Prospects for development of pharmacy in Poland until the year 2030 : the document of the national section of pharmaceutical care of the Polish Pharmaceutical Society

Modern society expects pharmacists to be more involved in monitoring and supervising pharmacotherapy. International documents clearly define pharmacists as guardians of the safety and effectiveness of pharmacotherapy, not coincidentally putting safety matters first. With regard to this issue, the National Section of Pharmaceutical Care of the Polish Pharmaceutical Society hereby presents its own proposal for the development of modern pharmaceutical practice in Poland. The purpose of the proposed actions is to increase the involvement of pharmacists from generally accessible pharmacies in ensuring the safety and effectiveness of pharmacotherapy applied outside of hospitals and improving health indicators within society over the next ten to twenty years

Hair loss impact on quality of life of patients with oncological diseases – pilot study

In oncological treatment hair loss is one of the adverse events related to the use of cytostatic drugs. Hair loss is a problem that to affects people’s well-being and quality of life. The aim of the study was to check the impact of hair loss in those patients who alopecia induced by cytotoxic drug therapy. The study performed from March to April 2018, and it was focused on the adult population of oncological patients who developed alopecia during oncological chemotherapy The study was conducted among 25 people. For that purpose a self – designed two questionnaires were developed: one concerning the quality of life and the other – the Hair Loss Impact Vignette (HLIV) and validated through the study. Hair loss in men has little or no effect on shopping, housework and sports, while in women it only affects housework. Both in case of women and men, it has a very strong influence on social life, perception in the environment and contacts with partners, family and friends. The quality of life related to hair loss was the overall result was -0,74 and it is considered as a low. 78,9% of the interviewed women strongly agreed that losing their hair negatively affects their social life or leisure time activities. Both women and men in the vast majority of respondents declared feeling discomfort and depression in connection with the hair loss. Most of the surveyed women believe that the loss of eyebrows and eyelashes is as negative an experience as the loss of the hair on the head. For the majority of men surveyed, the scalp hair is more important than the eyebrows and eyelashes. The study shows that hair loss in the course of cancer therapy with cytotoxic drugs has the greatest impact on the quality of life in relation to the social functioning and social activities, however does not significantly affect the individual activities. The pilot study for HLIV vignette validation confirms that the tool is appropriate for use to assess the impact of the hair loss on patients’ daily activities

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

Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study in 12 European countries using the Edinburgh Postnatal Depression Scale

Purpose: To explore the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Patients and methods: Multinational web-based study in 12 European countries (n=8069). Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with less than one year of age, could participate. We used the Edinburgh Postnatal Depression Scale (EPDS) to measure prevalence of antenatal and postnatal depressive symptoms according to severity, which were corrected by survey-weight adjustment (descriptive analysis). Within mothers with a psychiatric disorder (n=173), we estimated the association between antidepressant treatment in pregnancy and postnatal depressive symptom severity, as standardized EPDS mean scores, via inverse probability of treatment weight (association analysis). Results: In the descriptive analysis (n=8069), the period prevalence of moderate to very severe depressive symptoms was higher in the Western and Eastern regions relative to the Northern, both in the ante- (6.8-7.5% vs 4.3%) and postnatal period (7.6% vs 4.7%). One in two mothers with psychiatric disorders used antidepressant in pregnancy (86 out of 173). In the association analysis, women medicated at any time during pregnancy (adjusted β: -0.34, 95% CI: -0.66, -0.02) had a significant postnatal symptom severity reduction compared with the nonmedicated counterpart. This effect was larger (β: -0.74, 95% CI: -1.24, -0.24) when the analysis was restricted to mothers within six months after childbirth. Conclusions: The prevalence of self-reported antenatal and postnatal depressive symptoms differs across European countries. Among women with psychiatric disorders, those who had been on treatment with antidepressants during pregnancy were less likely to report postnatal depressive symptoms, particularly within the six-month period after childbirth, compared to the nonmedicated counterpart

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

Right of the Pharmacist to Conscientious Objection in Light of the Applicable of Legal Regulations

