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      Implementation of good pharmacy practice standards; a step forward in Libya's pharmacies

      review-article
      , ,
      Iberoamerican Journal of Medicine
      Hospital San Pedro
      Libya, Pharmacies, Pharmacist, WHO

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          Abstract

          Abstract The practice of pharmacy in health care societies continues to undergo evolutionary and even radical changes. It has changed to a personal health service charged with assuring pharmaceutic and therapeutic appropriateness of all its functions in the care of patients. The purpose of this study is to review and analysis the historical stages of development of the good pharmaceutical practice (GPP) requirements and to recommend a guideline for the implementation of GPP standards in Libya as a way to improve the pharmaceutical care and profession. The study designates that the development of the GPP standards should be committed at the public professional organizations levels as pharmaceutical syndicates and associations as the national regulation of pharmacy practices in various countries and the local health authorities. This requires basic skills of documentation, professional and communication with all relative professions and it, therefore, is important to establish standards for community, hospital and consultant pharmacists to promote the pharmaceutical mission.

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          Most cited references31

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          Pharmacist intervention to improve medication adherence in heart failure: a randomized trial.

          Patients with heart failure who take several prescription medications sometimes have poor adherence to their treatment regimens. Few interventions designed to improve adherence to therapy have been rigorously tested. To determine whether a pharmacist intervention improves medication adherence and health outcomes compared with usual care for low-income patients with heart failure. Randomized, controlled trial conducted from February 2001 to June 2004. University-affiliated, inner-city, ambulatory care practice. 314 low-income patients 50 years of age or older with heart failure confirmed by their primary care physician. Patients were randomly assigned to intervention (39% [n = 122]) or usual care (61% [n = 192]) groups and were followed for 12 months. A pharmacist provided a 9-month multilevel intervention, with a 3-month poststudy phase. An interdisciplinary team of investigators designed the intervention to support medication management by patients who have low health literacy and limited resources. Primary outcomes were adherence, as measured by using electronic prescription monitors, and exacerbations requiring emergency department care or hospital admission. Secondary outcomes included health-related quality of life, patient satisfaction with pharmacy services, and total direct costs. During the 9-month intervention period, medication adherence was 67.9% and 78.8% in the usual care and intervention groups, respectively (difference, 10.9 percentage points [95% CI, 5.0 to 16.7 percentage points]). However, these salutary effects dissipated in the 3-month postintervention follow-up period, in which adherence was 66.7% and 70.6%, respectively (difference, 3.9 percentage points [CI, -5.9 to 6.5 percentage points]). Medications were taken on schedule 47.2% of the time in the usual care group and 53.1% of the time in the intervention group (difference, 5.9 percentage points [CI, 0.4 to 11.5 percentage points]), but this effect also dissipated at the end of the intervention (48.9% vs. 48.6%, respectively; difference, 0.3 percentage point [CI, -5.9 to 6.5 percentage points]). Emergency department visits and hospital admissions were 19.4% less (incidence rate ratio, 0.82 [CI, 0.73 to 0.93]) and annual direct health care costs were lower ($-2960 [CI, $-7603 to $1338]) in the intervention group. Because electronic monitors were used to ascertain adherence, patients were not permitted to use medication container adherence aids. The intervention involved 1 pharmacist and a single study site that served a large, indigent, inner-city population of patients. Because the intervention had several components, intervention effects could not be attributed to a single component. A pharmacist intervention for outpatients with heart failure can improve adherence to cardiovascular medications and decrease health care use and costs, but the benefit probably requires constant intervention because the effect dissipates when the intervention ceases. ClinicalTrials.gov registration number: NCT00388622.
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            The evolving role of the community pharmacist in chronic disease management - a literature review.

