Pharmacy Practice <p><strong>Pharmacy Practice</strong> is a free full-text peer-reviewed journal with a scope on pharmacy practice. <strong>Pharmacy Practice</strong> is published quarterly. <strong>Pharmacy Practice <span style="text-decoration: underline; color: #ff0000;">does not charge and will never charge any publication fee or article processing charge (APC) to the author</span><span style="text-decoration: underline;"><span style="color: #ff0000; text-decoration: underline;">s</span></span></strong>.</p> Centro de Investigaciones y Publicaciones Farmaceuticas en-US Pharmacy Practice 1885-642X <p>The authors hereby transfer, assign or otherwise convey to Pharmacy Practice (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print or epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to <strong>Pharmacy Practice</strong> with this document.</p> <p>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_blank" rel="noopener">Creative Commons Attribution License</a> (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p> <p><strong><span class="label">Author Self-Archiving Policy</span></strong></p> <p><span class="label"><strong>Pharmacy Practice</strong> permits and encourages authors to post and archive the<strong> final </strong>PDFs of their respective articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.</span></p> The role of the pharmacist in low back pain management: A narrative review of practice guidelines on paracetamol vs Non-steroidal anti-inflammatory drugs <p>Low back pain (LBP) is a common and costly condition and a leading cause of disabilities across the globe. In Australia and other countries, there has been changes in LBP management guidelines and evidence in recent years, including the use of pharmacotherapy. Inadequately treated LBP is a burden with significant health and economic impacts. Although there is some variability, non-steroidal anti-inflammatory drugs (NSAIDs) have largely replaced paracetamol as the first-choice analgesic for non-specific LBP in many international clinical guidelines, including the current Australian Therapeutic Guidelines. More recent clinical evidence also supports that targeting LBP with the use of NSAIDs can provide superior and more effective relief of LBP symptoms compared with paracetamol. Community pharmacists are one of the most accessible and frequently visited health professionals that offer vital primary healthcare services aimed to provide enhanced clinical outcomes for patients. The position of a community pharmacist is pivotal in LBP assessment and management, from both a pharmacological and non-pharmacological standpoint, including the use of clinical guidelines, yet their roles are often not fully utilized in LBP therapy. Studies investigating the community pharmacist’s views, practices, knowledge, and roles, specifically in LBP management in Australia are variable and limited. This narrative review will briefly cover the impacts of LBP, and to provide a summary on recent evidence, updates and a comparison of the Australian and international low back pain management guidelines on paracetamol vs NSAIDs in LBP, as well as pharmacists’ roles and interventions in a primary healthcare setting in this context.</p> John Mishriky Ieva Stupans Vincent Chan Copyright (c) 2020 Pharmacy Practice and the Authors 2020-08-06 2020-08-06 18 3 2075 2075 10.18549/PharmPract.2020.3.2075 Pharmacists’ perception of their role during COVID-19: a qualitative content analysis of posts on Facebook pharmacy groups in Jordan <p><strong>O</strong><strong>bjective</strong>: This study aimed to evaluate the content available on Facebook pharmacy groups in Jordan regarding the perception of the pharmacists’ role during the coronavirus pandemic in Jordan.</p> <p><strong>Methods</strong>: Researchers identified Facebook pharmacy groups through the search engine on the Facebook website. The main search keywords were pharmacy, pharmacist, pharmacists, and Jordan using both Arabic and English. Two researchers analyzed the posts and discussion threads on local pharmacy Facebook groups in a period between March 20<sup>th</sup> and April 3<sup>rd</sup>. A total of 184 posts and threads were identified for the purpose of the study.</p> <p><strong>Results</strong>: Identified threads and responses resulted in three overarching themes: pharmacists having a positive role during the pandemic, taking additional responsibilities and services, and having passive or negative roles. A positive role was seen in pharmacists acting as first-line healthcare providers, creating public’s awareness regarding COVID-19, and being responsible for chronic medication refill during the pandemic. Taking additional responsibilities was summarized in home deliveries and involvement in industrial and corporate efforts to deal with the pandemic. A passive/negative role was seen mostly among hospital pharmacists not being proactive during the pandemic and by pharmacists trying to maximize profits during pandemic time.