OBJECTIVE: To study the role and responsibility of the pharmacist who can contribute to the sustainability of compulsory health insurance in Mali.
METHODS: This was a descriptive cross- sectional study that took place in Bamako from October 1, 2016 to December 31, 2017. We conducted a literature review and interviews with 36 pharmacists, 400 policyholders, 90 prescribers, and 04 resource personsfrom delegated management organizations. Analysis of the interview data was done using SPSS 20.
RESULTS: A total of 2 Acts and 6 Orders in Council enshrine the legislative and regulatory provisions of the AMO. Most insured persons (90%) thought the pharmacist was a drug specialist. More than 80% of the medications on the care sheets were fully available. Among their tasks in implementing the AMO, 38.9 % of pharmacists mentioned the availability of medicines, 27.70 % the application of good dispensing practices and 16.7 % the right to substitution.
CONCLUSIONS: Substitution of unavailable drugs is a factor that can contribute to reducing health care costs for patients and to their satisfaction.
OBJECTIVE: Etudier le rôle et la responsabilité du pharmacien pouvant contribuer à assurer la pérennité de l\'Assurance Maladie Obligatoire (AMO) au Mali.
UNASSIGNED: Il s\'agissait d\'une étude transversale descriptive qui s\'est déroulée à Bamako du 1 er octobre 2016 au 31 décembre 2017. Nous avons réalisé une analyse documentaire et des entrevues avec 36 pharmaciens, 400 assurés, 90 prescripteurs et 04 personnes ressources des organismes délégués de gestion. L\'analyse des données des entrevues a été faite par le logiciel SPSS 20.
UNASSIGNED: Au total 2 lois et 6 décrets consacrent les dispositions législatives et réglementaires de l\'AMO. La majorité des assurés (90 %) pensaient que le pharmacien est un spécialiste du médicament. Plus de 80 % des médicaments figurant sur les feuilles de soins étaient intégralement disponibles. Parmi leursmissions dans le cadre de la mise en œuvre de l\'AMO, 38,9% des pharmaciens ont cité la disponibilité des médicaments, 27,70 l\'application des bonnes pratiques de dispensation et 16,7% le droit de substitution.
CONCLUSIONS: La substitution des médicaments non disponibles est un facteur pouvant contribuer à la réduction des dépenses de santé pour les patients et à leur satisfaction.

BACKGROUND: Since the 2019 COVID-19 pandemic is not the first and will not be the last, pharmacists\' experiences during this period can be used to establish a more efficient healthcare system to face future pandemics.
OBJECTIVE: This study aims to explore Iranian pharmacists\' experiences in pharmacies using the content analysis method.
METHODS: In this qualitative study, a conventional content analysis approach was applied. Ten male and female pharmacists working in community pharmacies in Birjand, Iran participated using a purposeful sampling method. Semi-structured interviews were carried out for data collection. The data were analyzed using Graneheim and Lundman\'s method.
RESULTS: Four categories and ten subcategories were extracted as follows: Multifaceted concerns of pharmacists (familial, economical, professional, and personal concerns), Non-compliance with protocols from occurrence to cause (facing non-compliance with protocols by clients, obstacles to complying with protocols in the pharmacy), Prevention from COVID-19 (protective equipment usage, designing protection rules), and Double reactions to COVID-19 (emotional and; practical reactions).
CONCLUSIONS: Pharmacists dealt with different concerns and challenges during the COVID-19 pandemic. They are one of the main primary care providers and need to be supported by the authorities to maintain their standard level of services.

BACKGROUND: According to the Public Healthcare Code, contributing to primary care is one of the pharmacist\'s key missions. Accessibility without appointment and the territorial network of pharmacies make the pharmacist an essential player in the management of unscheduled care, which remains an important gateway for users into the primary care system. This type of requests, daily in pharmacies, has not been yet the subject of a qualitative or quantitative evaluation. The Grand-Est Region, regrouping nearly 8% of French pharmacies, wanted to conduct a specific survey to quantify and assess the unscheduled care requests addressed to pharmacists on its territory.
METHODS: The survey by URPS Pharmacists and ARS Grand-Est was conducted by Tous Pour la Santé over a period of 12months from November 2020 to November 2021. Participation in the study was on a voluntary basis. The main objective of this study was to define the typology of unscheduled care requests addressed to the Region pharmacies and to characterize the responses provided.
RESULTS: One hundred and eighty-nine pharmacies (nearly 12% of Grand Est pharmacies, the participation rate could certainly have been higher if the study had not been conducted during the COVID-19 pandemic), representing 11,010 unscheduled care requests, took part in the survey. Despite the profession\'s massive desire to get involved in handling unscheduled care requests, the survey revealed a lack of specific training for pharmacists on this subject and an all-too-rare update from the AFGSU. User requests concern both daily healthcare needs and more specific chronic patients\' needs. They evolve according to the profile of the applicant, the seasons, the days of the week and the type of pharmacy concerned. All ages are represented, including young adults. The average duration of care by the pharmacy team was 8minutes per request, even though in 20% of cases this did not lead to any delivery of product and in 11% of cases to no remuneration for the pharmacist.
CONCLUSIONS: This survey confirmed the role of the pharmacist in responding to unscheduled care requests as a first-line actor and referral agent in the health system. The implementation of shared multiprofessional protocols, including first and foremost general practionners, and the recognition of the contribution of pharmacy teams would allow to define a framework to optimize the patient\'s journey through the healthcare system.

