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Virtual pharmacist interventions on abuse of over-the-counter medications during COVID-19 versus traditional pharmacist interventions

https://doi.org/10.1016/j.japh.2021.02.003Get rights and content

Abstract

Objectives

This study aimed to investigate the frequency, nature, and clinical significance of pharmacist interventions on over-the-counter (OTC) medicines with abuse potential across community pharmacies with and without virtual care.

Methods

In this prospective observational study, a trained research team observed the dispensary teams of 12 community pharmacies in the United Arab Emirates (UAE), 6 of which were operating virtual pharmacy care. A standardized data collection form was used to include information about dispensing of OTC medicines and pharmacist interventions on those with abuse/misuse potential. The clinical significance of the interventions was evaluated by a multidisciplinary committee.

Results

The frequency of pharmacist interventions on OTC medicines with abuse potential across pharmacies with and without virtual services was 83.2% versus 91.0%, respectively, whereas the frequency of pharmacist interventions on OTC medicines with misuse potential across pharmacies with and without virtual services was 79.8% versus 41.2%, respectively. The proportions of clinically significant interventions across pharmacies with and without virtual services were 19.7% versus 10.5%, respectively. Cough medicines were dispensed significantly more across pharmacies with virtual care than across pharmacies without virtual care (25.6% vs. 9.7%, respectively; P = 0.04). Asking the patient to seek the advice of an addiction specialist (adjusted odds ratio = 4.11; P = 0.001) versus refusing to sell the drug was more likely to be associated with pharmacies with virtual services than with pharmacies operating traditional pharmacy services.

Conclusion

Virtual pharmaceutical care is a potential approach to reduce the abuse/misuse of OTC medicines but needs some improvements regarding detection of these cases. The UAE is the first country in the region to implement and regulate virtual pharmacy practice.

Section snippets

Methods

This was a prospective, observational, comparative study conducted over a period of 2 months (from August 1, 2020 to October 1, 2020) at community pharmacies operating remote services (intervention group) and community pharmacies operating traditional pharmacy services (control group) across the UAE. Trained researchers conducted a direct observation of the pharmacy dispensary team for 10 days to collect data related to the dispensing of OTC medications and the nature of pharmacist

Characteristics of pharmacies and customers

There were no significant differences in the number, educational level, and experience of pharmacy staff across pharmacies with and without virtual services (P > 0.05). Compared with the control group, pharmacies with virtual pharmaceutical services had a significantly higher frequency of customers who requested or received OTC medications (intervention group 2036 vs. control group 1163, P = 0.01). Of the customers who requested or received OTC medication using virtual pharmacy services, 20.7%

Discussion

Our findings suggest that the adoption of information technology by community pharmacies enables them to identify and intervene on the abuse and misuse of OTC medicines. Furthermore, we found that more older patients are involved in requesting OTC medicines through virtual pharmacy services than young people (aged < 30 years). The plausible explanation is that older patients may represent a specific cluster of patients with a high risk for developing COVID-19 with rapidly progressive clinical

Conclusion

The study demonstrates that the digitalization of pharmacy services improves pharmacist interventions on OTC misuse and allows patients with alarming symptoms, for example, a cough, to receive remote pharmaceutical care and reduces transmission of COVID-19. Furthermore, it enables older patients who are vulnerable to viruses to access pharmacies without the risk of contracting the infection. The development of an early warning system may further enhance the ability of remote pharmaceutical care

Nadia Al Mazrouei, PhD, Assistant Professor, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates

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    • Cited by (17)

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    Nadia Al Mazrouei, PhD, Assistant Professor, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates

    Rana M. Ibrahim, PharmD, Lecturer, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates

    Ahmad Z. Al Meslamani, MSc Laboratory, Supervisor, College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates

    Derar H.Abdel-Qader, PhD, Senior Clinical Lecturer & Consultant Pharmacotherapist, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan

    Osama Mohamed Ibrahim, PhD, Associate Professor, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates; and Associate Professor, Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt

    Disclosure: The authors declare no relevant conflicts of interest or financial relationships.

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