New Medicine Service as support for medication adherence by chronically ill patients

Effective management of the treatment for chronically ill patients is a multifactorial process. The crucial is an accurate diagnosis, appropriate and well-designed pharmacotherapy, as well as patient medication adherence. Adherence is defined as the extent to which patients are able to follow the general practitioner's recommendations for the prescribed treatments. Patients’ reasons for deviating from the treatment plan are diverse and may be intentional or unintentional. They may be non-adherent during different stages of their treatment. Some patients may decide not to fill physician prescriptions and not start their treatment at all. Patients may use more or less than the prescribed medication or use their treatments at the wrong time. They may also discontinue therapy prematurely. The common reasons for medication non-adherence may include lack of symptoms, improvement in health, in patients’ subjective opinion, fear of potential side effects, long-term conditions, multimorbidity, and polypharmacy. Poor knowledge about medicines can also lead to severe consequences such as non-adherence. Several interventions may contribute to improved adherence. The current legislation in pharmaceutical care enables registered pharmacists to intervene successfully when a medicine is prescribed, increase effective medicine taking for the treatment of a long-term condition, and optimize the therapy; they also may offer the patient, opportunistic advice on healthy living or public health topics in line with the promotion of healthy lifestyles. One of the proposed pharmaceutical care services for Polish patients – the New Medicine Service, was introduced in England in 2011 as support for subjects starting a newly initiated medication for long-term treatment. The article presents the assumptions and goals for this pharmaceutical consultation in polish system of health care, discusses the interview schedule and forms, and describes the service's beneficial contribution to better medication adherence by chronically ill patients

Evaluation of medication safety assessment tools for pharmacist-led medication reviews: the Eastern European pilot project

Background: Pharmacist-led medication reviews (MR) are one of the key methods to support medication safety in polypharmacy patients. The aims of this study were to pilot MRs in Eastern European community pharmacies, describe medication use in polypharmacy patients, and evaluate the usability of medication safety assessment tools.Methods: The MR pilot was undertaken in Estonia, Latvia, Poland, Hungary, Romania, and Bulgaria. Patients who used at least five medicines were directed to the service by their GPs. Data on drug-related problems (DRPs) and adherence were collected by pharmacists through structured patient interviews. Databases for identification of potential drug-drug interactions (pDDIs) and adverse drug reactions (ADRs) named Inxbase/Riskbase, as well as an integrated tool comprising potentially inappropriate medicines (PIMs) lists EU(7)-PIM and EURO-FORTA, were applied retroactively to the MR pilot data to investigate possibilities for their use and to describe medication use and potential risks in the study population.Results: A total of 318 patients were included in the study, 250 of them elderly (≥65 years). One hundred and eighty (56.6%) participants had a total of 504 pDDIs based on Inxbase analysis. On average, there were 1.6 pDDIs per participant. Twenty-five (5.0%) of the 504 pDDIs were in a high-risk category. A total of 279 (87.7%) participants had a potential ADR in at least one of 10 Riskbase categories. One hundred and fifty-four (20.8%) of the potential ADRs were in a high-risk category. Twenty-seven pDDIs and 68 ADRs documented as DRPs during the service were not included in the databases. Using the integrated EU(7)-PIM/EURO-FORTA PIM list, a total of 816 PIMs were found in 240 (96%) of the 250 elderly participants (on average 3.4 PIMs per elderly participant). Seventy-one (29.6%) of the participants were using high-risk PIMs. Twenty-one percent of high-risk PIMs and 13.8% of medium-risk PIMs were documented as DRPs by the pharmacists during the pilot.Conclusion: Medication safety assessment tools can be useful in guiding decision-making during MRs; however, these tools cannot replace patient interviews and monitoring. Tools that include a thorough explanation of the potential risks and are easy to use are more beneficial for MRs

Factors facilitating and hindering development of a medication use review service in Eastern Europe and Iran - cross-sectional exploratory study

Funding Information: European Association of Faculties of Pharmacy PRD 2019 grant for the project ?Develop-ment and Implementation of Medication Use Review Services at Community Pharmacy in Eastern European countries?. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Polypharmacy is a common issue in patients with chronic diseases. Eastern-European countries and Iran are exploring possibilities for implementing the Medication Use Review (MUR) as a measure for optimizing medication use and ensuring medication safety in polypharmacy patients. The aim of this study was to gain insights into the development of the community pharmacy sector and map facilitators and barriers of MUR in Eastern Europe and Iran. The representatives of the framework countries received a questionnaire on community pharmacy sector indicators, current and future developments of pharmacies, and factors encouraging and hindering MUR. To answer the questionnaire, all representatives performed document analysis, literature review, and qualitative interviews with key stakeholders. The socio-ecological model was used for inductive thematic analysis of the identified factors. Current community pharmacist competencies in framework countries were more related to traditional pharmacy services. Main facilitators of MUR were increase in polypharmacy and pharmaceutical waste, and access to patients’ electronic list of medications by pharmacists. Main barriers included the service being unfamiliar, lack of funding and private consultation areas. Pharmacists in the framework countries are well-placed to provide MUR, however, the service needs more introduction and barriers mostly on organizational and public policy levels must be addressed.publishersversionPeer reviewe