OBJECTIVE: Non-conventional medicines are not devoid of toxicity and it is relevant to establish an inventory of the general public\'s knowledge of essential oils. The objective is to identify the profile of the victims of a poisoning, the ways of administration and the symptoms as well as the incriminated essential oils.
METHODS: Two surveys, for the general public and health professional, were distributed (January-March 2019). In addition, data from the Angers poison control center for the period 2017-2018 were analyzed and compared with the data from our study.
RESULTS: Our surveys gathered 623 and 59 answers. The data of the poison control center of Angers counted 741 intoxications. The precautions for use and contra-indications of essential oils are not well known since 5% of the respondents identified them correctly. Our data show that using a mixture increases the risk of intoxication (P<0.02). The most cited essential oils in case of intoxication are Eucalyptus, Tea tree and Lavender. The symptoms mainly concern a cutaneous application (75%) and remain of short duration and without gravity. Concerning the intoxications referenced to the poison control center in Angers, the same essential oils are involved, the oral route is mostly used (70%) and the symptoms listed for 74% of intoxications concern oropharyngeal, ocular, abdominal and skin pain.
CONCLUSIONS: The delivery of essential oils is not harmless and the data obtained both through our surveys and the processing of data from the poison control center of Angers show that they must be used with caution.

BACKGROUND: The challenge of territorial hospital groups is to develop coherent care pathways for optimal patient care. Following the creation of a territorial pharmaceutical team, a common prescription review process was initiated in our health area. The objective of this study is to analyze the uses of statins in the elderly.
METHODS: The study included all statin-treated patients older than 75 years at the five participating institutions (including long-term nursing homes). In a prospective multicenter study, the benefit/risk ratio of statin prescription has been assessed up. Depending on the clinical situation, a proposal to stop or adjust the dosage could be made.
RESULTS: Nine hundred and forty-seven patients were included. Among them, 184 were treated with a statin. Forty-seven patients (26%) are treated in primary prevention and 137 patients (74%) in secondary prevention. Dosages are lower for long stays. Fifteen treatments interruption were accepted out of 44 proposals, mostly for long stays. The reasons given to continue treatment are the need for a new evaluation by a cardiologist or a high cardiovascular risk.
CONCLUSIONS: The variability of results according to the type healthcare institution makes territorial medical and pharmaceutical collaboration relevant. The challenge is to develop a coherent care pathway for optimal care of elderly patients, with congruent objectives.

BACKGROUND: As the healthcare system changes, the pharmacist\'s place does. In this context the health institutions are looking for improving prevention and so realize how well placed pharmacists were. For their competences as well as the trust patients are giving, they are serious actors in the implementation of prevention.
METHODS: We sought to understand which place pharmacists take in prevention policies. Thus, we have proceeded with an analysis of bibliography of the past ten years about articles registered in Medline talking about pharmacist\'s places in French prevention.
RESULTS: We have selected 47 articles classified according to San Marco\'s 3 levels of prevention: universal, oriented or targeted prevention. The pharmacist is involved in universal prevention, cancer screening or the proper use of antibiotics. In targeted prevention, they are specifically interested in the proper use of medicines and their correct prescription to patients. Finally, for targeted prevention, they offer patients therapeutic education adapted to their needs.
CONCLUSIONS: We can highlight that pharmacists improve consequently the patient\'s quality of life. They also enhance connections between health care professionals. Thanks to pharmacists, patients can find easy access and reliable health advice and government, trustworthy support for prevention.

