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DOCUMENT SCORE

Online Pharmacy dec 1 96 of 100

ISSUES FOUND IN THIS TEXT

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PLAGIARISM

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Contextual Spelling 1
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Incorrect Phrasing 1

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Style 24
Passive Voice Misuse 23
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Vocabulary enhancement 17
Word Choice 17
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Online Pharmacy dec 1

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Chapter 1
INTRODUCTION

Background of the Study

In today's digital world, there have been several
innovations in the way that products are marketed and sold
to consumers. Goods and services now sold via the
internet, and pharmaceutical goods are no exception. Thus,
online pharmacies or internet pharmacies have arisen
(Vagnozzi, 2016). When we say online pharmacies, these
are businesses selling prescription and non- prescription
medicines (Smith, 2016). Also, written prescriptions
replaced electronically. Online pharmacies also sell
pharmaceutical preparations including prescription-only
drugs for customers ordered through online and delivered
thru mail (Prashanti et al., 2017).
There are three types of online pharmacies, namely
traditional pharmacy, prescription pharmacy and rouge
pharmacy (Bachler, 2005; Alfahad et al., 2015). Traditional
online pharmacy only dispenses medicine to a consumer
who has first obtained a prescription from a doctor and
then submits this to the online pharmacy. Traditional
pharmacy is considered the most legitimate type and the
least controversial since this type does not initiate the drug
sale. The prescription pharmacy is generally known as
online consultation pharmacy
(www.pharmacychecker.com). This type offers online
consultation, remote consulting or prescribing where
physicians review a patient's self-reported medical history
obtained through online conversation and then writes a
prescription. This type of online pharmacy is more
appealing to consumers offering both physician's services
and pharmacy services. When purchasing prescription
drugs without the consent of doctor or purchasing without
prescription, it is called Rouge pharmacy. Most law
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enforcement agencies consider this type of online

pharmacy as illegal (Khurshid , 2015).
These types of online pharmacies gave rise to the
classification of online pharmacies mainly as legitimate
and illegitimate (Cordioli et al., 2017). As stated by
Samadbeik, when an online pharmacy follows verification
standards which provide high-quality pharmacy services it
is classified as a legitimate online pharmacy. On the other
hand, online pharmacies which are not verified and not
complying with professional standards and regulations both
in national or international were classified 1 as illegitimate
online pharmacies. This issue on illegitimate 2 online
pharmacies is posing a threat in this industry; hence,
finding out whether an online pharmacy is legitimate or
illegitimate 3 is a good practice. Meaning, a consumers
verify them first before using it (Orizio et al., 2017).
The most crucial verification system is that of Legitscript.
Legitscript classifies online pharmacies as legitimate,
unverified, unapproved or rogue. Certification of internet
pharmacy websites can also found on Food and Drug
Administration (FDA) websites for verifications (Bate, 1
Passive voice
2016). Worldwide online pharmacy sites were not focused 4 2
Repetitive word: illegitimate
on providing consumers with adequate protection. Most of
them give risks, with no security patches applied due to
their cross-site scripting and old version application. 3
Repetitive word: illegitimate
Security industry groups found out that security issue is
their main vulnerability. Making a site one hundred percent
(100%) secure is impossible, but they can use a multi-
phased approach to lessen the vulnerabilities (Kuzma,
2009). The regulated online pharmacies tend to use more
assessment trust features than unregulated online
pharmacies, while the usage of conventional trust features
is the same across both groups (Mavlanova, 2010).
In spite of this controversy, online sales of drugs have
overgrown. Consumers turn to online pharmacy due to
4

several reasons. It is easy 5 and convenient when buying Passive voice

medicines through an online pharmacy, considering the

time spent on traveling and waiting time for queues for a
conventional pharmacy. Ordering is available 24/7 and
shipping of medication can be done even at night right at
customer's doorstep. Ordering online can save time and
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money considering the transactions and also the stress

experienced in waiting. Disabled or housebound, the
elderly, as well as those living in rural areas, can order
drugs in open access not minding the travel time for the
delivery. It can also open avenues for comparison
shopping; thereby get the drugs at lower prices (Smith,
2016). Furthermore, consumers privacy were preserved 6 in
using online pharmacies and people with the medical
condition will be at is, feeling secured and not concerning
the embarrassment felt to a face to face interaction with a 5
Overused word: easy
doctor or go for pharmaceutical counseling (Alafad et al.,
2015).
Although the internet continues to bring many benefits to
the global community, the widespread availability of drugs
and medical services via the internet has the potential to
result in problems of a global nature (George, 2016). In
providing optimal care for patients, a high degree of
integrity is must be practiced 7 which is necessary to
maintain health standards and fulfill ethical responsibility
(Smith, 2016). Physician and pharmacists in internet
pharmacy make consumers without interaction 8 with them.
Thus, customers are not getting the same quality of
services offered in a conventional pharmacy. Determining
the legitimacy of a website is very difficult especially at
first, thus, determining whether drugs purchased online are 6
Passive voice
counterfeit, unapproved, or illegal is also tricky. Also, the
misdiagnosis and inappropriate use of medicines endanger
patients' safety. There are several other issues associated
with the online availability of drugs. The same brand can
even exist, but it is a different drug (Cicero, 2012). A
patient can also receive and get wrong medicines since the
patients lose interaction with the professional pharmacists.
The most dreaded thing is the sale of antibiotics that can
lead to immunization of the microorganism to antibiotics
that cause the disease. Moreover, appropriate storage for
retaining potency is required 9 for medicines, and with an
online pharmacy, storage points of medicine during
7

