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PURPOSE: Substance use disorders (SUDs) increase the risk and severity of infectious diseases, including coronavirus disease 2019 (COVID-19). Adults with a co-occurring SUD and psychiatric disorder were studied to elucidate the association between SUD severity and (1) COVID-19 vaccination status, (2) receptivity to a one-session intervention with a pharmacist advocating the benefits of vaccination, and (3) acceptance of referral for vaccination following the intervention. METHODS: COVID-19 vaccination status was recorded in 460 adults with SUD (324 males and 136 females) upon entry into inpatient treatment. A 2-parameter item response theory (IRT) model quantified SUD severity. Pharmacist-delivered intervention, modeled after the screening, brief intervention, and referral to treatment (SBIRT) protocol, was offered to unvaccinated participants. RESULTS: Higher SUD severity was associated with a lower vaccination rate. Nicotine, opioid, and sedative use disorders were most frequently associated with unvaccinated status. SUD severity was not associated with receptivity to intervention advocating vaccination or subsequent acceptance of a referral for vaccination. The portion of the sample that received the intervention was over 7 times more likely to accept a referral for vaccination when compared to participants who rejected the intervention (20.8% vs 2.8%). CONCLUSION: Pharmacist-administered intervention produced motivation for vaccination in a number of recipients; however, receptivity to the intervention was not related to SUD severity.

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Background: Despite improvements in health insurance coverage, out-of-pocket (OOP) health spending remains a public health issue in Peru, and OOP payment has implications for disease treatment in ethnic minorities. We aimed to analyze the ethnic disparities in the OOP payment and estimate the gaps related to observable risk factors in the OOP payment on medicines by ethnic conditions during 2014-2016 in Peru. Study design: cross-sectional study. Methods: We conducted a secondary data analysis using the National Health User Satisfaction Survey. The outcome was the participants' OOP payment in self-reported medications. Ethnic minorities were considered participants who habitually spoke a language other than Spanish at home. Crude and adjusted linear regression models were performed, and the Oaxaca-Blinder decomposition method was used to assess the OPP payment differential by ethnic minority condition, explained by their individual and sociodemographic characteristics. Results: We analyzed 11,346 surveyed, the mean age was 40.78 years, and 57.67 % were women. There was lower OOP payment in medications among ethnic minorities in the adjusted analysis (Beta coefficient [ß]: -0.11; 95 % confidence interval [95%CI]: -0.21 to -0.01; p = 0.043). In the Oaxaca-Blinder decomposition analysis, a gap of 0.19 USD in the OOP payment in medicines among ethnic minorities was found (p < 0.001), and the explained component by the variables measured in this research only represents 40.5 % of the gap (p = 0.001). Conclusion: There was less OOP expenditure on medicines in ethnic minorities. However, the measured variables explain only 40.5 % of these gaps. Therefore, we recommend future research that measures other variables that explain aspects of OOP spending on medicines not identified in this research. Likewise, our findings can be used to establish policies with an intercultural approach that adapt health documents to native languages or are disseminated by trained people from their communities.

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OBJECTIVE: Describe the knowledge, attitudes, and practices regarding the sale of antibiotics in pharmacies in Medellín, Colombia. METHOD: A cross-sectional descriptive study was conducted in 277 selected pharmacies using a stratified sampling method with proportional allocation to represent all areas of the city. Knowledge, attitudes, and practices (KAPs) were assessed using a scale, analyzed with absolute and relative frequencies for each item, and represented in a global score ranging from 0 to 100, with a higher score indicating better KAPs. Data were analyzed using relative frequencies with 95% confidence intervals, the Mann-Whitney U test, the Kruskal-Wallis test, and linear regression. RESULTS: Of the included pharmacies, 52.6% were chain pharmacies, 48.4% were attended by pharmacy assistants, and 59% of pharmacists had more than 5 years of experience. The median knowledge score was 70.8 (IQR 58.3-87.5), with 35.3% of pharmacists believing that antibiotics are effective in treating the common cold, 35.2% for treating COVID-19, and 29.4% considering them available for sale without a medical prescription. The attitude score was 53.3 (40.0-66.7), with 60.9% agreeing that prohibiting the sale of antibiotics without a prescription would decrease their sales. The practice score was 62.5 (40.0-79.2), with 65.4% of pharmacists stating that they sometimes sell antibiotics without a prescription due to patients struggling to obtain a medical consultation, 61.3% admitting to selling antibiotics without a prescription for urinary tract infections, and 41.3% for upper respiratory tract infections. Practices were predominantly influenced by pharmacy type (chain or independent) and, to a lesser extent, by knowledge and attitudes. CONCLUSION: Pharmacists in Medellín exhibit inadequate knowledge, attitudes, and practices regarding the use and sale of antibiotics without a medical prescription. These findings align with international evidence highlighting the need for educational and regulatory strategies promoting rational antibiotic use in pharmacies.

