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Background Italy has been the first non-Asian country affected by Coronavirus Disease 19 (COVID-19) pandemic. Community pharmacies are essential services authorized to continue their activity during the emergency. To date, a clear image is lacking of the critical issues Italian community pharmacists had to face and of how they responded in their daily work.. Objective To describe procedures and critical logistical-organizational issues encountered by Italian community pharmacists and to collect the main requests reported by patients to pharmacists. Setting A national survey on Italian community pharmacists. Method A cross-sectional survey using a reasoned questionnaire was sent during the pandemic peak to Italian pharmacies, divided in two groups according to the incidence of COVID-19: "Red Zones" and "non-Red Zones". Main outcome measure Exploring the most frequently adopted measures by the pharmacists. Results 169 community Pharmacists answered the questionnaire. The most frequently adopted measures were the use of gloves, surgical masks and protective barriers at the drug counter. Most implemented services for customers were: booking of prescriptions, delivery of medications and implementation of phone consultations. Overall, the questionnaire highlighted an increase in the number of health-related consultations and requests by customers. In Red Zones, there was a higher use of FFP2 and FFP3 masks by pharmacists, where customers were mainly interested in gaining information about specific classes of medications. Conclusion Community pharmacists adapted to lockdown measures by implementing a number of measures. There was an overall increase in pharmacists' personal protective equipment in Red Zones possibly linked to increased risk perception.

Upper gastrointestinal (GI) symptoms are usual complaints among patients presenting to Italian community pharmacies. However, information on treatment history of those patients is often lacking. This descriptive, cross-sectional study aims at exploring the medication history of individuals with upper GI tract symptoms visiting one of the 20 enrolled community pharmacies, over a period of 7 months, based on the administration of a questionnaire. Of 1,020 interviewees, 62.1% had asked for a medical consultation. The most frequent symptom was epigastric burning (31.8%), followed by acid regurgitation (14.6%) and post-prandial fullness (12.0%). Of the 1,609 therapies, proton pump inhibitors constituted the most represented therapeutic class (35.6%) followed by antacids (17.5%) and alginate-based products (17.2%). In treating symptoms, 38.1% of the patients do not seek medical advice, while 42.0% rely on non-prescription therapies. As findings suggest, support to patients with GI disorders in community pharmacies can be enhanced for a safer self-medication.

Introduction Cardiovascular diseases (CVD) are a leading cause of death worldwide, and several modifiable and unmodifiable risk factors contribute to this burden of disability and mortality. Thus, effective cardiovascular prevention relies on appropriate strategies to control risk factors within the frame of unmodifiable traits. Methods We conducted a secondary analysis of treated hypertensive adults aged ≥ 50 years enrolled in Save Your Heart . CVD risk and hypertension control rates based on the 2021 updated European Society of Cardiology guidelines were evaluated. Comparisons with previous standards in terms of risk stratification and hypertension control rates were performed. Results Among the 512 patients evaluated, with the application of the new parameters for fatal and non-fatal cardiovascular risk assessment, the proportion of individuals at high or very high risk rises from 48.7 to 77.1% of cases. A trend towards lower hypertension control rates was observed based on 2021 European guidelines compared with the 2018 edition (likelihood estimate for difference: 1.76%, 95% CI − 4.1 to 7.6%, p = 0.589). Conclusions In this secondary analysis on the Save Your Heart study, the application of the new parameters reported in the European Guidelines for Cardiovascular Prevention 2021 showed a hypertensive population with a very high probability of encountering a fatal or non-fatal cardiovascular event due to failure to control risk factors. For this reason, a better management of risk factors must be the main goal for the patient and all the involved stakeholders.

Effective management of asthma requires long-term adherence to inhaled drug therapies [1]. Regular use of maintenance treatment is associated with disease control, reduction in morbidity and costs, and, therefore, improvement in health-related quality of life [2]. Despite these benefits, nonadherence to asthma therapy is still frequent in clinical practice, ranging from 40% to 80% [3]. Although no gold standard exists, the various ways of assessing the level of adherence include laboratory values, pharmacy refill, electronic monitoring, and self-report questionnaires. These approaches are all characterized by strengths and limitations. In clinical practice, there is a need to assess adherence and improve the patient's engagement in shared decision-making and self-management. For a tool to be incorporated into the workflow of routine care, it must be valid, reliable, and inexpensive, as well as short and easy to complete, score, and interpret. Most available self-reported measures of medication have been developed to assess patient's behavior independently of the drug or route of administration [4]. The Test of Adherence to Inhalers (TAI) [5] is the only tool for evaluation of adherence to inhalers that is tailored to patients with chronic obstructive pulmonary disease or asthma. It is composed of 12 items: the first 10 are completed by the patient and evaluate the level of adherence; in the remaining 2, health professionals are asked to detect 2 possible causes of unwitting nonadherent behavior (patient's knowledge of the prescribed regimen and inhaler technique). The questionnaire was originally developed in Spain [5] and is available in many languages. The original Spanish TAI proved to be a valid and reliable instrument [6], and its validity was recently confirmed in Farsi [7]. Here, we describe the psychometric properties of the Italian version of the TAI in terms of validity and reliability [8]. Adult asthmatic patients (≥18 years) in treatment with inhaled therapy for at least 2 months and visiting community pharmacies that employed clinical pharmacy specialists were Manuscript