transport is not monitored damaging the effectiveness of Passive voice

the drug (Prashanti, 2017).

In America, the existence of internet pharmacies began in
January 1999. The first internet pharmacy which is the
8
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Soma.com is a company which sells drugs via mail-order Possibly confused word

since 1872. Followed by Pharmacy2u.co.uk in the United

Kingdom (UK) which started its operation of an online
pharmacy in November 1999 (George, 2016). Later a
survey conducted by the Alliance for Safe Online
Pharmacies (ASOP) in Indiana, a state of America, there
are approximately thirty-five thousand (035,000)
participating online pharmacies operating worldwide.
Online pharmacies that do not comply with American
federal and state laws and pharmacy standards were rated 10
to ninety-six percent (96%). More than twelve percent
(12%) of online pharmacies or roughly 3,400 sites sell
controlled substances. Each month, six hundred illegal
online pharmacy websites opened. One hundred percent of
search results for search text of "buy medicine online"
mainly provide consumers with illegal or provides unsafe
sites (ASOP, 2017).
In the Philippines, online pharmacies are now utilized 11. 9
Passive voice
Since 1994, e-commerce took a new manifestation and
businessmen 12 can now sell their goods through their
website and close sales transaction either online or through
e-mail (Toral, 2013). Among the popular 13 Philippine
internet pharmacy are muramed.com, rosepharmacy.com,
tgp.com, medexpress.com.ph, and rxpresscare.ph. Online
platforms are gradually becoming integrated health
solutions for consumers providing all services; medicine,
diagnostic care and doctor appointment (Cubex, 2017).
The passage of Philippine Republic Act 10918, a law for
the practice of pharmacy to be regulated, is seen to provide
better healthcare service for the public (Sambalud, 2017).
Now, Philippine FDA avails the use of a mobile application
to transform pharmacy services which are first in Asia to
implement such service 14. The Philippine FDA authorities
greatly 15 want and rushing in for innovation of the
pharmacy sector. They formulated what they call
Electronic Logbook, the e-EDPMS, which aims to
eliminate paper bureaucracy collecting information from
10

customers, never before seen data and life-saving insights. Passive voice

The e-EDPMS refers to Electronic Essential Drug Price

Monitoring System which was created by the Department
of Health (DOH) to support the establishment of an
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efficient and effective system and procedures for collecting

price and inventories of essential drugs and other drugs
stated in Republic Act 9502, also known as Universally
Accessible Cheaper and Quality Medicines Act of 2008.
The intent is for the DOH and Department of Trade 11
Passive voice
Industry (DTI) to monitor essential drug prices as well as
stocks of medicines in the local market and detect practices 12
Possible gender-biased language
such as overpricing and non-compliance to efforts of the
DOH to regulate excessive price 16 of drugs such as the
Government Mediated Access Prices (GMAP) & the 13
Overused word: popular
Maximum Drug Retail Prices (MDRP). It also aims to
educate consumers on prevailing market prices of essential
drugs to enable them to make informed choices (FDA,
2017).
For half a century, Philippine pharmacists noticed that
valuable time is lost 17 with patients filling out handwritten
paper logbooks only to comply that patient prescription is
documented 18 as the local law requires. This is a challenge
for the FDA, a bureaucratic process monitoring over
10,000 participating pharmacies in the Philippines
(mClinica Health Solutions, Inc, 2017). MediCard
Philippines, a leading health maintenance organization in
the country, has partnered with MedGrocer.com, an online
pharmacy that delivers FDA-certified medicines to your
14

doorstep. This is in line with the Health Management Repetitive word: service
15

Office (HMO) mission to make quality and affordable Overused word: greatly

healthcare accessible for every Filipino (Manila Standard

Lifestyle).
In Region I, there are pharmacies but doesn't offer online
pharmacy services. Customers use online shopping site like
shopee.com, Lazada.com and Facebook marketplace.
In La Union, a first class province, many people also use
online shopping. This is not new to them anymore. This
has brought convenience to consumers and pharmacist
when the availability of online shopping is concerned.
However, there are issues and concerns which surround the
operation of such services, problems like slow internet
connection. Although the internet is available in most
places due to a prepaid internet connection, the speed is not
that reliable having an intermittent connection from time to
time. Another issue is that some areas were not accessible
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by couriers limiting the coverage of online shopping.