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Aim: To evaluate the impact of the first year of the COVID-19 pandemic on antibiotic dispensation in three Brazilian hospitals. Methods: Stock movement was accessed from pharmacy databases and microbiological reports from 2018 to 2021. Results: Reduced antibiotic dispensation occurred during 2020 in all hospitals. The most significant reduction was in April at Hospital Doutor Jayme dos Santos Neves (∼58%), and in May at Hospital Doutor Roberto Arnizaut Silvares (∼66%) and Hospital Doutor Dório Silva (∼29%). However, azithromycin dispensation increased in all hospitals in 2020. Macrolide-resistant bacterial isolates rose from 66.6% in 2019 to 77.1% in 2020 and 88.3% in 2021. Conclusion: Despite reduced antibiotic dispensation, the increase in azithromycin consumption in 2020 highlights the urgency to monitor macrolide resistance after the pandemic and improve stewardship activities.

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Introduction: Pharmacists and community pharmacies play an important role in managing, identifying and preventing the spread of the COVID-19 outbreak. Objectives: To characterize the global panorama of action by pharmacists and community pharmacies in facing the COVID-19 pandemic. Methods: The scoping review was based on the search for scientific articles in the databases: PubMed; Scopus; ScienceDirect and Web of Science. The search was carried out on August 31, 2021. The selection process was divided into 3 phases: i) title analysis; ii) analysis of study abstracts; iii) analysis of the full texts of the studies selected in the previous step. Studies were independently selected by two investigators and discrepancies resolved by consensus during focus group discussions led by a third reviewer. Results: The final search yielded 36 articles for the review. The main strategies for coping with COVID-19 were grouped into 4 categories defined by consensus between the authors: (1) services for providing care to the patient; (2) product management; (3) infection prevention and control practices in community pharmacy; (4) preparation, sources of information used and training offered/received. Through these, the aim was to involve technical managerial, technical assistance and pedagogical technical actions adopted, as well as structure and process indicators that allowed the continuity of the offer of services. Conclusion: During the pandemic, pharmacists and community pharmacies have been providing essential health services to communities. The results of this review may help to identify the changes adopted to face the COVID-19 pandemic and may contribute to improving the quality of practices in these establishments during the pandemic and after it, in similar situations.

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Background: Older adults are a particularly vulnerable group to drug use and self-medication. The aim of the study was to evaluate self-medication as a factor associated with the purchase of brand-name and over-the-counter (OTC) drugs in older adults in Peru. Methods: A secondary analysis was performed using an analytical cross-sectional design of data from a nationally representative survey from 2014 to 2016. The exposure variable was self-medication, defined as the purchase of medicines without a prescription. The dependent variables were purchases of brand-name and OTC drugs, both as a dichotomous response (yes/no). Information of sociodemographic variables, health insurance, and the types of drugs purchased by the participants was collected. Crude prevalence ratios (PR) were calculated and adjusted using generalized linear models of the Poisson family, considering the complex sample of the survey. Results: In this study, 1,115 respondents were evaluated, with a mean age of 63.8 years and a male proportion of 48.2%. The prevalence of self-medication was 66.6%, while the proportions of purchases of brand-name and OTC drugs were 62.4% and 23.6%, respectively. The adjusted Poisson regression analysis revealed an association between self-medication and the purchase of brand-name drugs (adjusted PR [aPR]=1.09; 95% confidence interval [CI]: 1.01-1.19). Likewise, self-medication was associated with the purchase of OTC medications (aPR=1.97; 95%CI: 1.55-2.51). Conclusions: This study evidenced a high prevalence of self-medication in Peruvian older adults. Two-thirds of the surveyed people bought brand-name drugs, whereas one-quarter bought OTC drugs. Self-medication was associated with a greater likelihood of buying brand-name and OTC drugs.

