The pharmacists of Angoulême in the days of Honoré de Balzac

The large volume of Honoré de Balzac's correspondence testifies to his keen sense of friendship. He stayed in Angoulême three times at his friend Carraud's, which inspired his novel: Les Illusions perdues. His character, Lucien, is the son of Chardon, a pharmacist of the l'Houmeau, neighborhood similar to a real life character Evangelista. As the chemical revolution was dawning, the pharmacists of Angoulême, who often held their positions from their fathers, belonged to the town's 19th century bourgeoisie.     

Repackaging drugs in pill-box in France: an illegal activity for pharmacists?

Drug repackaging in pill-box by pharmacists is booming since few years. However, repackaging processes needed to open the industrially primary packaging will be found illegal in France. Thus, in this country drug repacking remains legal only by overwrapping medicines. Now, this solution is not applicable for example, with divisible or liquid forms. Therefore, packaging recommendations must be taken immediately in order to preserve the quality of drugs dispensed and to obtain a legalization of this activity.     

What's new in fillers?

This article is an in-depth review of various materials and products that have been used for the augmentation of soft tissue in the past, and covers several new products, methods, and techniques that may provide new options for dermatologists who use fillers in their practice. Pros and cons of each are discussed, along with mechanisms of action, dosages, approved and off-label uses, as well as a look ahead at some prospective technology.     

What's in a number?

Ten years ago, the first estimates of the existing number of drug targets were made. This month's issue features an article and poster that together summarize current drug targets and associated characteristics, providing a basis to better understand the potential for future therapeutic exploitation.     

The ORL-1 receptor system: are there opportunities for antagonists in pain therapy?

Following the cloning of the classical opioid receptors (mu, delta and kappa), the opioid receptor like-1 (ORL-1) was identified as a G-protein coupled receptor (GPCR) with 65% structure homology to the other members of the opioid family. Its endogenous ligand nociception/orphanin FQ (N/OFQ) was discovered shortly thereafter, becoming the subject of investigation in numerous studies. Since activation of the ORL-1 receptor by N/OFQ leads to G alpha(i)-coupling and signal transduction similar to that of opioid receptors, N/OFQ was thought to have a role in pain modulation, similar to that of the endogenous opioids. Surprisingly, studies characterizing N/OFQ's effects on pain transmission yielded conflicting results, attributing to N/OFQ both pronociceptive and antinociceptive actions, depending on doses and routes of administration as well as species and sex of the subjects. With the development of selective and potent ORL-1 antagonists, many scientists believed these contradicting actions would be elucidated. Here we review the recent literature reporting the use of novel ORL-1 antagonists, both peptide and non-peptide, in different models of pain and discuss their use as research tools or potential drug candidates.     

Dispensing of medicines in nursing homes for frail elderly: what role for mutualistic pharmacists?

According to articles L.5126-6-1 and L.5125-5-1 A in the code of public health, pharmacists can act in two different functions in nursing homes for frail elderly: pharmacist provider and/or pharmacist referent. The issue of access to these functions remained open for mutual pharmacists. With regard to their specific applicable legal regulations, arguments do exist questioning the possibility for mutual pharmacies of entering in the organization of the nursing home pharmacy provider. In addition, it appears that mutual pharmacists could exercise the duties of pharmacist referent only in nursing homes that refer to mutual residents.     

Do pharmacists use social media for patient care?

Background Social media are frequently used by consumers and healthcare professionals. However, it is not clear how pharmacists use social media as part of their daily professional practice. Objective This study investigated the role social media play in pharmacy practice, particularly in patient care and how pharmacists interact online with patients and laypeople. Setting Face-to-face, telephone, or Skype interviews with practising pharmacists (n = 31) from nine countries. Method In-depth semi-structured interviews; audio-recorded, transcribed verbatim, and thematically analysed. Main outcome measure Two themes related to the use of social media for patient care: social media and pharmacy practice, and pharmacists’ online interactions with customers and the public. Results Most participants were community pharmacists. They did not provide individualized services to consumers via social media, despite most of them working in a pharmacy with a Facebook page. No participant “friended” consumers on Facebook as it was perceived to blur the boundary between professional and personal relationships. However, they occasionally provided advice and general health information on social media to friends and followers, and more commonly corrected misleading health information spread on Facebook. Short YouTube videos were used to support patient counselling in community pharmacy. Conclusions Participants recognized the potential social media has for health. However, its use to support patient care and deliver pharmacy services was very incipient. Pharmacists as medicine experts are well equipped to contribute to improvements in social media medicines-related information, learn from consumers’ online activities, and design new ways of delivering care to communities and individuals.     

What are pharmacists recommending for infant teething treatment?

Objectives

In 2011, the Food and Drug Administration issued a warning to avoid the use of any benzocaine-containing products for infant teething treatment owing to a risk of methemoglobinemia. Several benzocaine-containing products targeted for infant teething are currently available over the counter. Pharmacists are commonly asked for medical advice in the community, and there is no current literature evaluating what pharmacists are recommending for infant teething. The objectives of this study were to evaluate what pharmacists are currently recommending for infant teething treatment and assess what percentage would inappropriately recommend a benzocaine-containing product.

Food for thought: Can community pharmacists help patients living in food deserts?

