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Objectives: Although there is a growing body of evidence suggesting that cannabinoids may relieve symptoms of some illnesses, they are relatively high-cost therapies compared with illicit growth and supply. This article aimed to comprehensively review economic evaluations of medicinal cannabis for alleviating refractory symptoms associated with chronic conditions.Methods: Seven electronic databases were searched for articles published up to September 6, 2020. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to types of medical conditions, organized into tables, and reported narratively.Results: This review identified 12 cost-utility analyses conducted across a variety of diseases including multiple sclerosis (MS) (N = 8), pediatric drug-resistant epilepsies (N = 2), and chronic pain (N = 2). The incremental cost-effectiveness ratio varied widely from cost saving to more than US$451 800 per quality-adjusted life-year depending on the setting, perspectives, types of medicinal cannabis, and indications. Nabiximols is a cost-effective intervention for MS spasticity in multiple European settings. Cannabidiol was found to be a cost-effective for Dravet syndrome in a Canadian setting whereas a cost-utility analysis conducted in a US setting deemed cannabidiol to be not cost-effective for Lennox-Gastaut syndrome. Overall study quality was good, with publications meeting 70% to 100% (median 83%) of the Consolidated Health Economic Evaluation Reporting Standards checklist criteria.Conclusions: Medicinal cannabis-based products may be cost-effective treatment options for MS spasticity, Dravet syndrome, and neuropathic pain, although the literature is nascent. Well-designed clinical trials and health economic evaluations are needed to generate adequate clinical and cost-effectiveness evidence to assist in resource allocation. [ABSTRACT FROM AUTHOR]

The world has faced an unprecedented challenge when coronavirus (COVID-19) emerged as a pandemic. Millions of people have contracted the virus and a significant number of them lost their lives, resulting in a tremendous social and economic shock across the globe. Amid the growing burden of the pandemic, there are parallel emergencies that need to be simultaneously tackled: the proliferation of fake medicines, fake news and medication misinformation surrounding COVID-19. Pharmacists are key health professionals with the required skills and training to contribute to the fight against these emergencies. Primarily, they can be a relevant source of accurate and reliable information to the public or other fellow health professionals thereby reducing the spread of COVID-19 medication misinformation. This can be achieved by providing accurate and reliable information based on recommendations given by relevant health authorities and professional associations to make sure the community understand the importance of the message and thus minimise the detrimental consequences of the pandemic. This commentary aims to summarise the existing literature in relation to the promising treatments currently under trial, the perils of falsified medications and medicine-related information and the role of pharmacists in taking a leading role in combating these parallel global emergencies. [ABSTRACT FROM AUTHOR]

With the growing popularity and use of nicotine vaping products (NVPs, also known as e-cigarettes) as a way to quit smoking, pharmacy staff are frequently asked by smokers for advice about NVPs. In Australia, there are currently no clear guidelines or policy statements provided by any of the professional organisations for pharmacists on how they should handle customer enquiries about NVPs, or on extemporaneous compounding of prescriptions for nicotine solution for use in NVPs as a smoking cessation aid. This commentary summarises the current evidence surrounding the safety and efficacy of NVPs, the Australian regulatory landscape, and provides a guide for pharmacy staff to use in discussions with customers regarding NVPs. Evidence strongly points to NVPs being considerably less harmful than smoking tobacco cigarettes and that they can be effective for smoking cessation. The maximum benefit from using NVPs as a harm reduction tool, however, will only be realised if smokers completely stop smoking rather than using NVPs as a partial substitute, because even low level smoking still confers substantial health risk. Vaping products containing nicotine are illegal to sell in Australia but users can still legally access nicotine e-liquid through some limited pathways if they hold a valid prescription from a registered medical practitioner. It is important that pharmacy staff keep abreast of the current evidence surrounding these products and provide evidence-based advice to customers. [ABSTRACT FROM AUTHOR]