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As plantas medicinais foram os primeiros recursos terapêuticos obtidos pelos povos e há registros do seu uso em todos os momentos da História, por grande parte das civilizações. No Brasil, o uso das plantas medicinais é resultado dos conhecimentos de três populações: indígena, europeia e africana. O presente trabalho tem como objetivo caracterizar a manipulação mensal de um laboratório de fitoterápicos na cidade de Francisco Beltrão, Paraná. Os dados que foram coletados para a presente pesquisa são: número de cápsulas manipuladas mensalmente para cada um dos fitoterápicos, os quais serão obtidos a partir dos relatórios de manipulação de fitoterápicos mensais no ano de 2021 e individuais de cada unidade de saúde, fornecidos pela Secretaria de Saúde. Não havendo acesso a informações de pacientes e tampouco contato com eles. As informações dos relatórios foram tabuladas em planilha a fim de se estabelecer os três principais fitoterápicos manipulados no período preestabelecido. Trata-se de um estudo de campo, exploratório, documental e retrospectivo. Observamos que a média de manipulação foi de 34.029 cápsulas por mês, os fitoterápicos mais manipulados no ano de 2021, foram: Passiflora incarnata (maracujá), Aesculus hippocastanum (castanha da índia) e Curcuma longa. Também foi possível notar que houve um aumento gradual de dispensações após a capacitação dos profissionais, ocorrida entre junho e setembro. Além disso, verificamos que há uma grande diferença na quantidade dispensada por cada farmácia municipal, possivelmente devido ao nível de conhecimento dos profissionais de saúde e se preferem ou não prescrever aos pacientes.

Medicinal plants were the first therapeutic resources obtained by people and there are records of their use at all times of history, by a large part of civilizations. In Brazil, the use of medicinal plants is a result of the knowledge of three populations: indigenous, European and African. The present work aims to characterize the monthly handling of a plant medicine laboratory in the city of Francisco Beltrão, Paraná. The data that were collected for this research are: number of capsules handled monthly for each one of the phytotherapics, which will be obtained from the reports of handling of monthly phytotherapics in the year 2021 and individual of each health unit, provided by the Secretariat of Health. There is no access to patient information and no contact with them. The information in the reports was tabulated into a spreadsheet in order to establish the three main phytotherapics handled in the pre-established period. This is an exploratory, documentary and retrospective field study. We observed that the average handling was 34,029 capsules per month, the most manipulated phytotherapics in the year 2021, were: Passiflora incarnata (passion fruit), Aesculus hippocastanum (chestnut from India) and Curcuma longa. It was also possible to note that there was a gradual increase in dispensations after the training of professionals, which took place between June and September. In addition, we note that there is a big difference in the amount dispensed by each municipal pharmacy, possibly due to the level of knowledge of health professionals and whether or not they prefer to prescribe to patients.