</p> <p><strong>Conclusions</strong>: Pharmacists perceived their role as a positive role during the coronavirus pandemic. Not only they took responsibilities for their daily services during the crises, but they took additional responsibilities to assure patient safety and satisfaction.</p> Tareq L. Mukattash Anan S. Jarab Ibrahim Mukattash Mohammad B. Nusair Rana Abu Farha May Bisharat Iman A. Basheti Copyright (c) 2020 Pharmacy Practice and the Authors 2020-07-31 2020-07-31 18 3 1900 1900 10.18549/PharmPract.2020.3.1900 A survey on feasibility of telehealth services among young Italian pharmacists <p><strong>Background</strong>: Telemedicine is defined as “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health status”. This relatively new concept of healthcare is based on the fusion between medical assistance and Information and Communication Technology (ICT) to provide support to people located in remote and underserved areas. It can be found not only in hospitals, but also in other healthcare facilities such as pharmacies. Starting from 2010, telemedicine or telehealth was formally introduced in the Italian pharmaceutical context with the "Pharmacy of Services Decree". In spite of this regulatory framework, the implementation of this technology was very slow and there are no data about the spreading and use of these services in Italian pharmacies.</p> <p><strong>Objective</strong>: The present study has therefore developed a survey to collect information on the diffusion of telemedicine/telehealth services within Italian pharmacies.</p> <p><strong>Methods</strong>: A two-part questionnaire in Italian was developed using SurveyMonkey, setting a mechanism aimed to have different outcomes according to the answers given. Six hundred eighty-three respondents returned the questionnaire. The results were then analysed statistically.</p> <p><strong>Results</strong>: The questionnaire results have shown a limited diffusion of telemedicine/telehealth services among Italian pharmacies and an apparently limited interest of health authorities in supporting the integration of this technology.</p> <p><strong>Conclusions</strong>: More efforts should be spent by national public health stakeholders to better analyse the contribution of telemedicine services available in public pharmacies and to find the best solutions to implement this innovative technology as an established service.</p> Simone Baldoni Graziano Pallotta Enea Traini Getu G. Sagaro Giulio Nittari Francesco Amenta Copyright (c) 2020 Pharmacy Practice and the Authors 2020-08-06 2020-08-06 18 3 1926 1926 10.18549/PharmPract.2020.3.1926 The role of the community pharmacist in veterinary patient care: a cross-sectional study of pharmacist and veterinarian viewpoints <p><strong>Background</strong>: The role of the community pharmacist is rapidly expanding to encompass the care of veterinary patients in the United States of America This change makes it imperative for pharmacists and veterinarians who practice in community settings to establish mutual agreement on the roles of pharmacists in the care of these patients.</p> <p><strong>Objective</strong>: To examine community-based pharmacist and veterinarian viewpoints on interprofessional collaboration and the role of the community pharmacist in veterinary patient care.</p> <p><strong>Methods</strong>: Cross-sectional surveys were sent to pharmacists and veterinarians who practice in a community setting in Ohio. Surveys collected demographic information and addressed the following themes: attitudes toward collaboration, perceived roles of the pharmacist, expectations of the pharmacist, and previous collaborative experiences. A chi-square test was used for statistical analysis.</p> <p><strong>Results</strong>: In total, 357 pharmacists and 232 veterinarians participated in the study. Both professions agreed that pharmacist-veterinarian collaboration is important in order to optimize veterinary patient care (chi-square (1, N=589)=7.7, p=0.006). Overall, veterinarians were more likely to identify an important role of the community pharmacist to be compounding medications (chi-square (1, N=589)=26.7, p&lt;0.001) compared to counseling pet owners (chi-square (1, N=589)=171.7, p&lt;0.001). Both groups reported similar levels of agreement regarding the importance for pharmacists to have adequate knowledge of veterinary medicine.