Current legislation in Italy provides that medical Cannabis may be administered orally or by inhalation. One of the fundamental criteria for the administration of oral formulations is that they deliver a known consistent quantity of the active ingredients to ensure uniform therapies leading to the optimisation of the risks/benefits. In 2018, our group developed an improved Cannabis oil extraction technique. The objective of the present work was to carry out a stability study for the oil extracts obtained by this method. Furthermore, in order to facilitate the consumption of the prescribed medical Cannabis therapy by patients, a standard procedure was defined for the preparation of a single-dose preparation for oral use (hard capsules) containing the oil extract; thereafter, the quality and stability were evaluated. The hard capsules loaded with the oil extract were analysed and found to be uniform in content. The encapsulation process did not alter the quantity of the active molecule present in the oil. The stability tests yielded excellent results. Since the capsule dosage form is easily transported and administered, has pleasant organoleptic properties and is stable at room temperature for extended periods of time, this would facilitate the adherence to therapy by patients in treatment.

Pharmacists in the community and the essential requirement to safeguard their own health have become fundamental since the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aims of this paper were (I) to analyze the directives provided to pharmacists in 2020 regarding preventative safety measures to be adopted; (II) to determine the number of pharmacists who came into contact with SARS-CoV-2 in North-West Italy and relate this to the adopted preventative measures. The first aim was pursued by conducting a bibliographic research, consulting the principal regulatory sources. The second one was achieved with an observational study by administering a questionnaire and performing a serological test. The various protection measures imposed by national and regional legislation were analyzed. Two hundred and eighty-six pharmacists (about 8% of the invited ones) responded to the survey. Ten pharmacists reported a positive result to the serological test. Of the subjects who presented a positive result, three declared that they had not used a hand sanitizer, while two stated that they had not scheduled the cleaning and decontamination of surfaces. Two interviewees had not set up a system of quota restrictions on admissions. In four cases, a certified cleaning company had decontaminated the premises. The results of our study show that during the coronavirus disease 2019 (COVID-19) pandemic, the most pressing challenge for community pharmacists has been the protection of staff and clients inside the pharmacy; the challenge to be faced in the near future will probably be the management of new responsibilities.

Introduction: Type 2 diabetes is an important public health issue, yet adherence to drugs and regular clinical follow-up is still suboptimal. This study aims to evaluate a community pharmacy programme for monitoring and enhancing adherence to prescribed pharmacological therapies and recommended examinations among patients with confirmed diabetes. Methods: The intervention was conducted in different Italian areas between April 2017 and January 2018. All adult patients who entered a pharmacy with a personal prescription for any antidiabetic drug and agreed to participate, were interviewed. Those found to be non-adherent received counselling from the pharmacists. All patients were invited for a follow-up interview after 3 months. Results: Overall, 930 patients were enrolled and completed the baseline interview. We found low rates of non-adherence, ranging from 8% to 13% for prescribed pharmacological therapies, and 11–29% for the recommended clinical examinations. Non-adherence to oral therapies was higher among younger and recently diagnosed patients; that to clinical examinations was higher in men, those with an intermediate duration of diabetes and less educated patients. Large geographical differences persisted after the adjustment for individual factors. Only 306 patients (32.9%) returned for the follow-up interview, most of whom were already adherent at baseline. Conclusions: Poor adherence to drugs or clinical examinations is not easy to identify in the usual operating setting of community pharmacies. Furthermore, the majority of patients did not return for follow-up, making it impossible to evaluate the efficacy of the pharmacists’ counselling. It might be more effective to plan interventions addressed to specific subgroups of patients or areas.

