Health literacy and medication adherence in psoriasis patients: a survey in Iran

Background: Medication adherence among Psoriasis patients is often inadequate identified as a significant problem in Psoriasis symptoms management. Poor medication adherence could necessitate stronger and more expensive medications, which could place a significant burden on the healthcare system. Moreover, the importance of health literacy assessment as a factor influencing adherence in psoriasis patients cannot be overstated. This study aimed to evaluate the medication adherence level of Iranian Psoriasis patients and its relationship with the patients' health literacy level and demographic conditions. Methods: This is a cross-sectional study among Iranian psoriasis patients conducted through a web-based questionnaire survey between 26 July 2020 and 5 January 2021 and a total of 575 samples were collected. The questionnaire consisted of 3 sections: First, demographic information and disease characteristics were evaluated. Second, the medication adherence was evaluated by using valid Morisky Medication Adherence Scale-8 (MMAS-8), and, finally, the health literacy was evaluated by using Health Literacy for Iranian Adults (HELIA). Data were analyzed using SPSS software, version 22 with descriptive statistics; Chi-square and Kruskal-Wallis tests. Stepwise multiple linear regression was also used to evaluate the impact of independent variables related on medication adherence score. Results: Results showed that the mean health literacy score in the study population was 74.3 ± 14.23, and the mean medication adherence score was 4.1 ± 2.18. Out of the total participants, 28.8% had high health literacy, 67.1% had adequate health literacy, and 4% had inadequate health literacy. The majority of the participants (70.7%) reported low adherence, while 24.1% reported moderate and 5.2% reported high adherence. The results of the Chi-square test showed a significant relationship between age, comorbidities, type of treatment, satisfaction with treatment, the experience of adverse effects, and health literacy with medication adherence (P < 0.05 for all). The final constructed model of stepwise multiple linear regression was highly statistically significant. The highest beta coefficient in the final model belonged to the total health literacy score. Conclusions: Based on the results, medication adherence among Iranian psoriasis patients is low. Health literacy correlates most strongly with medication adherence and is the best variable to determine it. Improving the access to the internet and the ICTs to enhance the patients` health literacy along with developing the patient education approaches and techniques should be considered by health policymakers

An application of analytic network process model in supporting decision making to address pharmaceutical shortage

Background: The present study aimed to develop an Analytic Network Process (ANP) model to assist policymakers in identifying and prioritizing allocation indicators, which are being used or should be used to distribute drugs in short supply among different provinces. Methods: The model encompasses the interactions between various indicators and efficiency, equity, and effectiveness paradigms. Accordingly, a set of clusters and elements, which were associated with the allocation of drugs in short supply in Iran's pharmaceutical system, were detected to develop the model and were then compared in pairs in terms of a specified factor to show the priorities. Results: Equity had the highest priority (0.459) following by Efficiency (0.37), and Effectiveness (0.171). The 4 most important allocation indicator were "number of prescriptions"(0.26) and "total bed occupancy rate"(0.19) related to equity, "total population"(0.21) in efficiency and "the burden of rare and incurable disease"(0.07) in effectiveness paradigm. Conclusions: The capability to overcome inefficient resource allocation patterns caused by both oversupply and undersupply derived from historic resource allocation may be highly limited in the absence of the need indicators. The quality of the decision is related to a careful balancing act of the three paradigms which represents roughly the triple aim of public healthcare systems: clinical improvement (effectiveness), population health improvement (equity and access), and reducing cost (economic aspects -efficiency). © 2020 The Author(s)

The structure of the world pharmaceutical market: Prioritizing Iran�s target export markets

Iran�s pharmaceutical products market has faced fluctuations over time. Suitable market selection is necessary for stability of pharmaceutical exports. This study aimed to determine the structure of the world pharmaceutical market and to identify the target of Iranian pharmaceutical export. T do so, concentration ratios and Herfindahl index were used to address the world pharmaceutical market from 2001 to 2012. Also, a composite index was used to identify the target markets of Iran�s pharmaceutical industry. The results showed that the export side of world pharmaceutical trade has shifted to open oligopoly, thereby decreasing the monopolistic power of exporters. The import side, however, follows monopolistic competition. It has been observed that the structure of Iran�s pharmaceutical export is shifting to open oligopoly; though, pharmaceutical importers from Iran have not been stable. Moreover, 27 countries were identified as target markets. Due to significant differences between the current and potential export destinations of Iran�s pharmaceutical products, exporters should choose suitable strategies in order to diversify export markets. Such mechanisms as setting preferential tariffs on the basis of bilateral agreements, following effective advertisment, and paying attention to global consumers�preferences can be used to develop Iran�s pharmaceutical export to target countries. © 2019, Iranian Journal of Pharmaceutical Research. All rights reserved

The balanced scorecard as a strategic management tool in hospital pharmacies: an experimental study

Purpose: A balanced scorecard (BSC) is an applied tool for implementing strategic management in various organizations. Implementing strategic management using the BSC approach has not received much attention in pharmacy departments. This study aims to provide a model for the strategic management of pharmacy departments using the BSC framework. Design/methodology/approach: This experimental study was conducted from 2015 to 2018 in a 300-bed hospital and regional healthcare centers affiliated with the Petroleum Industry Health Organization in Tehran province, Iran. After carefully reviewing the organization's mission and vision, the strategic objectives were determined via the internal matrix and the external matrix (IE matrix), and the strengths–weaknesses–opportunities–threats matrix (SWOT matrix) were examined. Then, six BSC measures and interventions were identified, and each was examined from the perspectives of finance, patient satisfaction, internal processes and learning/growth. Finally, the proposed strategy was evaluated. Findings: Results showed significant increases in patient satisfaction and gross profit. The observed increase range, from 0.09 to 0.29, indicates more effective operational management for optimal resource utilization. In addition, the pharmacy department was able to save US $539,137 by implementing prepared protocols for expensive medications. Similarly, the pharmacy department saved$442,899 during the two years of our strategic management plan by implementing the standard mechanism for returning unused medications to the pharmacy department after patients were discharged from various treatment units. Originality/value: This study is among the first studies to demonstrate the simultaneous development, implementation and evaluation of the proposed strategy using the BSC in a pharmacy department in a public healthcare center. The BSC application improved the optimal use of resources and reduced costs while increasing patient satisfaction. It appears that the application of such an intervention may be as valuable to public pharmacies as it is to other private centers