            We appraised the roles and responsibilities assigned to community pharmacists internationally and in Singapore. A systematic search of international peer-reviewed literature was undertaken using Medline. Grey literature was identified through generic search engines. The search period was from 1 January 1991 to 30 July 2009. The search criteria were English language manuscripts and search terms "community pharmacist", "community pharmacy", "disease management" and "roles" as a major heading. Boolean operators were used to combine the search terms. Identified abstracts were independently reviewed and the findings were presented as a narrative summary. Overall, we reviewed 115 articles on an abstract level and retrieved 45 of those as full text articles for background information review and inclusion into the evidence report. Of the articles included in the review, 32% were from United Kingdom (UK). Literature highlights the multi-faceted role of the community pharmacist in disease management. Community pharmacists were involved in the management of asthma, arthritis, cardiovascular diseases, diabetes, depression, hypertension, osteoporosis and palliative care either alone or in the disease management team. Evidence of effectiveness for community pharmacy/ community pharmacist interventions exists for lipid, diabetes, and hypertension management and for preventive services such as weight management, osteoporosis prevention and fl u immunisation services. Majority of the community pharmacists in Singapore play the traditional role of dispensing. Attempts by the private community pharmacies to provide some professional services were not successful due to lack of funding. Factors found to impede the growth of community pharmacists are insufficient integration of community pharmacist input into healthcare pathways, poor relationship among pharmacists and physicians, lack of access to patient information, time constraints and inadequate compensation. Evidence from observational studies points out the wide range of roles played by the community pharmacist and provides insights into their integration into chronic disease management programmes and health promotion.
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              Pharmaceutical care in a community-based practice setting in Jordan: where are we now with our attitudes and perceived barriers?

              The objective of this study was to answer the following questions. How do community pharmacists in Jordan understand pharmaceutical care? What is the extent of pharmaceutical care practice in community pharmacies in Jordan? What are the main barriers to practising pharmaceutical care in Jordan? What is the attitude of community pharmacies in Jordan when considering provision of pharmaceutical care? A questionnaire was hand delivered to a random sample of 310 community pharmacists. The questionnaire was composed of six different sections including patient demographics, pharmacists' understanding of pharmaceutical care, frequencies of practice of pharmaceutical care, pharmacists' general attitudes about pharmaceutical care, pharmacists' intentions to provide specific pharmaceutical care activities and barriers to providing pharmaceutical care. Frequencies, percentages, means and standard deviations were used to describe pharmacists' responses. Chi-square and regression analysis were also conducted to identify important associations. More than 62% of respondents had a correct understanding of the basic concept of pharmaceutical care. The data show that the level of reported pharmaceutical care activities was limited. In general pharmacists have very good attitudes toward pharmaceutical care. Interestingly, more than 90% of respondents fully support the concept of pharmaceutical care. The need for pharmaceutical care training was found to be the top barrier to the provision of pharmaceutical care as indicated by more than 80% of pharmacists. While pharmaceutical care provision is limited at this stage in Jordan, the responding pharmacists had a good understanding of pharmaceutical care. They expressed a willingness to implement pharmaceutical care practice but have identified a number of barriers to successful implementation. With the introduction of PharmD and Master of Clinical Pharmacy programmes, publication of the results of local studies on the benefit of pharmaceutical care, improved communications with physicians and modification of the current undergraduate pharmacy curriculum to include more focus on therapeutics and pharmaceutical care, many of these perceived barriers may be eliminated in the future. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2020
                : 2
                : 4
                : 377-380
                Affiliations
                [3] Tripoli orgnameUniversity of Tripoli orgdiv1Faculty of Pharmacy Libia
                [1] Zawia orgnameUniversity of Zawia orgdiv1Faculty of Pharmacy orgdiv2Department of Pharmaceutical Chemistry and Pharmacognosy Libia
                [2] Zawia orgnameUniversity of Zawia orgdiv1Faculty of Pharmacy orgdiv2Department of Pharmacology and Biochemistry Libia
                Article
                S2695-50752020000400019 S2695-5075(20)00200400019
                10.5281/zenodo.4095782
                a3329035-bc34-4b92-a12f-ca4eee888e95

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 16 October 2020
                : 28 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 4
                Product

                SciELO Spain

                Categories
                Review

                Libya,WHO,Pharmacist,Pharmacies
                Libya, WHO, Pharmacist, Pharmacies

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