BackgroundCommunity pharmacists can play an important role in helping patients who live in food deserts through screening, adjusting therapeutic recommendations and counseling practices, and making referrals to community resources. However, literature regarding community pharmacists’ knowledge, practices, and attitudes regarding food deserts is scant.ObjectivesThe primary objective of this study was to assess Ohio community pharmacists’ knowledge regarding food deserts. Secondary objectives included determining their attitudes, practices, and perceived barriers related to this topic.MethodsAn anonymous 26-question survey was created and distributed to a random sample of 500 licensed community pharmacists in Ohio. Participants were granted 3 weeks to complete the survey and were offered a link to free Accreditation Council for Pharmacy Education–approved continuing pharmacy education as an incentive. The survey was deemed exempt by the Institutional Review Board.ResultsThe survey was successfully delivered to 491 pharmacists; 72 participated (14.7% response rate). About 43% of respondents were familiar with the term “food desert,” and less than one-third (31.9%) reported being aware of community resources. Of those who thought that some of their patients lived in food deserts, the majority indicated that they did not consider it in patient interactions (65.1%) and “never” adjusted their counseling practices (65.1%). Barriers that prevented them from referring patients included lack of knowledge and confidence as well as workflow constraints. About 68% of respondents somewhat or strongly agreed that pharmacists could help patients living in food deserts, and 65.3% were interested in learning more information about food deserts.ConclusionDeficiencies in knowledge regarding food deserts and available resources were found among Ohio community pharmacists, but they showed interest in learning more information. Efforts should be made to educate community pharmacists about food deserts and to determine how to optimize their ability to assist patients as needed.     

The pharmacists’ potential to provide targets for interventions to optimize pharmacotherapy in patients with asthma

Background Despite of pharmacists’ specialized knowledge of medication and his/her regular contact with patients, the expertise of the pharmacist may not be used enough yet. Furthermore, the potential of pharmacy dispensing data is underestimated. Objective To provide targets for tailored interventions in asthma patients and to illustrate the potential value of pharmacists in the identification of these targets using individual pharmacy dispensing data. Setting We performed a cross sectional retrospective analysis assessing the quality of asthma patients’ pharmacotherapeutic treatment. Method Drug dispensing data from 2008 to 2009 were retrieved from a Dutch pharmacy database. All asthma patients were screened for potential suboptimal pharmacotherapy in 2009. Results were projected to a single community pharmacy to provide an estimate of the number of patients eligible for potential interventions. Main outcome measures (1) frequent use of short-acting β-agonists without preventive medication, (2) concomitant use of β-blockers, (3) multiple short courses of oral corticosteroids without using inhaled corticosteroids and 4) use of long-acting β-agonist without inhaled corticosteroids. Results A total of 8,504 patients were eligible for analysis of the quality of their asthma treatment. 20.9 % of all asthma patients used >100 DDD short-acting β-agonists per year, whereas between 21.2 % (≥400 DDD) and 31.4 % (100–199 DDD) of these patients did not receive preventive medication. Approximately 5.2 % of the asthma patients are using β-blockers concomitantly and 21.8 % of them received non-cardioselective β-blockers. 6.3 % of the asthma patients received two or more oral courses of corticosteroids in 2008 and 17.4 % of these patients did not receive inhaled corticosteroids in 2009. 2.9 % of the patients used a long-acting β-agonists without inhaled corticosteroids. 8.4 % of the asthma patients using both long-acting β-agonists and inhaled corticosteroids received these drugs in two separate inhalers. We estimated that about 400 asthma patients could be identified in an average pharmacy population (8,000 patients) and 33 (95 % CI 22–44) of these patients would be eligible for interventions. Conclusion This study shows the potential for pharmacists to use their own pharmacy records to identify suboptimal therapy of asthma patients, who may be targets for tailored interventions.     

Disparities in pharmacists’ patient education for Hispanics using antidepressants

ObjectivesTo assess pharmacists’ provision of antidepressant information and to examine the effect of patient ethnicity and language skills on pharmacists’ provision of information and patient education.DesignCross-sectional, randomized, between-subjects study.SettingWisconsin, from September to November 2008.Participants540 community pharmacists.InterventionParticipants were exposed to one of three vignettes describing a patient coming into the pharmacy for an initial dispensation of an antidepressant. Vignettes varied according to patient ethnicity (white or Hispanic) and language spoken (English or Spanish).Main outcome measuresRespondents’ information and education messages given to patients about antidepressants and whether Hispanic patient ethnicity and English language ability reduced pharmacists’ communication about antidepressants.ResultsA majority of participants would provide information regarding the medication's name (93.3%) and dosage schedule (92.8%). Many pharmacists also reported that they would tell the patient to take the medication on a daily basis (92.6%) and that it takes 2 to 4 weeks for the medication to have a noticeable effect (87.8%). Multivariate models showed that pharmacists would provide significantly less information (β = ?0.24 [95% CI ?0.31 to ?0.17]) and education messages (–0.17 [–0.24 to ?0.09]) to Spanish-speaking patients.ConclusionThese findings suggest that Spanish-speaking patients may face disparities in the level of care received from community pharmacists. Interventions should be available to enhance pharmacists’ communication with Spanish-speaking patients in an effort to facilitate safe and effective medication use.