BACKGROUND: The development of vaccines against SARS-Cov-2 has enabled the deployment of vaccination, particularly through dispensing pharmacists, who are already authorised to administer influenza vaccines in France.
METHODS: We surveyed pharmacists in the Auvergne-Rhône-Alpes region to assess the current status of SARS-Cov-19 vaccination in the region. A questionnaire was sent to them; the analysis was carried out jointly with the URPS-Pharmacists.
RESULTS: 739 pharmacies took part in our survey, and gave us their impressions of the organisation of the anti-COVID-19 vaccination and the information to be transmitted to patients.
CONCLUSIONS: The commitment of pharmacists to the anti-COVID-19 vaccination testifies to the attachment of pharmacists to their patients, and their privileged place in prevention in France. The extension of their competences to the general vaccination of the population expects legitimacy from the decision-making authorities.

In Europe, the prevalence of food allergy is estimated at 6-8% of children. Ten to 20% of pediatric food-induced anaphylaxis reactions occur at school. Individual healthcare plans (IHP) for food allergy aim at: identifying children at risk of allergic reactions; reducing the risk of allergen exposure; providing emergency kits containing adrenaline auto-injectors (AAI) if needed with emergency action plans and instructions about when and how to use AAI. In France, IHP were introduced into law in 2003 and was updated in 2021. The number of IHP for allergy is increasing since 10 years (50,000 IHP for allergy/year). While the recommendations of the learned societies have resulted in the national harmonization of criteria for the implementation of IHP for allergy and for the prescription of emergency kits with AAI, adrenaline remains underused. In 2019, a national policy stated that all high schools must have a provision of spare AAI in case of anaphylaxis and the promotion of school staff training about food allergy and anaphylaxis was encouraged. These recommendations should be assessed widely and allergy training should be widespread. Pharmacists play an important role to take care of food-allergic children: provision of AAI prescribed for the most at-risk food allergic patients, advice and information on AAI. The pharmacist is therefore a key player in the therapeutic education of the patient to reinforce the key messages on the efficacy and safety of adrenaline used for anaphylaxis.

BACKGROUND: Insomnia is a common sleep disorder that affects a large portion of the population in a situational, recurrent, or chronic way. In Canada, it is estimated that 13% of the population suffers from it.
OBJECTIVE: The primary objective of this literature review is to identify and describe studies dealing with the role and impact of the management of insomnia by a pharmacist.
METHODS: PubMed®, EMBASE® and CINALH Complete were searched to extract articles published between January 1st, 1990 and May 28, 2020. Studies on the role and impact of management of insomnia by a pharmacist, in French and English, descriptive or quantitative, with or without control group were included. Articles that did not deal with insomnia as the primary topic or where insomnia is a secondary condition were excluded, conference abstracts and studies showing no concrete results. The following variables were extracted: author, type of study, duration, location, sample size and characteristics of participants, description of pharmacist interventions, limits and biases, outcomes assessed and results. The quality of the pharmacists\' interventions description was evaluated with DEPICT2.
RESULTS: Our review identified eight articles published from 2006 to 2018 evaluating 14 types of outcomes and 41 separate outcomes. A total of 37% (7/19) of the quantitative outcomes had statistically significant positive results, regarding insomnia qualification, symptoms and adequate use. Six studies were conducted in community pharmacy. The quality score varied between 8 and 10 out of 11.
CONCLUSIONS: There is little data on the role and impact of the management of insomnia by a pharmacist. The pharmacist can have a positive impact, particularly when practicing in a community pharmacy. Given the limited data and the prevalence of insomnia, it appears relevant to invest in pharmaceutical evaluative research for this condition.

During the twentieth century, French colonial rule in West Africa was marked by the establishment of a homogeneous health organization in the colonies. It was based on the health service of the colonial troops, the hospital service under the general service and other services such as health police, epidemics and hygiene. This health system made it possible to protect the colonizers and indigenous populations from the major endemics of the time, to conduct research on new diseases hitherto unrecognized and to bring \"civilization\" to the overseas territories. The pharmacist\'s missions in the colonial health system were manifold. Our study aims to shed light on the profession of colonial pharmacist in the health history of French West Africa. To do this, it concerned the period between the creation of the Federation of French West Africa (1895) and the end of colonization (1960). Drawing on the available documentation, including archival material and bibliographic sources, this article shows that the colonial pharmacist was already exercising a multidisciplinary profession. He was in fact hospital manager, wholesaler-distributor, pharmacy, biologist, chemist, botanist, teacher, central actor in public health.