W pracy przedstawiono ogólną sytuację prawną i faktyczną dotyczącą prawa farmaceuty do sprzeciwu sumienia. Poruszany problem budzi w Polsce wiele kontrowersji i spotyka się z żywą dyskusją. Zwolennicy klauzuli sumienia powołują się na prawo do wolności sumienia oraz postępowania zgodnie z nim, zaś przeciwnicy podnoszą problem naruszenia praw pacjenta. W niniejszym artykule omówione zostały polskie przepisy prawne regulujące pracę farmaceuty oraz procedurę wydawania leków z apteki. Porównawczo przedstawiono także przykłady postępowania w sprawie klauzuli sumienia we Francji i Włoszech. Akty prawne oraz przykłady z innych krajów zostały poddane analizie w kontekście wysuwanych postulatów wprowadzenia do prawa polskiego klauzuli sumienia dla farmaceutów.The paper presents a general legal and factual situation on applicable law pharmacists to conscientious objection. Issue addressed in Poland arouses a lot of controversy and meets with a lively discussion. Supporters of conscience clause invoke the right to freedom of conscience and act in accordance with him, while opponents raise the issue of patients' rights violations. This article discusses the Polish legislation governing the work pharmacists and dispensing process from the pharmacy. Comparatively also presented examples of conduct on the conscience clause in France and Italy. Legislation and examples from other countries have been analyzed in the context of the introduction of postulates conscience clause for pharmacists to Polish law

Assess the quality of pharmaceutical services provided in public pharmacies using results of audits carried out by the Pharmaceutical Inspection. Part 1. General analysis.

Assess the quality of pharmaceutical services provided in public pharmacies using results of audits carried out by the Pharmaceutical Inspection. Part 1. General analysis. In Poland, quality supervision and marketing of medicinal products is the task of the State Pharmaceutical Inspection. The main goal of its activities include securing social interests in terms of health and life safety of people using medications purchased, among others in pharmacies. The manuscript proposes a new solution to assess the quality of pharmaceutical services provided in public pharmacies using results of audits carried out by the Pharmaceutical Inspection. Research material consists of data obtained from the Voivodeship Pharmaceutical Inspectorates (WIF) regarding the number of carried out inspections and detected irregularities between January 1, 2015 and June 30, 2016. The research was conducted in 2016, among all 16 Voivodeship Inspectorates. At the request to provide essential information, 12 WIF responded positively, data from the remaining inspectorates was obtained from public information made available on their websites. In 2015, 3988 audits of public pharmacies were carried out. At that time, 13,469 public pharmacies operated in Poland and 134 inspectors were employed. On average one inspector carried out 2.5 audits monthly, which means that a single pharmacy was inspected once in 3.5 years (these calculations do not refer to other entities supervised by this office). The number of inspectors to entities and imposed tasks is insufficient, translating into the frequency of pharmacy’s inspections. This frequency can have a direct impact on the quality of provided services, as each inspection is aimed at eliminating mistakes. A hypothesis can be drawn that the less frequently an entity is audited, especially an entity where irregularities are noted, the easier it is to repeat and consolidate those irregularities to everyday practice. This in turn can lead to providing low quality pharmaceutical services.W Polsce nadzór nad jakością i obrotem produktami leczniczymi sprawuje Państwowa Inspekcja Farmaceutyczna. Podstawowym celem jej działań jest zabezpieczenie interesu społecznego w zakresie bezpieczeństwa zdrowia i życia ludzi stosujących leki nabywane m.in. w aptekach. W pracy zaproponowano nowe rozwiązanie możliwości oceny jakości usług farmaceutycznych świadczonych w aptekach ogólnodostępnych z wykorzystaniem kontroli prowadzonych przez Inspekcję Farmaceutyczną. Materiał badawczy stanowią dane otrzymane z wojewódzkich inspektoratów farmaceutycznych dotyczące: liczby przeprowadzonych kontroli oraz wykrytych nieprawidłowości w okresie od 1 stycznia 2015r. do 30 czerwca 2016r. Badanie przeprowadzono w 2016 r. wśród wszystkich 16 wojewódzkich inspektoratów. W 2015r. zrealizowano 3988 kontroli aptek ogólnodostępnych. W tym czasie w Polsce funkcjonowało 13 469 aptek ogólnodostępnych a zatrudnionych było 134 inspektorów. Miesięcznie jeden inspektor średnio przeprowadził 2,5 kontrole aptek, co prognozuje częstotliwość kontroli pojedynczej apteki średnio co ok. 3,5 roku. Wyliczenia częstotliwości kontroli aptek ogólnodostępnych przypadające na jednego inspektora nie odnoszą się do innych placówek nadzorowanych przez ten urząd. Liczba inspektorów w stosunku do liczby podmiotów gospodarczych oraz zadań jakie narzuca na inspekcję ustawodawstwo, jest niewystarczająca, co przekłada się na częstotliwość kontroli każdej apteki. Częstotliwość kontroli może mieć bezpośredni wpływ na jakość usług świadczonych przez apteki, gdyż każda kontrola ma za zadanie eliminować popełniane błędy. Można wysunąć hipotezę, że im rzadziej kontrolowany jest podmiot, w którym stwierdzono nieprawidłowości w jego funkcjonowaniu, tym łatwiej może dochodzić do utrwalenie działań nieprawidłowych i braku możliwości usunięcia ich z codziennej praktyki aptekarskiej. Utrwalenie nieprawidłowości może prowadzić do świadczenia usług farmaceutycznych o niskiej jakości

