A mini review on the Community Pharmacy practice experiences in selected Southeast Asian countries

The aim of this short review article is to deliver enough data and information on several studies on the experiences related to Community Pharmacy during COVID-19 pandemic in selected Southeast Asian countries. The spread of COVID-19 infections across countries challenges different health care professionals including Community Pharmacists to perform under difficult circumstances. During the pandemic, the key functions in public health and medication therapy of Community Pharmacists were highlighted. These are significant contributions that they can impart in an outbreak of infectious diseases. In the countries under Southeast Asian region such as Indonesia, Malaysia, Philippines, Singapore Thailand and Vietnam, Community Pharmacy practice became challenging but it is the first point of contact in the health care systems of the said countries. In the response to the pandemic, Community Pharmacists extended their duration of services not just in their respective health care establishments but as well as thru communication lines and ensuring continuity of medicine supply in societies. Thus, Community Pharmacy practice is very substantial in the primary healthcare system in times of global health crisis.


Introduction
Coronavirus disease in 2019 or COVID-19 is a worldwide health crisis occurred in the late of 2019 and its causative agent is SARS-COV-2 or known as Severe/Acute Respiratory Syndrome Coronavirus 2 [1].This caused a major problem in healthcare systems globally and was a challenge for healthcare professionals including Community Pharmacists.The practice of Community Pharmacy serves as a direct point of approach to health care.Since drug retail establishments are very accessible to different societies, for this reason people would tender health related concerns to Pharmacists present in the said type of establishment especially in this time of COVID-19 pandemic [2].Pertinent roles of Community Pharmacists in health care system partake in medication therapy, management of diseases, vaccinations and medication adherence support.Although these roles are significantly established, the pandemic brought by COVID-19 emphasized contributions tendered by them particularly in global health crisis [3].Community Pharmacists situated in different regions of the world specifically in Asia had experienced different challenges in giving quality health care services to people.This review article recapitulates the results and data through mini literature review of the different experiences and challenges of Community based Pharmacists in selected countries of Southeast Asia.

Methodology
This review was conducted utilizing journal databases such as BMJ, Directory of Open Access, Elsevier, Google Scholar, and Wiley online library.Search process was conducted for articles on each database without variations on language in the duration of the process of the study.The search started in June 2, 2022.The search keywords applied include Community Pharmacists, Community Pharmacy Practice, COVID-19, Experiences, Asian region, Southeast Asia region.Suitable studies or articles were classified using specific criteria as follows: articles focused on clinical trials on Community Pharmacy practice in Southeast Asia articles related to reports of experiences or challenges of Community Pharmacists in Southeast Asia and research studies related to recent Community Pharmacy practice in Southeast Asian countries.Other parameters considered were the study design, population size, and data of the studies.There was no online review undertaking for this study that occurred [4][5][6].

Results and discussion
Community Pharmacy practice is developing from a role of product preparation and dispensing to a primary point of contact in health care systems.Community based Pharmacy settings impact care to patients due to their accessibilities to societies.A study demonstrated patients visited a Community Pharmacy 35 times per year as with a primary care physician with a frequency of an average of 4 times per year.Community-based Pharmacists give a broad range of services which includes medication management, educational consultations, care coordination, chronic condition management, patient empowerment and wellness services [7].
Community Pharmacists have modified their practices in the COVID-19 pandemic in order to ensure health care and support to their clients or patients.They are designated as a pertinent frontline service by which they face broad range of challenge to safeguard the continuity of patient care during the global pandemic.COVID-19 greatly affected the poor and vulnerable groups of people.Pharmacist based responses have greatly contributed to minimize the impact of the infection outbreak [8].In different parts of the globe specifically in the Asian region, most of them had challenging experiences in providing pharmaceutical care to patients.
A cross-sectional study was performed in Malaysia to assess coping strategies of Community Pharmacists and their services during COVID-19 pandemic.Most of their respondents reported a positive outlook and were able to balance work and self-care during the pandemic period.The findings of this study suggest the important roles of Community based Pharmacists in tendering responses to the pandemic and creating opportunity to establish areas where pharmaceutical services is required to enhance the public health system [9].
In Indonesia, a cross-sectional online survey of Community Pharmacists was conducted in July 2020.Findings of this study demonstrated that drug retail outlets continue to operate as frontline service during the COVID-19 pandemic.The respondents reported that they require regular access to accurate guidelines and supplies for personal protective equipment.The continuous services they offer to their clients and patients include provision for drug therapy information and surveillance [10].
Both in the Philippines and Singapore, Community Pharmacists played a significant role in telemedicine during the COVID-19 pandemic specifically in providing telepharmacy services to people.A drugstore in Singapore collaborated for a telehealth service program.Pharmacists observed that more than 50% of patients in telehealth services were international patients residing in Singapore but unable to travel due to the restrictions.Another group of patients said that they ought to use this type of service for safety and minimization of risk for COVID-19 infections.In the Philippines, a number of Community Pharmacists developed an online telepharmacy service in which patients and respondents realized that this type of online digital health service could be utilized further for provisions and clarifications in medication information and management as a pertinent part of primary health care during outbreak of diseases such as COVID-19 [11][12].
In Thailand during the COVID-19 pandemic, Community based Pharmacies experienced impacted income and recovery was still not certain and there is a low probability to expand the operations and profitability of the establishments including drug retail outlets.They ought to hope that after the COVID-19 outbreak, developments and new opportunities of Pharmacies would occur [13].
A cross-sectional based study was done in Vietnam for practices of Community Pharmacists during the COVID-19 pandemic during June to August 2020.Findings of this work demonstrated that Community Pharmacists in Vietnam in terms of COVID-19 knowledge was good.However, they reiterated that observing proper health protocols such as wearing face masks in communication during dispensing and counseling should always be observed.They also sought for solutions from their health agencies for enhancement of knowledge for the outbreak of COVID-19 [14].
The outbreak of COVID-19 has increased the appreciation of the important role that Community Pharmacists possess in the health care systems of different countries.Health agencies and organizations might need to develop from timeto-time guidelines for Community based Pharmacies to enhance Pharmacists' skills for providing healthcare services i and safety as well in diseases outbreak [15,16].

Conclusion
During COVID-19, community pharmacy practice in Southeast Asian nations has grown to be a crucial element in halting the spread of the disease and offering direct medical care to those in need.