Corporate social responsibility and customer loyalty during the Covid-19 pandemic: evidence from pharmacy practice

Purpose: In recent years, corporate social responsibility (CSR) has taken on a more prominent role in both large and small businesses because of its significant impact on various aspects of business performance. To date, a growing body of literature has demonstrated the mechanisms whereby CSR practices affect organizational outcomes; however, there has been little research examining how CSR practices contribute to customer loyalty within the pharmacy context. As such, this study aims to explore how CSR practices influence the loyalty of pharmacy customers, particularly in relation to the mediatory effects of customer-company identification (CCI) and customer trust. Design/methodology/approach: A survey questionnaire was developed and administered to collect the required data from the pharmacy context. The resultant data were subjected to exploratory factor analysis to identify the scale dimensions, followed by multiple regression analysis to test the hypotheses. Findings: Analysis of the results (n = 528) revealed that perceived CSR indirectly impacts loyalty through the mediatory effects of trust and CCI. All hypothesized effects were also confirmed via empirical testing. Originality/value: The findings of this research suggest that not only are CSR activities responsive to societal concerns, but they can also promote customer identification with pharmacies and strengthen customer trust, which can, in turn, lead to long-term customer loyalty

Resilience level and its relationship with hypochondriasis in nurses working in COVID-19 reference hospitals

Introduction: A new coronavirus, called COVID-19, is an acute respiratory disease, which may arouse many psychological disorders since there is no specialized knowledge about it. The present study aimed to investigate the level of resilience and its relationship with hypochondriasis in nurses working in a COVID-19 reference hospital in south of Iran. Methods: This cross-sectional study was conducted in 2020, in which 312 nurses participated using the census method. Data collection tools were the Conker-Davidson standard resilience scale (CD-RISC) and the Evans Hypoglycaemia Awareness Questionnaire. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient, and multiple linear regression using SPSS software version 23. Results: The mean scores of resilience and hypochondriasis were 72.38 ± 7.11 and 49.75 ± 8.13, respectively, indicating the moderate level of these two variables among nurses. Hypochondriasis in 18.91, 61.22, and 1.28% of the nurses was mild, moderate, and severe, respectively. There was a significant negative correlation between resilience and hypochondriasis (r = − 0.214 and P < 0.001). In this regard, control (P < 0.001), positive acceptance of change (P < 0.001), spiritual effects (P = 0.001), trust in individual instincts (P = 0.001), and perception of competence (P = 0.002) were detected as the predictors of nurses’ hypochondriasis. Conclusion: The nurses had moderate levels of resilience and hypochondriasis. Promoting knowledge about COVID-19and increasing information on how to protect oneself and others against the disease along with supportive packages from their managers are thus recommended

Challenge of politico-economic sanctions on pharmaceutical procurement in Iran: a qualitative study

Background: Politico-economic sanctions over the recent years have led to significant challenges in the pharmaceutical supply chain (PSC) in Iran. Given the importance of the chain's resilience for the health system and its impact on accessibility, equity, and public health, this study was conducted to determine the major challenges facing pharmaceutical procurement in Iran after the imposition of these sanctions. Methods: This study was a qualitative research with a content analysis approach conducted in 2019. Eighteen policymakers and administrative managers in food and drug administration of two Iranian Medical Universities and Iran's Ministry of Health were included in the present study via snowball sampling and semi-structured interview. The data were analyzed using the framework analysis of MAX QDA10. Results: Five main themes and 15 sub-themes were identified, which addressed pharmaceutical supply chain challenges under politico-economic sanctions. These included the challenges in financing, purchasing, importing, and manufacturing domestic products in addition to storing and distributing medicines, along with challenges facing the general public, particularly patients. Conclusion: The results revealed that pharmaceuticals are not immune to politico-economic sanctions, although they are not directly subjected to them. Sanctions, similar to any economic crisis, can affect public health and limit their access to healthcare. Identifying supply chain challenges and planning to address them could help policymakers find solutions to enhance PSC resilience in the future

How does organizational learning contribute to corporate social responsibility and innovation performance? The dynamic capability view

Purpose: Innovative organizations are increasingly facing challenges in a dynamic market to address corporate social responsibility (CSR) issues; however, research on how organizational learning (OL) contributes to organizations’ social responsibility and innovation remains sparse. This study aims to bridge the gap in previous research and examines how OL and dynamic capabilities (DCs) act as drivers of CSR performance (CSRP) and innovation performance. Design/methodology/approach: This study is survey-based and uses time-lagged, multisource data from 151 pharmaceutical industry-related companies in Iran. Structural equation modeling was applied to test the validity of the measurement model and hierarchical regression was used to test the key hypotheses. Findings: DCs mediate the relationship between OL and CSRP. Moreover, CSRP significantly mediates the relationship between OL and innovation. Originality/value: Drawing on the perspective of DCs, this research is among the first to offer new insights in a new context on what antecedent conditions lead to the successful implementation of organizational CSRP and how CSRP would, in turn, lead to subsequent innovation performance improvement