Protocols for pharmacist recommended medicines

Abstract

Product counterfeiting was already increasing worldwide, both in terms of the volume, level of sophistication, and in the number the countries affected, both in the developed and developing world. There was a sudden but inevitable shift in the global trade setting in which consumers were given access to unrestricted and often substandard medicines with the use of their mobile phones due to the increase of e-commerce and internet shopping. This has posed serious threats in the public health due to increase access of patients to counterfeit medications, such as drugs for erectile dysfunction. In 2017, the UK MHRA reclassified sildenafil citrate from a prescription-only medicine (POM) to a pharmacy (P) medicine, under a supervision of a pharmacist. In the recommendation, making sildenafil available as over-the-counter (OTC) medication could promote appropriate use of the medication and provide a safer means of obtaining sildenafil with proper intervention of pharmacists in the community. The study was conducted in community pharmacies in Malta and Gozo, and participants were selected via convenience sampling method. The interview questions adapted from a study by Lem, et al (2022), and developed by the principal investigator were used to determine the following: (1) to assess the readiness of community pharmacists in Malta in dispensing sildenafil citrate without prescription, and (2) to identify the view and opinions of pharmacists in dispensing sildenafil citrate without prescription. A pilot study was performed to validate the content of tool used in the research. Key pointers were identified to be evaluated through interview with pharmacists are risk minimization measures, effective trainings material required, and baseline knowledge of pharmacists with interventions at point of dispensing sildenafil citrate. A total of 35 pharmacists were recruited as participants in which 69% of the community pharmacists strongly disagree or disagree, citing patient safety considerations as a major factor, 20% either strongly agree or agree, and 11% of community pharmacists have no reaction in dispensing sildenafil as OTC medicine. All of the community pharmacists (100%) agree that aRMMs such as patient screening checklist and interviewing patients prior to dispensing sildenafil were indispensable measures in order to ensure that patient safety was guaranteed in the event that sildenafil was made to be available as OTC medicine. The data collected in this study could be used to gauge the challenges that is needed to overcome if sildenafil is to be dispensed as OTC medication in Malta. This could provide an opportunity for patients suffering from ED to safely manage their condition under a proper medical intervention and promote safe access to the medication without the negative stigma associated with the disease.