The Potential of Incorporating a Pharmacist-Only Medicine Category in Poland

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

1. The title should be changed. In the current form is difficult to understand (and comprehend).

2. “It is also noticeable in Poland, and recent legislative changes have strengthened this trend”. Please add more specific information.

3. “However, despite the common direction of development based on patient orientation, each pharmaceutical market may have different operating principles. These are the result of, for example, the legal and economic environment in the form of its level of regulation, problems related to supply chains, drug availability categories on a given market, or local patient habits and their economic capabilities”. Please add the table in which you provide details regarding Polish pharmaceutical market in terms of problems related to supply chains, drug availability, drug categories. In the context of drug categories, please provide a simple comparison with other European markets.

4. What do you mean by “proprietary survey”? Please define the concept.

5. What about pharmaceutical technicians? Did they participate in the survey? Why not?

6. “After preparation, the study tool was passed on to 10 pharmacists for the purpose of assessing the consistency and clarity of the questions”. How did you assess consistency and clarity? Qualitative approach?

7. “In order to collect the largest possible number of responses, a link to the survey along with a request to participate in the study was shared on the Facebook platform on nationwide groups bringing together pharmacists.” How did you avoid the situation in which one pharmacist responded several times to the survey? Was the ID checked in some way?

8. “For the purpose of anonymization, feedback received from the pharmacy’s email address was marked numerically, which also prevented accidental dissemination of the pharmacy’s name and, as a consequence, suspicion of legally prohibited advertising of pharmacies in Poland.”. If the person understands polish pharmaceutical law, the possibility of this suspicion is understandable; however, for foreigner this problem remains pretty unclear. Please try to define whether the suspicion can emerge.

9. Please describe the questionnaire in a more detailed way. Please add information regarding questionnaire domains (thematic domains). Please try to add more information about the development of the tool. Did you use any scientific literature to create first version of the questionnaire?

10. Please (at least estimate) how many respondents received questionnaire vs. filled in the questionnaire. Obviously, it could be quite difficult but at least some estimation is warranted to define the generalizability of the results.

11. 500 respondents? Really? All questionnaires were fully answered?

12. “Ketoprofen (26.2% of responses) was most often indicated here, followed by sildenafil (24.8% of responses) and mometasone (24.4% of responses).” Sildenafil and mometasone are already available as over-the-counters. So, does it make any sense to introduce additional drug categories for these drugs?

13. Please add more advanced statistical methods, e.g., logistic regression to deepen results. Just basic descriptive statistics were used to describe results. It is not enough.

14. I did not understand why so many questions in the questionnaire referred to new pharmaceutical services (and advancement of pharmaceutical services/pharmacy role/pharmacy profession). As it was mentioned by the Authors, the primary aim was to investigate pharmacists’ opinion on drug categories. The questionnaire might be too heterogenous; thus, the internal validity of the questionnaire seems to be poor. Please clarify your standpoint. Add limitations.

15. The conclusion is too wide. Please be more specific to your results.

16. Add more limitations, mostly in terms of methodological constraints.

17. Add the questionnaire (tool) both in Polish and English form.

18. Add explanation on ethics committee opinion the conducted study.

 

In the current manuscript has many flaws and must be improved before publication.

Comments on the Quality of English Language

English must be improved. In the current form, it sounds poor. 

Author Response

On behalf of the authors, I would like to thank you for the insightful review. We found many of the comments beneficial. Besides, these comments allowed us to improve the study. Each suggestion was considered very carefully, taking into account comments received from Reviewer#2 as well. 

 

1. We simplified the title.

1. Exact Acts are presented within the text. Hence, we gave more specific information.
2. We added information within the text. Considering also comments obtained from Reviewer #2, such a Table might be out of the study's scope.
3. We changed the wording using "self-designed" instead of "proprietary survey".
4. We explained the participation of the pharmacy technicians within the manuscript.
5. The text is amended to clarify the point.
6. It's presented in the "limitation" section.
7. We rewrote this section.
8. The information is added in the "material and methods" section.
9. The explanation is provided within the "limitation" section.
10. Yes. Having collected more than 400 answers, we decided to gain precisely 500. The information is added to the manuscript.
11. Yes, it makes sense. According to the results, the mentioned substances shouldn't be accessible as OTC brands. These medicines should be scheduled as POMs.
12. We did a statistical analysis. Results are presented in the text.
13. The structure of the study has changed. Considering the Reviewer's comments, we altered each section, making the text clearer. Thank you for your engagement and support.
14. It's changed.
15. The limitations section has been developed.
16. The questionnaire is available upon request. We added a table with a question content as supplementary material.
17. I hope the facets related to the approval from the Bioethics Committee are precise right now.

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript needs improvements however before it may interest an international audience.

*Introduction: Please provide a more comprehensive overview of the international context regarding Prescription Only Medicines (POM). This should include specific molecules and detailed procedures.

*A complete translation of the questionnaire, as well as all numerical results, is necessary. It would be beneficial to make this data publicly available in a repository. What as exactly told in the questionnaire about POM should be crystal clear,  " after familiarizing respondents with the POM category of drugs "  is clearly not a reproducible description of the methods!

*Discussion: The focus seems to be diverted towards other topics such as testing and vaccination, rather than concentrating on the survey results. This has led to excessive self-referencing.

*The manuscript should cater more to an international audience. For instance, an explanation of what furazidinum is, potential number of respondents, and a comparison of prescription-only medicines in contrast with other countries would be helpful.

*Conclusions: These should be more directly tied to the survey results.

*In numerous countries, obtaining approval from an Ethics Committee would be  a requirement for such a study. While this is a topic open to discussion, it’s crucial that this aspect is addressed.

Comments on the Quality of English Language

Can be improved

Some sentences in the introduction are much too long.

 

Author Response

Responses to the Reviewer 2# (detailed comments):

Thank you for the comments. All of them were considered very carefully. 

1. The manuscript's text has changed, adding more information about POMs.
2. We rewrote the statement" after familiarizing respondents with the POM category of drugs." Now, it's precise and clear.
3. The discussion, like the whole manuscript, has changed, including reducing self-referencing and adding new references.
4. The manuscript has changed, and the manuscript as a whole refers to your comments. We explained the activity of furaginum within the text. We added a table with a question content as supplementary material.
5. We believe that, after amendments, conclusions are directly tied to the results at the moment.

 

 

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

thanks for improving the manuscript.

I suggest adding both the English and Polish version of the questionnaire  in the supplementary material and that includes the definition given to the pharmacists before the start of the questionnaire.  
The "multiple choice possibility" should be spelled out verbatim.

This is rather important  if this (kind of) questionnaire would be used in another setting at another time.

Comments on the Quality of English Language

 

 

 

 

 

 

Author Response

Thank you for your comments, which we considered very carefully. 

1. Questionnaires are added as supllemenetary materials.
2. We amended the spelling of the "multiple choice possibility".

 

Author Response File: Author Response.docx