Objectives: This study examined views of pharmacy staff regarding the safety of e-cigarettes compared to nicotine replacement therapies (NRTs) and conventional cigarettes, as well as views on their regulation in Australia.Methods: We conducted a cross-sectional survey among pharmacy staff (64 pharmacists and 76 pharmacy assistants) from the greater Brisbane region, Queensland, Australia. The self-administered questionnaire included closed- and open-ended questions that explores pharmacy staff perception on harms of e-cigarettes versus NRT and traditional cigarettes, knowledge of current e-cigarette regulations, views on how they should be regulated and information needs regarding e-cigarettes. Pearson's chi-square test was employed for computing differences between variables. A content analysis of responses to open-ended questions was also performed.Results: Over 90% of pharmacy staff regarded e-cigarettes without nicotine and NRTs as less harmful than regular tobacco cigarettes. This reduced to 72% for e-cigarettes containing nicotine, with 24% of respondents believing they are equally as harmful as conventional cigarettes. Moreover, few respondents were confident about the short and long term safety of e-cigarettes containing nicotine (36% and 15% respectively) whereas pharmacy staff were more comfortable with the safety of NRTs for short (88%) and long term (35%) use. The majority of respondents believed that e-cigarettes with nicotine should be regulated as a medicine, either requiring a prescription (24%) or sold only by pharmacies (22%), though many believed that they should be regulated in the same way as regular tobacco cigarettes (27%). Some pharmacy staff (39%) reported having been asked about e-cigarettes by customers and 75% believed that their customers would be interested in using e-cigarettes as a smoking cessation aid.Conclusions: There is a need to provide evidence-based and customised education for pharmacists regarding e-cigarettes to help them guide their clients. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia.Methods: An institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH). An interviewer-administered and semi-structured questionnaire were utilized to collect the data.Result: Of the total respondents, 240 (74%) reported the use of CAM, with herbal medicine and spiritual healing being the most commonly utilized CAM modalities (50.4% and 40.8% respectively). Dissatisfaction with conventional therapy (40.8%) and belief in the effectiveness of CAM (30.8%) are the most commonly cited reasons for the use of CAM therapies. Rural residency, higher educational status, higher average monthly income and presence of co-morbidity were positively associated with the use of CAM.Conclusion: This survey revealed a higher rate of CAM use among elderly patients with chronic diseases, along with a very low rate of disclosing their use to their health care providers. Special attention should be given for these patient population due to the potentially harmful interaction of different herbal remedies with the prescribed medications, thereby predisposing the patient to untoward adverse effects and compromised overall health outcome. [ABSTRACT FROM AUTHOR]

Background: People living with HIV/AIDS (PLWHA) are increasingly using herbal remedies due to the chronic nature of the disease, the complexities of treatment modalities and the difficulty in adhering to the therapeutic regimens. Yet, research on herbal medicine use in this patient population is scarce in Ethiopia. The present study aimed at investigating the prevalence and factors associated with the use of traditional herbal medicine among PLWHA in Gondar, Ethiopia.Methods: A cross sectional survey was conducted on 360 PLWHA attending the outpatient clinic of University of Gondar referral and teaching hospital from September 1 to 30, 2016. A questionnaire about the socio-demographic, disease characteristics as well as traditional herbal medicine use was filled by the respondents. Descriptive statistics, univariate and multivariate logistic regression analyses were performed to determine prevalence and correlates of herbal medicine use.Results: Out of 360 respondents, 255 (70.8%) used traditional herbal medicine. The most common herbal preparations used by PLWHA were Ginger (Zingiber officinale) (47%), Garlic (Allium sativum L.) (40.8%) and Moringa (Moringa stenopetala) (31.4%). Majority of herbal medicine users rarely disclose their use of herbal medicines to their health care providers (61.2%). Only lower educational status was found to be strong predictors of herbal medicine use in the multivariate logistic regression.Conclusions: The use of herbal medicine among PLWHA is a routine practice and associated with a lower educational status. Patients also rarely disclose their use of herbal medicines to their health care providers. From the stand point of high prevalence and low disclosure rate, health care providers should often consult patients regarding herbal medicine use. [ABSTRACT FROM AUTHOR]

The world has faced an unprecedented challenge when coronavirus (COVID-19) emerged as a pandemic. Millions of people have contracted the virus and a significant number of them lost their lives, resulting in a tremendous social and economic shock across the globe. Amid the growing burden of the pandemic, there are parallel emergencies that need to be simultaneously tackled: the proliferation of fake medicines, fake news and medication misinformation surrounding COVID-19. Pharmacists are key health professionals with the required skills and training to contribute to the fight against these emergencies. Primarily, they can be a relevant source of accurate and reliable information to the public or other fellow health professionals thereby reducing the spread of COVID-19 medication misinformation. This can be achieved by providing accurate and reliable information based on recommendations given by relevant health authorities and professional associations to make sure the community understand the importance of the message and thus minimise the detrimental consequences of the pandemic. This commentary aims to summarise the existing literature in relation to the promising treatments currently under trial, the perils of falsified medications and medicine-related information and the role of pharmacists in taking a leading role in combating these parallel global emergencies. [ABSTRACT FROM AUTHOR]

Highlights from the article: Both pharmacy students and practicing pharmacists had positive attitudes toward smoking cessation and both groups had similar mean knowledge scores. B Discussion: b Educating pharmacists about smoking cessation supports as part of a continuous professional development and providing a hands-on customized educational intervention, such as a practice guidelines in a form of Ask-Advise-Refer approach, about smoking cessation would be useful.