COVID-19 AND THE ENVIRONMENT – THE ROLE OF THE PUBLIC HEALTH INSTITUTE

The Croatian National Health Care Act defines the areas of activities of the public health institute, including the activities of the epidemiology of infectious diseases and chronic non-communicable diseases, public health, health promotion, environmental health, microbiology, school and adolescent medicine, mental health and addiction prevention at Zagreb City level. This paper reviews the highly variable activities in the Andrija Štampar Teaching Institute of Public Health with the aim of promoting a comprehensive approach to the COVID-19 pandemic. Human and analytical resources in the Institute, activities and rapid implementation of innovations testify to the high capacities for adaptation to emerging risks. In the Institute, it is possible to carry out a whole range of tests and to monitor the environmental factors with predominant impact on human health and safety of the Zagreb environment. The supply of safe water for human consumption in the Republic of Croatia during the current COVID-19 crisis has been uninterrupted and in accordance with applicable legislation. Also, our laboratories have been developing and introducing a method for wastewater testing for SARS-CoV-2 presence. The sludge from wastewater treatment plants is used in agriculture, and potential risks associated with the COVID-19 outbreak should be assessed prior to each application on the soil. Increased use of disinfectants during the epidemic may present a higher risk to the aquatic environment. Air quality monitoring indicates a positive impact on air quality as result of isolation measures

PHARMACIST COMPETENCES AND IMPACT OF PHARMACIST INTERVENTION ON MEDICATION ADHERENCE: AN OBSERVATIONAL STUDY

Background: The aim of this study is to determine the results of pharmacist interventions on patient\u27s adherence to drugs in community settings. Subjects and methods: The study was designed using a standard EQ-SDQ questionnaire and a Culig questionnaire about the adherence to drug. General Level Framework (GLF) was used as a tool for competence assessment among community pharmacists. Participants were pharmacists that issued the medication on repeat prescription in the pharmacy. They interviewed the patient at the first visit to the pharmacy and the next time when the patient came to refill the prescription. The survey was conducted during a twomonth period in the Atlantic Pharma pharmacy chain. A total of 152 patients were included at the first visit and 87 patients at the second visit. Results: About two thirds of patients (65.5%) identified themselves as adherent during the first survey, and this number increased slightly during the second interview (by 3.5%), but not statistically significant (p=0.75). A total number of drugs prescribed during the first and second survey was 252 and 253 respectively. The percentage of the advices given to the patients increased during the second survey, but not statistically significant (p=0.62). Conclusion: It is definitely important to check that a patient understands current disease and what are doubts and difficulties in taking a therapy. The reasons for possible nonadherence are different: fears, worsening of the clinical state or other negative treatment outcomes. Enough time should always be left to clarify anything that is unclear and to listen. Application of GLF program for improving pharmacist competences resulted in slightly increased patient adherence to medication. For further development of competences, pharmacist intervention should include some other contents, i.e. tailoring the dosage scheme, counselling about drugdrug and drug-food interactions. The pharmacist counseling should be reimbursed by the Croatian Health Insurance Fund