</p> <p><strong>Conclusions</strong>: Our study found that while both pharmacists and veterinarians conveyed a positive attitude regarding interprofessional collaboration, they disagreed on what role the pharmacist should play in the care of veterinary patients. Rectifying the discordant perceptions of these health care professionals may be critical to developing collaborative initiatives and optimizing veterinary patient care.</p> Mary E. Fredrickson Hayley Terlizzi Rikki L. Horne Stanley Dannemiller Copyright (c) 2020 Pharmacy Practice and the Authors 2020-08-06 2020-08-06 18 3 1928 1928 10.18549/PharmPract.2020.3.1928 Exploring discrimination towards pharmacists in practice settings <p><strong>Background</strong>:&nbsp; Discrimination towards pharmacists, as a public-facing health professional group, is reported but not well-studied.</p> <p><strong>Objectives</strong>:&nbsp; The aims of this study were to identify accounts of discrimination in pharmacy practice and to explore the nature and impacts of and discrimination experienced by pharmacists.</p> <p><strong>Methods</strong>:&nbsp; A cross-sectional survey was emailed to practice-based preceptors associated with the School of Pharmacy at the University of Otago. The survey included demographic questions, in addition to questions asking about the frequency and sources of different types of discrimination and abuse encountered in practice. Survey respondents could also provide their contact information for follow-up interviews. Interviews occurred after completion of the survey to better understand the nature of discrimination in pharmacy practice. A thematic analysis of interview transcripts was conducted to identify pertinent themes.</p> <p><strong>Results</strong>: A total of 43 participants completed the survey. A total of 29 (67.4%) respondents reported experiencing discrimination in pharmacy practice. The most common types of discrimination experienced included discrimination based on gender, appearance, or past, present, or expected pregnancy. Verbal abuse and sexual harassment were also frequently reported. Most discrimination was sourced from patients, colleagues, or supervisors/leaders. Discrimination specific to pregnancy was largely sourced from supervisors/leaders. Verbal abuse was sources primarily from patients, patient’s family, supervisors/leaders, and other healthcare professionals. Patients were the primary source of sexual harassment. Three themes were identified from the interview phase: Discrimination occurs for a variety of reasons from different sources with different behaviors, the impact on a person is individualized/personal, and preventative strategies can be broad and encompass multiple layers of society.</p> <p><strong>Conclusions</strong>:&nbsp; Findings of this study support the notion that training programs must adjust to adequately train pharmacists with effective coping strategies, prevention mechanisms, and resilience building strategies. Pharmacist employers should also be accountable to creating zero tolerance workplaces and providing route maps for how pharmacists report and navigate situations when faced with discrimination. Doing so may result in a better equipped workforce that is able to navigate the pressures encountered through discrimination in practice.</p> Lik De Chun Rebecca Ye Kyle J. Wilby Copyright (c) 2020 Pharmacy Practice and the Authors 2020-08-11 2020-08-11 18 3 1966 1966 10.18549/PharmPract.2020.3.1966 Evaluation of the entrustable professional activities (EPAs) of the population health promoter domain by North Dakota pharmacists <p>Objective.<em>&nbsp; </em>Entrustable Professional Activities (EPAs) are a list of professional tasks (with associated competency ratings) that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. This manuscript assesses the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota.</p> <p>Methods. &nbsp;This survey assessed the self-reported EPA activities (inclusive of the PHP domain) of registered pharmacists living and practicing in North Dakota. There were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded.</p> <p>Results. Within the PHP domain, pharmacists reported performing “Minimize adverse drug events and medication errors” most frequently (mean=3.4, SD=2.0), followed by “Ensure that patients have been immunized against vaccine-preventable diseases” (mean=2.3, SD 2.3), “Maximize the appropriate use of medications in a population” (mean=2.2, SD 2.3), and “Identify patients at risk for prevalent diseases in a population” (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists.</p> <p>Conclusion. Pharmacists in North Dakota reported that EPAs in the PHP domain are practiced regularly. Thus, EPAs in the PHP domain have potential as a means to assess outcomes in pharmacy education and practice.</p> <p>&nbsp;</p> David M. Scott Michael Kelsch Anqing Zhang Daniel L. Friesner Copyright (c) 2020 Pharmacy Practice and the Authors 2020-08-12 2020-08-12 18 3 1980 1980 10.18549/PharmPract.2020.3.1980 Primary health care policy and vision for community pharmacy and pharmacists in Portugal <p>The central role of the Portuguese National Health Service (P-NHS) guarantees virtually free universal coverage. Key policy papers, such as the National Health Plan and the National Plan for Patient Safety have implications for pharmacists, including an engagement in medicines reconciliation. These primary health care reform, while not explicitly contemplating a role for pharmacists, offer opportunities for the involvement of primary care pharmacists in medicines management. Primary care pharmacists, who as employees of the P-NHS work closely with an interdisciplinary team, have launched a pilot service to manage polypharmacy in people living with multimorbidities, involving potential referral to community pharmacy. Full integration of community pharmacy into primary health care is challenging due to their nature as private providers, which implies the need for the recognition that public and private health sectors are mutually complementary and may maximize universal health coverage. The scope of practice of community pharmacies has been shifting to service provision, currently supported by law and in some cases, including the needle and syringe exchange program and generic substitution, remunerated. Key changes envisaged for the future of pharmacists and their integration in primary care comprise the development and establishment of clinical pharmacy as a specialization area, peer clinician recognition and better integration in primary care teams, including full access to clinical records. These key changes would enable pharmacists to apply their competence in medicines optimization for improved patient outcomes.</p> Nadine Ribeiro Helder Mota-Filipe Mara P. Guerreiro Filipa A. Costa Copyright (c) 2020 Pharmacy Practice and the Authors 2020-07-17 2020-07-17 18 3 2043 2043 10.18549/PharmPract.2020.3.2043 Primary health care policy and vision for community pharmacy and pharmacists in Indonesia <p>The practice of community pharmacy in low and middle-income countries, including in Indonesia, is often described as in the state of infancy with several intractable barriers that have been substantially and continuously hampering the practice. Such description might be valid in highlighting how pharmacy is practiced and the conditions within and beyond community pharmacy organizations. Therefore, it is not surprising that the concept of integrating community pharmacy into the primary care system may not be considered in the contemporary discourse despite the fact that community pharmacy has been operating within communities for years. However, in the case of Indonesia, we argue that changes in the health care system within the past decade particularly with the introduction of the universal health coverage (UHC) in 2014, may have significantly amplified the role of pharmacists. There is good evidence which highlights the contribution of pharmacist as a substantial health care element in primary care practice. The initiative for employing pharmacist, identified in this article as primary care pharmacist, in the setting of community health center [puskesmas] and the introduction of affiliated or contracted community pharmacy under the UHC have enabled pharmacist to work together with other primary care providers. Moreover, government agenda under the “Smart Use of Medicines” program [Gema Cermat] recognizes pharmacists as the agent of change for improving the rational use of medicines in the community. Community pharmacy is developing, albeit slowly, and is able to grasp a novel position to deliver pharmacy-related primary care services to the general public through new services, for example drug monitoring and home care. Nevertheless, integrating community pharmacy into primary care is relatively a new notion in the Indonesian setting, and is a challenging process given the presence of barriers in the macro, meso- and micro-level of practice.</p> Andi Hermansyah Luh Wulandari Susi A. Kristina Sherly Meilianti Copyright (c) 2020 Pharmacy Practice and the Authors 2020-07-22 2020-07-22 18 3 2085 2085 10.18549/PharmPract.2020.3.2085