Polish Patients’ Needs and Opinions about the Implementation of Pharmaceutical Care in Diabetes

The study aimed to get to know patients’ opinions on implementing pharmaceutical care for diabetic patients in a community pharmacy to prevent and effectively and holistically approach the treatment of people with diabetes. It was based on an authorial survey form and conducted from August to October 2021 in a community pharmacy in Poznan, Poland. A total of 131 pharmacy patients over 18 years were included in the study. Results showed that the vast majority of patients confirmed their interest in pharmaceutical care in diabetes conducted by pharmacists. Moreover, 79.4% of respondents would like to benefit from medicines use review, while 87.0% confirmed an interest in the ‘New Drug’ service, with diabetic patients being particularly interested in this (p = 0.2447). Most respondents were also interested in education on how to use a glucose meter, administer insulin and use a lancing device. In addition, the study showed patients’ insufficient knowledge about risk factors and prevention of diabetes with the need for patient education. As the source of funding, 91.7% of diabetic patients indicated the National Health Fund. Given that such a service has not been implemented in Poland yet, this study may support established teams at the Supreme Pharmaceutical Chamber or the Ministry of Health in introducing such new services

THE ROLE OF VITAMIN D IN NEOPLASMS AND NEURODEGENERATION DISEASES - A REVIEW OF THE LITERATURE

In recent years, a significant increase in the incidence of cancer and neurodegenerative diseases has been observed. This is mainly because of the higher life expectancy and thus prolonged contact with risk factors, inadequate diet and lack of physical activity. Along with aging processes, the prevalence and incidence of many diseases rise dramatically. New drugs and solutions are constantly being sought that would help in particular preventing. One way could be the use of vitamin D or its analogues, which through their proven pleiotropic action, have become the focus of the interest of many scientists in the last decade. One might think that the problem of vitamin D deficiency should affect a small part of the population, due to health campaigns carried out and the availability of many OTC preparations with vitamin D in various forms. Research, however, confirms that the need for vitamin D supplementation is overlooked by healthcare professionals, and its deficiencies are widespread worldwide and affect all ages. It is very meaningful problem. It is important to check the concentration of this vitamin in the blood, which in the case of low levels can be correlated with potential health problems. The influence of vitamin D on physiological processes, confirmed by numerous studies and scientific publications, and thus also the prevention of numerous diseases, is an important argument indicating the need for patient education on how to take it regularly. For this reason, preventive actions carried out by professional medical staff, including pharmacists in community pharmacies, regarding awareness of the important role of vitamin D and its impact on our health are important. Patient counseling may have a significant effect on improving quality of life. This article discusses some mechanisms of antiproliferative, neuroprotective and immunomodulatory activity of active vitamin D derivatives on the example of selected cancers, Alzheimer's disease, and multiple sclerosis.W ostatnich latach obserwuje się znaczny wzrost zachorowań na nowotwory i choroby neurodegeneracyjne. Wciąż poszukuje się nowych leków i rozwiązań, które pomogłyby zwłaszcza w zapobieganiu tym chorobom. Jednym ze sposobów może być stosowanie witaminy D lub jej analogów, które poprzez swoje udowodnione wielokierunkowe działanie, stały się w ostatniej dekadzie przedmiotem zainteresowania wielu naukowców. Można by pomyśleć, że problem niedoboru witaminy D powinien dotyczyć niewielkiej części populacji, ze względu na przeprowadzane kampanie zdrowotne i dostępność wielu preparatów OTC z witaminą D w różnej postaci. Badania potwierdzają jednak, że potrzeba suplementacji witaminy D jest pomijana przez pracowników służby zdrowia, a jej niedobory są powszechne na całym świecie i dotykają wszystkich grup wiekowych. Duże znaczenie ma sprawdzanie stężenia tej witaminy we krwi, co w przypadku niskiego poziomu można skorelować z potencjalnymi problemami zdrowotnymi. Potwierdzony w licznych badaniach i publikacjach naukowych wpływ witaminy D na procesy fizjologiczne, a przez to także na zapobieganie licznym chorobom, jest istotnym argumentem wskazującym na potrzebę edukacji pacjentów na temat jej regularnego przyjmowania. Z tego powodu istotne są akcje profilaktyczne prowadzone przez fachowy personel medyczny, w tym także przez farmaceutów w aptekach ogólnodostępnych, dotyczące uświadamiania pacjentom ważnej roli witamy D i jej wpływu na nasze zdrowie. W niniejszym artykule omówiono niektóre mechanizmy działania antyproliferacyjnego, neuroprotekcyjnego i immunomodulującego aktywnych pochodnych witaminy D na przykładzie wybranych chorób nowotworowych, choroby Alzheimera oraz stwardnienia rozsianego

