Adverse-event management and reporting for electronic cigarettes (e-cigarettes)

Aldamkhi

2021

Tob Use Insights

Self Cite

Introduction: Pharmacy staff are a trusted source of advice on the safe and appropriate use of medicines and devices. Retail pharmacies deliver smoking cessation services and sell e-cigarettes in the UK. This review asks ‘what knowledge, experience and ability do staff have to support e-cigarette users to quit smoking’. Methods: A systematic literature search was undertaken drawn on predefined eligibility criteria and a comprehensive search strategy following the PRISMA guideline. Eligible papers reported survey-research published in English from 2015 to 2020. PubMed, Google Scholar, OVID, EMBASE and MEDLINE Databases were searched. No restrictions on study design or language were applied. Two reviewers independently screened for inclusion/exclusion and then extracted the relevant information from the articles for synthesis. Results: Of 12 potentially eligible full-text studies, 1 was a duplicate, 7 were excluded as per eligibility criteria. Four papers were finally included in this literature review. Two studies indicated that pharmacy staff are less confident in giving advice on e-cigarette use. Knowledge on the adverse effects of e-cigarettes compared to traditional smoking cessation aids remain unclear. In one study, 42% of community pharmacists did not believe that e-cigarettes could be used for smoking cessation. Three studies identified need for specific regulations and professional support. The overall certainty of the evidence is ‘low’ or ‘very low’, with moderate levels of bias. Conclusion: Pharmacists may be well placed to implement e-cigarette smoking cessation interventions, but most practitioners lacked knowledge and ability to support these customers citing unclear risk of harm. Pharmacists felt secure in recommending traditional cessation tools. Further regulation, guidelines and training is needed. Findings may be less generalizable in countries where e-cigarettes are banned. Their extent of knowledge, experience and ability to support users of e-cigarettes within their community to quit smoking is lacking.

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Evaluation of the Knowledge and Perceptions of Pharmacy Staff and Pre-Registration Students of E-Cigarettes Use: A Systematic Review

Aldamkhi

2021

Tob Use Insights

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“…Messages raising public awareness of SFs has not been reaching the public via pharmacy professionals, which raises important questions about promoting this message and getting it out to frontline staff and patients. While all pharmacy undergraduates are taught about the YCS in UK universities, this does not translate into practice as evidenced by general under-reporting52 53 of ADRs. Few respondents had reported SFs but more believed it helped to combat SFs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of community pharmacists’ readiness to implement the Falsified Medicines Directive (Directive 2011/62/EC): an English cross-sectional survey with geospatial analysis

2020

BMJ Open

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ObjectivesTo evaluate the readiness to implement the Falsified Medicines Directive (FMD) by community pharmacies in England. Eight secondary objectives were assessed.SettingCommunity/retail pharmacies.ParticipantsWe invited pharmacists from 501 pharmacies to complete a survey. Non-contractors, non-pharmacists or pharmacists practising abroad were excluded. We randomly selected addresses, ensuring that they were nationally representative.InterventionsWe mailed the survey in October 2018 with a single follow-up in January 2019. Respondents were invited to provide self-reported answers. A prepaid self-addressed envelope was provided. We received favourable ethical approval.Results102 responses (20.44% response rate) were received. Readiness to implement was poor: 4 (3.9%) said very much, while 40 (39.2%) said not at all and 29 (28.4%) said not really. Increased workload and reduced profitability were anticipated, accompanied with improved patient safety. Prevalence of ‘substandard and falsified (SF) medical products’ was estimated at 1%–5%, with erectile dysfunction at greatest risk of falsification. Different packaging would raise suspicions. Five (4.9%) had identified SFs (p<0.001 one-sample binomial test). Of these, three (2.9%) informed the medicines agency. None had been involved in any public health campaigns. Confidence and self-efficacy was low. Strategies to reduce SFs reaching the public are described. Pharmacist’s role in combating SFs was elucidated. SFs were identified in deprived areas 4 (9%) more often than in affluent areas 1 (2%).ConclusionsMany pharmacies are not ready to implement FMD, potentially not capturing anticipated benefits of the directive, with greatest risk of harm in deprived area. We further validated a confidence scale. Limited public health campaigns may result in a lack of awareness among pharmacy professionals and patients. Limited awareness of technologies to identify falsified medicines exist, though further training is welcome. A worrying trend of under-reporting maybe prevalent. A larger sample study using this survey would be valuable.

“…Primarily this could relate to 'professional bias's towards e-cigarettes. (Barrett, 2019) As a category, e-cigarettes are licenced as consumer products and they are not traditional regulated items such as 'medicine', 'food', 'cosmetic' or 'supplements'. Consequently, they may be considered 'safe' self-care consumer items, even though nicotine can cause harm.…”

Section: No Patient and Public Involvementmentioning

confidence: 99%

An evaluation of community pharmacists' perception of e-cigarette: An English cross-sectional survey with geospatial analysis.

British Journal of Pharmacy

Vythelingum

2022

We wanted to establish prevalence of e-cigarette sale via Englishcommunity pharmacies. A cross-sectional survey of 500 retail-pharmacies was completed.Seventeen out of the 66respondents sold e-cigarettes, indicating a sales-prevalence of 25.76%. NRTwas widely available for sale (n=16, 94.1%), cessation services were lessfrequently available (n=7, 41.2%), or not available (n=9, 52.9%). ‘Dailysmokers’ were likely to use e-cigarette (n=8, 47.1%). Accessories were sold to0-2 people (n=13, 76.5%), χ² p=2.454 x 10-4. Young women purchasede-cigarettes (n=4, 23.5%), p=0.049, which were placed on top of the counter (n=7,41.2%), reflecting ‘impulse sales’ strategy. NRT was available forself-selection (n=14, 82.4%) (p=0.004), however staff-assistance was required(n=12, 70.6%), posing barriers. Costs for e-cigarette (£10.99-£29.99) versusNRT (£4.25-£35.99) represents value for money. Labelling and packaging werefound to be attractive, p=0.049, fashionable, colourful p=0.049, healthy,potentially breaching laws. All respondents provided NRT counselling, p<1x10-8.Less than half (n=8, 47.1%) provide e-cigarette’s counselling, while a majority(n=9, 52.9%) did not. Eight respondents describe 22 flavours, providing goodmouth feel. Aggregate ‘deprived’ versus ‘affluent’ analysis revels interestinginsights. We find some support of non-smokers initiating use. Pharmacists help patientsbut have limited support. We make recommendations to improve practice.