Crisis management in Finnish hospital pharmacies during the COVID-19 pandemic

Background: Although hospital pharmacies have played a central role in managing the COVID-19 pandemic, there is a lack of crisis management theory-based empirical research on the topic. The purpose of this study was to fill this gap in the Finnish context and identify areas for development to improve future crisis preparedness. Methods: A national cross-sectional survey was developed based on crisis management process models and sent to all hospital pharmacy heads (n = 21) during the second wave of the pandemic in October–November 2020. Descriptive statistics were calculated, and qualitative data from open-ended responses were studied using deductive content analysis. The results were confirmed and enriched through data triangulation with six semi-structured interviews of purposively selected hospital pharmacy heads in March–May 2021. Results: The response rate was 57% (n = 12). Following the onset of the pandemic, the risk perception of a crisis concerning pharmaceutical supply chain rose from 58 to 100%. A pre-existing pandemic preparedness plan was available in four (25%) pharmacies. Seven (58%) pharmacies developed a new plan. A pandemic crisis team was established in four (33%) pharmacies. Changes in internal communication and management (92%), clinical pharmacy services (67%), medicine supply (58%), procurement (42%), and pharmaceutical production operations (25%) were implemented. Collaboration with peers or other actors in the pharmaceutical supply chain increased or improved in nine (75%) hospital pharmacies, whereas in three (25%), it decreased or was unchanged. Mandatory reserve stockpiles provided a buffer for the increased need for emergency medicines. Positive and negative experiences of the pharmaceutical supply chain’s crisis response indicated an unequal distribution of medicines and crisis management-related information. Conclusions: Crisis management process models provided a holistic framework for analysing the pandemic response in hospital pharmacies. The study provided an alternative data collection approach by utilising process models in the development of the survey instrument. Preparedness of hospital pharmacies could be improved with pre-established crisis teams and plans, and data management systems providing easily accessible information to support decision-making. Developing prerequisites for coordinated information sharing and equitable distribution of medicines is essential to ensure effective crisis response, equitable medicine availability among hospitals and patient safety

Crisis management in the pharmaceutical industry during the COVID-19 pandemic

Despite the vulnerabilities of the pharmaceutical industry and its critical role in functioning healthcare systems, no previous crisis management theory–based empirical studies focusing on this field during the COVID-19 pandemic has been published. The present study aims to fill this gap and identify areas for development to improve future crisis preparedness. Organisational crisis management process models provided a theoretical framework. A cross-sectional survey study was conducted during the second wave of the pandemic (October–November 2020). This online survey was developed based on the crisis management process models and sent to managing directors working in the pharmaceutical and wholesale companies (n = 73) in Finland. Descriptive statistics were calculated, and open-field responses were analysed qualitatively using content analysis. Nine semi-structured interviews with industry leaders and managers conducted in March–May 2021 were utilised in data triangulation. The results revealed that crisis preparedness improved concurrently during the pandemic due to increased risk perception, updated preparedness plans and operational changes. Crisis decision-making was made via teams or shared efforts between key persons. Anticipation of and responses to increased demand and stocking, coordination and collaboration among pharmaceutical supply chain stakeholders were identified as key challenges. The study extends crisis management process models to the pharmaceutical industry context and advances this research field by drawing on a novel approach for data collection utilising crisis management process models for survey development. Practical implications for improving future preparedness are suggested

Organisation of cross-sector collaboration and its influence on crisis management effectiveness among pharmaceutical supply chain stakeholders during the COVID-19 pandemic

Objectives: To investigate the organisation of cross-sector collaboration and how it influenced crisis management effectiveness among pharmaceutical supply chain stakeholders in Finland during the COVID-19 pandemic. Study design: Qualitative semi-structured interview study. Methods: Purposeful selection was used to obtain the study sample consisting of leaders and specialists from the pharmaceutical industry and wholesalers (n = 9), community pharmacy owners (n = 9), hospital pharmacy heads (n = 6), government agency directors and officials (n = 5) and advocacy organisation representatives (n = 2). Inductive content analysis was performed to examine the data from the semi-structured individual (n = 29) and paired (n = 2) interviews in March–May 2021. Results: A new conceptual model was developed to describe the organisation of collaborative crisis management. Without a predefined crisis management organisation, cross-sector collaboration was organised based on previous collaboration structures, channels and relationships and through the establishment of issue-specific groups by government agencies as per legal mandates. Crisis dynamics and related issues guided the group formation and meeting frequency. Advocacy organisations and government agencies acted in bridging role between stakeholders. Shared knowledge among pharmaceutical supply chain stakeholders enabled anticipation and preparedness during crisis; shared resources fostered maintenance of core functions; and shared problem-solving facilitated cross-sectoral solutions. Conclusion: This was the first study exploring cross-sector collaboration among pharmaceutical supply chain stakeholders during a crisis. Sharing knowledge, resources and problem-solving increased the crisis management effectiveness. The study presented a new illustration of organising for collaborative crisis management and added knowledge about private-third sector collaboration and issue-specific groups to the cross-sector collaboration and crisis management literature

Difficulties in administration of oral medication formulations to pet cats: an e-survey of cat owners