Pharmacists’ Preparedness to Patients Education at the Time of Pandemic—A Cross-Sectional Study with an Example of SARS-CoV-2 Outbreak in Poland

Although pharmacy employees’ involvement in patient education has great potential, the extent to which they actually provide cognitive services seems inadequate. Given the overburdening of the healthcare system and limited access to medical services due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, this study aimed to evaluate the preparedness of Polish pharmacy employees for patient education on the new threat. The study was conducted using the mystery shopper method. Two interviewers phoned 90 randomly chosen community pharmacies throughout Poland and presented some inquiries on the SARS-CoV-2. Pharmacists devoted more time to patients than pharmacy technicians (2:22 vs. 1:54), and the information they provided was significantly more comprehensive (p = 0.006). The majority of respondents provided an evidence-based recommendation on prevention, symptoms, and management of SARS-CoV-2; however, the scope of advice significantly varied. Community pharmacy staff often expressed their concern about the lack of time to address patients’ questions adequately. No statistically significant differences were found in recommendations provided by chain and non-chain pharmacy staff. Obtained results seem to confirm the possibility of involving pharmacists in public health activities during a pandemic. Nevertheless, providing proper working conditions and adequate just-in-time learning solutions is crucial

OPINIONS OF PHARMACISTS ON COMMUNITY PHARMACY-BASED HEALTH SCREENINGS FOR COMMON CHRONIC DISEASES

Rising number of chronic diseases worldwide requires improvement of patients’ care system, especially in disease prevention and health promotion. Therefore it is justified to broaden the range of services in community pharmacies in Poland. The aim of this study was to evaluate pharmacists’ opinion about health screenings for chronic diseases in community pharmacies. Research was based on original, anonymous questionnaire administered between July 2016 and March 2017 to pharmacists (n=175; 77.7% women and 22.3% men) practicing in a community pharmacy in Wielkopolska (n=106; 77.4% women and 22.6% men) and Zachodniopomorskie Region (n=69; 78.3% women and 21.7% men). The effect of age and gender on pharmacists’ opinions was evaluated. Among pharmacists who responded, 93.7% agreed that patients don’t have health check-ups when they don’t experience bothersome symptoms of a disease. Almost three fourth of respondents considered implementation of health screening services in pharmacy as valuable as it can have positive influence on development of pharmaceutical care. Younger pharmacists (p=0.019) who collaborate with physicians (p=0.009) were most certain about it. 80,0% of pharmacist, in particular younger one, would offer their patients the screening services (p=0.006). 79,4% pharmacists confirmed that this new service should be reimbursed by National Health Fund. Development of new health screening services in community pharmacies may help to prevent or lower the risk of complications associated with common chronic diseases

INFLUENCE OF COMMUNITY PHARMACY SPECIALIZATION ON PROFESSIONAL PHARMACEUTICAL COUNSELLING SCHEME IN PHARMACIES IN POZNAN AND WARSAW (POLAND)-PILOT STUDY

Education of community pharmacy workers is a very important part of everyday practice, especially in professional counselling (PC) which brings many health benefits for the patients. The aim of the study was to investigate if the community pharmacy specialization has an influence on the scope and quality of counsels given by pharmacy workers during PC scheme implementation in community pharmacies. The research was carried out between May and November 2017. After PC scheme implementation in community pharmacies, an anonymous questionnaire was administered to 245 pharmacy workers in Poznan and Warsaw (241 women, 4 men): 146 pharmacists (143 women, 3 men) and 99 pharmacy technicians (98 women, 1 man). In the conducted study, 14.7% of pharmacists had community pharmacy specialization (according to Polish law). Pharmacists with a community pharmacy specialization referred patients more often to physicians (p<0.0001), as well as after earlier physician consultation (p<0.0001). Furthermore, they often noticed the interaction between drugs in patients’ self-treatment and in the treatment ordered by a physician (p≤0.001). The indication of medication contraindications after a physician consultation was also significantly higher within pharmacists with specialization (p<0.0001). It can be noted that pharmacists with community pharmacy specialization were asked more often for self-treatment consultation and after physician visits (p<0.0001). Development of PC in Polish community pharmacy, especially among pharmacy owners well-educated in community pharmacy specialization, may help to increase safety of pharmacotherapy