Chain Community Pharmacists\u27 Willingness, Attitudes, and Barriers in Providing Self-Care Medication and Supplement Recommendations

BACKGROUND: Pharmacists are commonly called on as the first resource for patients when selecting an appropriate self-care medication or supplement. This study examines pharmacists’ over-the-counter (OTC) recommendations in the chain community pharmacy setting in the United States. OBJECTIVES: The objective of the study was to assess chain community pharmacists’ willingness and attitudes to provide self-care recommendations to patients and to identify chain community pharmacists’ barriers to making OTC medication and supplement recommendations. METHODS: An anonymous survey was created to identify pharmacists’ attitudes and their willingness to perform these recommendations. The questionnaire included specific questions to identify barriers that exist to making OTC recommendations. The survey was distributed by fax and email to 527 pharmacists in the Mid-South regional district of a U.S. grocery chain pharmacy. Descriptive statistics were used to identify demographic trends and display results. RESULTS: Pharmacists are overwhelmingly willing to provide OTC recommendations (100%) and see it as an important part of community practice (99%). The greatest barriers were time/prescription volume (94%) and staffing demands (78%). The greatest need for education was in the areas of eye/ear care and vitamins/herbal products. CONCLUSIONS: The results affirmed pharmacists’ willingness and overall positive attitude to providing OTC medication counseling in the community pharmacy setting. The research uniquely identified barriers that pharmacists experience when attempting to make OTC recommendations. This information can be used not only for the implementation of patient care services targeting self-care needs but also in the application of general community pharmacy practice

Development and Implementation of an Influenza Point-of-Care Testing Service in a Chain Community Pharmacy Setting

Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% of patients testing positive received a prescription as a result. While health insurance cannot be billed for the service due to current pharmacy reimbursement practices, this did not appear to negatively affect patient willingness to participate. As point-of-care testing services become more commonplace in community pharmacy settings, patient awareness will similarly increase and allow for more widespread access to acute outpatient care

Outcomes of pediatric patients with therapy-related myeloid neoplasms

Long-term outcomes after allogeneic hematopoietic cell transplantation (HCT) for therapy-related myeloid neoplasms (tMNs) are dismal. There are few multicenter studies defining prognostic factors in pediatric patients with tMNs. We have accumulated the largest cohort of pediatric patients who have undergone HCT for a tMN to perform a multivariate analysis defining factors predictive of long-term survival. Sixty-eight percent of the 401 patients underwent HCT using a myeloablative conditioning (MAC) regimen, but there were no statistically significant differences in the overall survival (OS), event-free survival (EFS), or cumulative incidence of relapse and non-relapse mortality based on the conditioning intensity. Among the recipients of MAC regimens, 38.4% of deaths were from treatment-related causes, especially acute graft versus host disease (GVHD) and end-organ failure, as compared to only 20.9% of deaths in the reduced-intensity conditioning (RIC) cohort. Exposure to total body irradiation (TBI) during conditioning and experiencing grade III/IV acute GVHD was associated with worse OS. In addition, a diagnosis of therapy-related myelodysplastic syndrome and having a structurally complex karyotype at tMN diagnosis were associated with worse EFS. Reduced-toxicity (but not reduced-intensity) regimens might help to decrease relapse while limiting mortality associated with TBI-based HCT conditioning in pediatric patients with tMNs

Outcomes of Pediatric Patients with Therapy-Related Myeloid Neoplasms

Long-term outcomes after allogeneic hematopoietic cell transplantation (HCT) for therapy-related myeloid neoplasms (tMNs) are dismal. There are few multicenter studies defining prognostic factors in pediatric patients with tMNs. We have accumulated the largest cohort of pediatric patients who have undergone HCT for a tMN to perform a multivariate analysis defining factors predictive of long-term survival. Sixty-eight percent of the 401 patients underwent HCT using a myeloablative conditioning (MAC) regimen, but there were no statistically significant differences in the overall survival (OS), event-free survival (EFS), or cumulative incidence of relapse and non-relapse mortality based on the conditioning intensity. Among the recipients of MAC regimens, 38.4% of deaths were from treatment-related causes, especially acute graft versus host disease (GVHD) and end-organ failure, as compared to only 20.9% of deaths in the reduced-intensity conditioning (RIC) cohort. Exposure to total body irradiation (TBI) during conditioning and experiencing grade III/IV acute GVHD was associated with worse OS. In addition, a diagnosis of therapy-related myelodysplastic syndrome and having a structurally complex karyotype at tMN diagnosis were associated with worse EFS. Reduced-toxicity (but not reduced-intensity) regimens might help to decrease relapse while limiting mortality associated with TBI-based HCT conditioning in pediatric patients with tMNs