In many countries in Europe and in the world, pharmacists are allowed to prescribe or modify therapies. In Italy, the only healthcare professions authorised to prescribe are medical doctors and veterinary surgeons. The extension of the duties of the Italian pharmacist to include prescribing would be extremely important considering the challenges the National health system is facing regarding the shortage of healthcare workers. In this article, we report the findings of a survey on the role of the pharmacist prescriber conducted among pharmacists, family doctors, and pharmacy users in the North-West of Italy. The investigation was conducted by means of interviews carried out, using category-specific questionnaires. Interviews were conducted with 234 pharmacists, 926 users and 9 family doctors. The majority of pharmacists and users would agree to the introduction of the prescribing pharmacist. In return for taking on the increased responsibility, the pharmacists stressed the need for appropriate legal status and additional training. The reasons most commonly indicated by pharmacists for introducing such a service are the ability to respond immediately to a pathology or minor condition, and the prevention of inappropriate self-medication by patients. More than three-quarters of pharmacists and family doctors feel that the most suitable pharmacist prescribing procedure would be that within a clinical management plan. The family doctors, expressed reservations regarding the pharmacist prescriber: the cases in which they were really open to a change were the renewal of a prescription. This study highlights the fact that both pharmacists and pharmacy users tend to be favourable to the introduction of the figure of the pharmacist prescriber in Italy. Many obstacles remain to be overcome but, based on the procedures already experimented in other European countries and worldwide, a route leading to the introduction of the pharmacy prescriber role may be hypothesised.

Objective: COPD is one of the most important causes of morbidity and mortality worldwide. The health and economic burden of COPD may in part be reduced by early disease case finding and a correct therapy. This study aimed to investigate the feasibility of a community pharmacy programme for COPD case finding among previously undiagnosed subjects and for monitoring and enhancing adherence to prescribed pharmacological therapies among patients with confirmed COPD. Methods: The intervention was conducted in hundred community pharmacies in Piedmont (northwest Italy) and developed in two different arms: a case finding one through the administration of a specific questionnaire and the spirometry measurement and the adherence one through the administration of a questionnaire exploring the impact of the disease and the therapy adherence. Persons considered at risk to develop the COPD disease or non-controlled patients were referred to the GP or were invited to return in the pharmacy for a follow-up interview. Results: Overall, 844 subjects, out of 934 enrolled, completed the baseline interview. 103 subjects (25.7% of the 401 enrolled in the case finding arm) were considered at risk of suffering from COPD. Lower educated subjects and those without social support were more frequently at very high risk. Five returned to the pharmacy with a confirmed medical diagnosis. Among the 443 patients interviewed we found non-adherence value (depending on the drug) varying from 31% to 46%. A significant protection from non-adherence to bronchodilators was found among patients with comorbidities and among people living alone. Conclusions: We showed that opportunistic screening for COPD is feasible in community pharmacies. Concerning adherence to therapy in pharmacies, it would be necessary to identify different methods of enrolment in order to involve only those patients who are less adherent or who have difficulties in the management of therapy and chronic pathology

Objective: To investigate the role of community pharmacists in the therapeutic process of oncological patients and to assess these patients’ state of acceptance of their disease and their relationship with their therapies, we performed a survey in some oncological clinics in Turin (north-west of Italy). Methods: The survey was carried out in a three months’ period by means of a questionnaire. The questionnaire was administered on paper to oncological patients that attended 5 oncological clinics in Turin. The questionnaire was self-administered. Results: 266 patients filled out the questionnaire. More than half of patients reported that their cancer diagnosis interfered with normal life very much or extremely and almost 70% of patients reported that they were accepting of what happened and were trying to fight back. 65% of patients answered that it is important or very important that pharmacists are aware of their health status. About 3 out of 4 patients thought that pharmacists giving information on medicines purchased and on how to use them is important or very important and that it is important to receive information concerning health and the effects of medication taken. Conclusion: Our study underlines the role of territorial health units in the management of oncological patients. It can be said that the community pharmacy is certainly a channel of election, not only in cancer prevention but also in the management of those patients who have already been diagnosed with cancer. More comprehensive and specific pharmacist training is necessary for the management of this type of patient. Furthermore, it is necessary to improve the awareness of this issue in community pharmacists at the local and national levels by creating a network of qualified pharmacies developed in collaboration with oncologists, GPs, dermatologists, psychologists and cosmetics companies.