Las plantas médicas fueron los primeros recursos terapéuticos obtenidos por los pueblos y hay registros de su uso en todo momento de la historia, por una gran parte de las civilizaciones. En Brasil, el uso de plantas medicinales es el resultado del conocimiento de tres poblaciones: indígenas, europeos y africanos. El presente trabajo tiene como objetivo caracterizar la manipulación mensual de un laboratorio fitoterapéutico en la ciudad de Francisco Beltrão, Paraná. Los datos recogidos para esta investigación son: el número de cápsulas manejadas mensualmente para cada una de las fitoterapias, que se obtendrán de los informes mensuales de manipulación fitoterapéutica en el año 2021 y el individuo de cada unidad de salud, proporcionados por el Departamento de Salud. No hay acceso a la información del paciente ni contacto con ella. La información contenida en los informes se tabuló en una hoja de cálculo para establecer las tres principales fitoterapias manipuladas en el periodo predefinido. Se trata de un estudio de campo, exploratorio, documental y retrospectivo. Observamos que la manipulación media fue de 34.029 cápsulas al mes, las fitoterapias más manipuladas en 2021 fueron: Passiflora incarnata (fruto de la pasión), Aesculus hippocastanum (castaño indio) y Curcuma longa. También es posible señalar que se ha producido un aumento gradual de las dispensaciones después de la capacitación de profesionales, que se llevó a cabo entre junio y septiembre. Además, vemos que existe una enorme diferencia en la cantidad que proporciona cada farmacia municipal, posiblemente debido al nivel de conocimiento de los profesionales de la salud y si prefieren recetarla a los pacientes o no. PALABRAS CLAVE: Fitoterapias; Farmacias Municipales; Curcuma Longa; Passiflora Incarnata; Aesculus Hippocastanum.

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BACKGROUND: The indiscriminate use of antimicrobials is considered a major contributing factor to the increase in antimicrobial resistance. Community pharmacies are the main source of access to antimicrobials, and pharmacists are in a strategic position to promote rational use of these medicines. Therefore, it is important to know dispensing service quality. OBJECTIVE: To evaluate the behavior of pharmacists in dispensing antimicrobials in community pharmacies in northeast Brazil. METHODS: This cross-sectional pilot study was conducted from August to October 2021 in a private community pharmacy chain in Sergipe. Dispensing was evaluated using the simulated patient (SP) technique. Two SP asked the pharmacists for the antimicrobials (case clinic 1: upper respiratory infection; case clinic 2: urinary tract infection) and recorded the service through audio. Dispensing practices were independently analyzed by two researchers based on the tools available in the literature. Data were presented using descriptive statistics. RESULTS: A total of 54 simulated patient visits were conducted. Based on the 12 steps recommended by the research team for good dispensing, pharmacists asked an average of 1 (±1.17) question for upper respiratory infections and 0.3 (±0.54) for urinary tract infections, as well as provided counseling (mean number of recommendations, 2.6 (±1.44) and 4.5 (±2.35), respectively). As for communication skills, pharmacists had a regular score (3.07 ± 0.34). Furthermore, there was no significant difference in the number of steps and counseling recommendations by pharmacists in dispensing clinical cases 1 and 2 (p = 0.0674). CONCLUSION: The quality of antimicrobial dispensing was evaluated as suboptimal, requiring improvements in practice and multifaceted strategies to promote continuing education of these professionals. In addition, awareness actions for the population must be implemented to promote the rational use of antimicrobials and reduce microbial resistance.

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Price caps through international reference pricing are widely used worldwide but not so commonly in over-the-counter markets. We study the short-term effects of a price cap regulation for oral contraceptives in Colombia, a market dominated by the presence of several branded generics with multiple active ingredients. Most of the regulated products were fourth-generation contraceptives, and the Colombian health benefits plan only covers second-generation ones, resulting in a de facto over-the-counter market. Our aim is to establish whether the regulation triggered a competitive response within and across product categories, by price levels and regulatory status. The panel data analysis of quarterly level data for 52 drugs (and 79 drugs in an expanded sample without transactions for some quarters) reveals a massive expansion of transactions, for the directly regulated products that were formerly the most expensive, and for the indirectly regulated (i.e., a regulated ingredient) among those with an intermediate price. Although this price reduction could have led to a crowd out of the publicly provided contraceptives, we show that this is not the case. Since the information system cannot trace the final consumers' purchases, we complement our analysis with an audit study involving 213 pharmacies in Bogota. We find that the price reduction was effectively transmitted to the final consumers.

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Background: The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient's life. Objectives: This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil. Methods: This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage. Results: 182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility. Conclusions: Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care.