Diet Quality and Level of Nutrition Knowledge among Young People with Orthorexic Tendencies

The aim of the study was to determine the level of nutrition knowledge and diet quality, understood in terms of healthy and unhealthy eating habits, among young people with orthorexic tendencies. The participants were school students, university students, and those employed in the Lublin region (N = 473). The data were collected by means of a questionnaire. The participants were asked to provide socio-demographic data through filling in the ORTO-15 questionnaire and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). The participants obtained results ranging from 9.3 to 100 (M = 31.15; SD = 11.81) in the non-healthy diet index, from 0.4 to 78.6 in the pro-healthy diet index (M = 21.79; SD = 11.08), and from 0 to 23 in the domain of nutrition knowledge (M = 13; SD = 4.23). A variance analysis showed no significant differences between the pro-healthy diet index and the level of nutrition knowledge. The group with orthorexia obtained statistically higher results in the pro-healthy diet index. Those with a tendency toward orthorexia obtained statistically higher results in the non-healthy diet index. The variance analysis showed that the level of nutrition knowledge of those not focused on healthy foods was significantly lower than in the other groups. The results of the ORTO-15 questionnaire correlated negatively with the pro-healthy diet index and the level of nutrition knowledge, and positively with the non-healthy diet index. We concluded that: 1. the orthorexic group and the group with a tendency toward orthorexia could be characterized with a moderate intensity of a healthy diet and a low intensity of a non-healthy diet; and 2. the level of nutrition knowledge in the orthorexic group did not significantly differ from that of the other groups

Real world data supporting identification of the pharmacist’s role in obesity and overweight treatment in Poland – a preliminary report

Introduction. Obesity is a significant health and economic problem, both for the patient and the health care system. An essential element in the prevention and treatment of each disease is the engagement of all groups of healthcare professionals. In our study, we performed an analysis of the real world data, obtained from a survey of the medical and socioeconomic problems associated with overweight and obesity. We aimed to identify the pharmacist’s role in the management of overweight and obese patients, including their individualized education in an outpatient setting. Material and methods. The study material consisted of responses obtained from a specially designed questionnaire. Our findings indicate that the study patients had easy access to a pharmacist’s professional knowledge, relevant to comprehensive treatment of obesity. In addition, our data indicates a lack of patient knowledge of a healthy lifestyle and an inability to implement such knowledge in practice. Results. The community pharmacist should actively provide support to patients with obesity (including the primary obesity and those who want to lose excessive body mass for health-related and also for aesthetic reasons) and the management of their weight. The results of our study should be considered as an introduction to further research to facilitate the understanding of problems and expectations of patients and to prepare pharmacists to perform pharmaceutical care (PC) in this regard. Conclusion. One of the potential options to protect society against the obesity epidemic is an education about the risks inherent to obesity and promotion of a healthy lifestyle