key: cord-0910719-6y86188c authors: Pantasri, Tanapong title: Expanded roles of community pharmacists in COVID-19: a scoping literature review date: 2021-12-24 journal: J Am Pharm Assoc (2003) DOI: 10.1016/j.japh.2021.12.013 sha: 8081b8a7ef4fc68f30a01f11381d4fcae138b47c doc_id: 910719 cord_uid: 6y86188c Background COVID-19 has affected the world healthcare system adversely, but has also brought out innovative roles for healthcare professionals to cater to growing healthcare needs. Community pharmacists provide community pharmacy services and can play a vital role in fighting the pandemic by taking on novel roles that complement their pre-existing roles. Objectives To provide a scoping review of current and emerging literature about the novel roles adopted by community pharmacists during the COVID-19 pandemic. Methods Online databases such as Google Scholar and PubMed were searched systematically using the keywords “COVID-19”, AND “pharmacist”, AND “community”. Articles were selected based on availability of full text in English language, with time limit from 1st December 2019 to 31st October 2021; case reports, cross-sectional studies, literature reviews, qualitative studies and systematic reviews were included while commentary reviews and editorials were excluded from the search methodology. An independent review of the articles was carried out for inclusion based on relatability to study subject; those chosen were screened for references to find additional gray literature. Findings were arranged in themes and the results were organized accordingly. Results Novel roles for community pharmacists were found in relation to maintenance of drug supply chains; delivery of tele-pharmacy and telehealth services; provision of ambulatory pharmacy services; use of digital software to coordinate medication delivery for patients with chronic conditions; dispelling of misinformation; and roles in research and clinical trials. Roles in a post-COVID world regarding immunization of population, and involvement in lifting lockdown strictures alongside other stakeholders were also explored. Conclusion Although COVID-19 has challenged the healthcare system, it has also provided an opportunity for development of novel and innovative roles that can ultimately have profound consequences for the healthcare system. Community pharmacists, despite facing multiple challenges in the community, should be facilitated to adapt with these new roles, which can be beneficial in achieving mass immunization and better healthcare in a post-COVID world. The COVID-19 pandemic has impacted almost every profession in the world. Sociocultural 30 repercussions aside, the impact of COVID-19 on already strained healthcare resources has been 31 enormous. According to economic estimates by the American Hospital Association, $50.7 billion 32 per month of lost revenue affected America's hospitals and healthcare systems (1). The impact has 33 been worse in developing countries, where a delayed public health response led by limited 34 resources and overworked healthcare force has led to mayhem (2). 35 The role of both community and hospital pharmacists in this pandemic has been multifold. 36 Pharmacists have not only served to ensure medication management and patient adherence, but 37 have also played an important role in providing essential services, providing frontline healthcare 83 Since the study topic mostly included qualitative themes with guidelines and recommendations 84 based on various reviews, so statistical analysis was deferred in favor of thematic analysis, in 85 which major themes were extracted and curated data from various sources was systematically 86 presented in this review. 99 Pharmacists have played an important role in ensuring smooth flow of the drug-supply chain 100 during the pandemic. The COVID-19 pandemic led to a gross imbalance between the supply 101 and demand of drugs; this was further potentiated by decreased production, as well as increased 102 stockpiling by individuals, companies, and even countries in some instances (9). The impact 103 of this has been even more striking in lower middle income countries (LMICs), where the 104 unavailability of pharmaceutical imports as well as decreased production have led to increased 105 vulnerability of patients with chronic diseases as well as those with general pharmaceutical 106 needs (3). The role of pharmacists has expanded from refilling medicines to providing a 107 therapeutic substitution for physicians, which has helped in ensuring the continuity of care consult a healthcare provider when needed, and get referred readily when needed. Based on operational models for pandemic vaccinations at regional supermarket chain Community pharmacists can provide healthcare access to populations that are usually 327 deprived, due to geographical or socioeconomic constraints, from visiting healthcare facilities. They can further provide vaccination services remotely for these population subgroups, The new roles of community pharmacists in a post-COVID world coincide with the ending of 379 lockdown restrictions, and the incidence of mass immunization programs across the globe. Pharmacists now have expanded roles; not only are they important public health stakeholders, but 381 they are also at the forefront of ensuring that the post-COVID world does not fall into disarray as 382 it did during the pandemic. Describe the rationale for the review in the context of what is already known. Explain why the review questions/objectives lend themselves to a scoping review approach. Objectives 4 Provide an explicit statement of the questions and objectives being addressed with reference to their key elements (e.g., population or participants, concepts, and context) or other relevant key elements used to conceptualize the review questions and/or objectives. Indicate whether a review protocol exists; state if and where it can be accessed (e.g., a Web address); and if available, provide registration information, including the registration number. Eligibility criteria 6 Specify characteristics of the sources of evidence used as eligibility criteria (e.g., years considered, language, and publication status), and provide a rationale. Information sources* 7 Describe all information sources in the search (e.g., databases with dates of coverage and contact with authors to identify additional sources), as well as the date the most recent search was executed. Search 8 Present the full electronic search strategy for at least 1 database, including any limits used, such that it could be repeated. Selection of sources of evidence † 9 State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review. 5, 6 Data charting process ‡ 10 Describe the methods of charting data from the included sources of evidence (e.g., calibrated forms or forms that have been tested by the team before their use, and whether data charting was done independently or in duplicate) and any processes for obtaining and confirming data from investigators. For each included source of evidence, present the relevant data that were charted that relate to the review questions and objectives. Synthesis of results 18 Summarize and/or present the charting results as they relate to the review questions and objectives. 7 Summarize the main results (including an overview of concepts, themes, and types of evidence available), link to the review questions and objectives, and consider the relevance to key groups. Limitations 20 Discuss the limitations of the scoping review process. 22 Provide a general interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps. Describe sources of funding for the included sources of evidence, as well as sources of funding for the scoping review. Describe the role of the funders of the scoping review. NA JBI = Joanna Briggs Institute; PRISMA-ScR = Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. * Where sources of evidence (see second footnote) are compiled from, such as bibliographic databases, social media platforms, and Web sites. † A more inclusive/heterogeneous term used to account for the different types of evidence or data sources (e.g., quantitative and/or qualitative research, expert opinion, and policy documents) that may be eligible in a scoping review as opposed to only studies. This is not to be confused with information sources (see first footnote). ‡ The frameworks by Arksey and O'Malley (6) and Levac and colleagues (7) and the JBI guidance (4, 5) refer to the process of data extraction in a scoping review as data charting. § The process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision. This term is used for items 12 and 19 instead of "risk of bias" (which is more applicable to systematic reviews of interventions) to include and acknowledge the various sources of evidence that may be used in a scoping review (e.g., quantitative and/or qualitative research, expert opinion, and policy document). 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