The purpose here was to determine the problems cat owners encounter in medicating their cats with orally administered drugs at home. The study was carried out as an open e-questionnaire survey addressed to cat owners in which the authors focused on the oral administration route. A total of 46 completed questionnaires were included in the survey. In the study, 46 cats received 67 orally administered drugs. Approximately half of the drugs were registered for use in cats by the European Medicines Agency (54 per cent), and there were also off-label drugs registered for human (36 per cent) and canine medication (7.4 per cent) and an ex tempore drug (3.0 per cent). The owners were unable to give the doses as prescribed for their cats for one-fourth of the medications (16/67). Drugs that were registered for feline medication were significantly more palatable than drugs registered for other species (odds ratio (OR) 4.9), and liquid formulations were significantly more palatable than solid formulations (OR 4.8). However, most of the owners (22/38) preferred a solid dosage form, while few (4/38) chose a liquid formulation. The results indicate that there is still a need for more palatable and easily administered oral drugs for cats.Peer reviewe

Effective implementation of relationship orientation in new product launches

The critical role of relationships in business performance is widely recognized in the business marketing literature. However, to date, the prevailing new product launch research has concentrated on firms&#39; general customer and competitor focus on predicting launch performance, and mainly applied a product centered or marketing mix perspective on considering effective strategic and tactical launch activities. Consequently, there is only scant knowledge on the relevance of a relational perspective when launching new products. The study contributes to this gap by examining the impact of firms&#39; relationship orientation on launch performance and the key activities through which it is transformed into performance in the new product launch context. A set of hypotheses is developed and tested with data collected from 109 new product launches in pharmaceutical companies. The results show that sales force management and relationship leveraging mediate relationship orientation&#39;s impact on launch performance through complexly intertwined relationships. From a theoretical perspective, this study highlights the role of the relational perspective in new product launch and fosters our understanding on how relationship-focused culture is effectively implemented in practice. From a managerial perspective, the results offer insights on how firms can effectively enhance the successful commercialization of new products through relationship-oriented sales and marketing activities.</p

Medication Counselling on Unlicensed Medicines Should Be Improved &ndash; Results from a Finnish Survey for Patients and Pharmacy Staff

Tiina Liipo,1,2 Tuire Prami,2 Ilona Iso-Mustajärvi,2 Mari Pölkki,2 Anne Juppo1 1University of Helsinki, Faculty of Pharmacy, Division of Pharmaceutical Chemistry and Technology, Helsinki, Finland; 2Oriola, Espoo, FinlandCorrespondence: Anne Juppo, University of Helsinki, Faculty of Pharmacy, Division of Pharmaceutical Chemistry and Technology, Viikinkaari 5 E, 00014 University of Helsinki, Helsinki, Finland, Tel +358505306147, Email [email protected]: Finnish authorities have published specific instructions for prescribing, handling, and dispensing unlicensed medicines and for the associated communication with patients. However, there is a clear research gap concerning the quality of medication counselling given by doctors and especially pharmacists to patients who are prescribed unlicensed medicines. The success of such counselling was studied with a survey for both pharmacy staff and patients.Methods: The survey was conducted in 2022 with two electronic semi-structured questionnaires, one for patients (or caregivers of underaged patients) purchasing medicines with special or fixed-term special permits from community pharmacies in Finland and one for the pharmacy staff dispensing such medication.Results: In all, 49% of the 389 pharmacists did not know if the prescribing doctor had given any counselling to the patient, and 52% of the pharmacists had not given any counselling to the patient themselves. Still, 51% of the pharmacists considered that the patient had received sufficient medication counselling. Almost every one of the 36 patients expressed that they had received medication counselling, 61% of them from the prescribing doctor and 53% from a pharmacist.Conclusion: Medication counselling on unlicensed medicines should be improved to ensure their safe and effective use. This survey revealed that many patients did not receive any such medication counselling as required by the Finnish Medicines Decree.Plain Language Summary: If patients need medicines that are not available in their own country, they can be treated with unlicensed medicines imported from abroad.Community pharmacies deliver tens of thousands of packages of unlicensed medicines yearly in Finland, and we wanted to find out whether patients receive appropriate information about their use.We contacted pharmacy staff and patients using unlicensed medicines and conducted an electronic survey to ask about their experiences on whether patients receive sufficient information on these medicines.Almost every patient participating the survey felt that they had received counselling on their unlicensed medication, more often from a doctor than a pharmacist, despite most of the pharmacist responding to this survey had a lot of work experience and dispensed these medicines regularly.Patients have the right to receive supporting information to ensure the effectiveness and safety of their medication, and pharmacists have a crucial role in ensuring this.Based on this study, we suggest that pharmaceutical companies and authorities should provide reliable supporting material on the use of unlicensed medicines for doctors, pharmacists, and patients, bearing in mind the respective information needs of these groups.Keywords: unlicensed medicines, medicines with special permit, medication counselling, surve

The influence of tertiary butyl hydrazine as a co-reactant on the atomic layer deposition of silver

Ultra-thin conformal silver films are the focus of development for applications such as anti-microbial surfaces, optical components and electronic devices. In this study, metallic silver films have been deposited using direct liquid injection thermal atomic layer deposition (ALD) using (hfac)Ag(1,5-COD) ((hexafluoroacetylacetonato)silver(I)(1,5-cyclooctadiene)) as the metal source and tertiary butyl hydrazine (TBH) as a co-reactant. The process provides a 23 °C wide ‘self-limiting’ ALD temperature window between 105 and 128 °C, which is significantly wider than is achievable using alcohol as a co-reactant. A mass deposition rate of ∼20 ng/cm2/cycle (∼0.18 Å/cycle) is observed under self-limiting growth conditions. The resulting films are crystalline metallic silver with a near planar film-like morphology which are electrically conductive. By extending the temperature range of the ALD window by the use of TBH as a co-reactant, it is envisaged that the process will be exploitable in a range of new low temperature applications