estimated mean South African COVID-19 patient discharge rate was 11.9 days per patient. While the estimated mean of the South African COVID-19 patient case fatality rate (CFR) in hospital and outside the hospital was 2.06%, 95% CI [1.86-2.25] (deaths per admitted patients) and 2.30%, 95% CI [1.12-3.83](deaths per severe and critical cases) respectively. The relatively high coefficient of variance in COVID-19 model outputs observed in this study shows the uncertainty in the accuracy of the reviewed COVID-19 models in predicting the severity of COVID-19. However, the reviewed COVID-19 models were accurate in predicting the progression of the first COVID-19 epidemic wave in South Africa.ConclusionThe results from this study show that the COVID-19 NPI policies implemented by the Government of South Africa played a significant role in the reduction of COVID-19 active, hospitalised cases and deaths in South Africa's first COVID-19 epidemic wave. The results also show the use of COVID-19 modelling to understand the COVID-19 pandemic and the impact of regressor variables in an epidemic.
| S-EPMC10403893 | biostudies-literature
Project description:We estimated the impact of a comprehensive set of non-pharmeceutical interventions on the COVID-19 epidemic growth rate across the 37 member states of the Organisation for Economic Co-operation and Development during the early phase of the COVID-19 pandemic and between October and December 2020. For this task, we conducted a data-driven, longitudinal analysis using a multilevel modelling approach with both maximum likelihood and Bayesian estimation. We found that during the early phase of the epidemic: implementing restrictions on gatherings of more than 100 people, between 11 and 100 people, and 10 people or less was associated with a respective average reduction of 2.58%, 2.78% and 2.81% in the daily growth rate in weekly confirmed cases; requiring closing for some sectors or for all but essential workplaces with an average reduction of 1.51% and 1.78%; requiring closing of some school levels or all school levels with an average reduction of 1.12% or 1.65%; recommending mask wearing with an average reduction of 0.45%, requiring mask wearing country-wide in specific public spaces or in specific geographical areas within the country with an average reduction of 0.44%, requiring mask-wearing country-wide in all public places or all public places where social distancing is not possible with an average reduction of 0.96%; and number of tests per thousand population with an average reduction of 0.02% per unit increase. Between October and December 2020 work closing requirements and testing policy were significant predictors of the epidemic growth rate. These findings provide evidence to support policy decision-making regarding which NPIs to implement to control the spread of the COVID-19 pandemic.
| S-EPMC8192111 | biostudies-literature
Project description:BackgroundThe coronavirus disease 2019 (COVID-19) pandemic of early 2020 was one of the most impactful events in living memory. As an essential service, community pharmacies remained open to provide care and service. The unprecedented nature and scale of the pandemic triggered considerable change in daily practice. In anticipation of future pandemic waves and similar mass-scale civil disruptions, it is important to understand how community pharmacies adapted and responded in the early weeks of COVID-19.MethodsA combination of convenience, snowball and purposive sampling methods was used to recruit staff from community pharmacies across Ontario, from a variety of different practice locations and types. A semistructured focus group interview protocol was used to elicit experiences. Data gathering was undertaken until the point of saturation. Thematic analysis was used to surface common experiences and to describe how community pharmacies adapted and responded.ResultsA total of 39 participants (pharmacists, registered technicians and assistants) from 11 different pharmacies participated in this study. Data were coded based on 1) what happened, 2) how community pharmacies responded, and 3) what worked and did not work to support pharmacy staff in continued provision of service and care. Key findings included the collapse of provision of nondispensing remunerated services, the central role of managerial decisions in supporting resilience (e.g., change to 8-hour shifts from 12-hour shifts) and the central role of technology in supporting continuity of quality pharmacy services.DiscussionWith anticipated future pandemic waves, preparedness of community pharmacy will be essential. This study provides important insights based on participants' own experiences regarding ways employers can better support staff in provision of care and service to patients during times of mass-scale civil disruption. Can Pharm J (Ott) 2020;153:xx-xx.
| S-EPMC7429913 | biostudies-literature