Thus, this study aims to determine the overall knowledge
and level of acceptability of the community pharmacists
and the consumers in La Union regarding online pharmacy. 16
Repetitive word: price
Results of this study may serve as baseline information on
how online pharmacy is perceived by the community
pharmacists who will be significantly affected by the
establishment of online pharmacy. It will explore the
possibility of consumers in patronizing online pharmacy
despite the risks involved as well as the readiness and
acceptability of community pharmacists to address the risks 17
Passive voice
involved in online pharmacies. Further, determination of
the consumers' knowledge would provide information on 18
Passive voice
how they are to be educated about online pharmacy use in
the future.

Research Framework
E-commerce now plays an important 20 role in man's life.
Almost anything can be bought over the Internet and
delivered right to the consumer's front door by just
clicking. Payments can be done 21 online also in less effort.
Prescription medication can also be bought online that
makes it risky. Not only is it possible to order prescribed
medications over- the Internet, in some cases it is even not
necessary to be examined, or to consult with a doctor.
Some people consider this "cybermedicine" as nullification
to traditional medicine, giving dangers to consumers
(Mills, 2000). E-commerce paved the way for the operation
of an online pharmacy, As such the goal of online
pharmacy, other than to improve patient care and safety has
also been to reduce racial and ethnic disparities. Anyone
can order as long as the internet is available. Online
pharmacy has enabled the supply of medicines through the
creation of electronic health records (EHRs) or electronic
patient records (EPRs) in a digital format that is capable of
being shared across different health care settings.
Governments across the world have encouraged online
pharmacy as it has the potential for ushering in advantages
for consumers, pharmacists, and the government, too.
Consumers aim for convenience and price discounts, and
the pharmacists look for volumes through the e-portals
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(Bhatia, 2013).
The Theory of Planned Behavior (TPB) by Ajzen (2002)
serves as the framework of the study. This theory suggests
that individual behavior is a function of beliefs relevant to
the behavior 22 where beliefs 23 are the salient information
known to the individual that would determine his intention
or action. The individual behavior is determined 24 by the
interplay of his beliefs 25 and knowledge, his attitude, self-
efficacy and social factors called subjective norms.
Attitude 26 is a construct that guides or causes the intention
that ultimately leads to a particular behavior.
Aforementioned indicates how the individual's feeling,
whether positive or negative, about their acceptability of
the situation, would prompt him to action. Self-efficacy
refers to the individual's confidence level on his capability
to do the work, and social factors are the influence exerted
by others that could affect the individual's decision to take
action.
19

When talking about acceptability, this is defined 27 as the Passive voice

method of deliberately and non-judgmentally engaging

with negative emotions (Segal, Williams, & Teasdale,
2002). It is theorized as an active method that leads to
20

higher emotional awareness and understanding (Segal et Overused word: important

al., 2002). Acceptability is the opposite of avoiding

negative emotion and has been shown to lead to lower
negative affect, across experimental and clinical
21

intervention studies (Campbell-Sills, Barlow, Brown, & Possibly confused do and make

Hofmann, 2006a; Ma & Teasdale, 2004; Twohig et al.,

2010). Two factors that affect acceptability includes age
and educational attainment (Shallcross, 2013; Kudrat, 2015
)
When we talk about age, they consider it as related to
experience. The life a person survived in his every life.
Age is a sign of existence. It is usually said 28 that age
brings wisdom. Age brings knowledge (Kudrat, 2015;
Smith, 2007).
Another frequently examined factor is the level of
education of consumers. Education is seen 29 as a means to
assist consumers with their actions, and to articulate their
needs and preferences more coherently. Education 30 is
directly related to knowledge (Smith, 2007).
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Since age and educational attainment is related to

knowledge, finding the correlation of knowledge to
acceptance must be considered. Increasing the
knowledge 31 of a person can either increase or decrease his
level of acceptance (Alfahad et al. 2015).
For the usage of online marketing, one study shows that
more online users are identified 32 in the age group below
30 years old. (Gregorio, 2015).
Given this theory and concepts, the research will look into
the extent of knowledge and acceptability of the
community pharmacists and the consumers about online
pharmacy.

Statement of the Problem

This study aims to assess the knowledge and acceptability
22

of online pharmacy practice among community Repetitive word: behavior

23

pharmacists and consumers in La Union. Specifically, it Repetitive word: beliefs

will answer the following questions:

24

What is the profile of the respondents in terms of age and Passive voice
25

highest educational attainment? Repetitive word: beliefs

What is the extent of knowledge of the respondents

26

regarding online pharmacy? Repetitive word: Attitude

3. Is there a significant difference in the assessment of the

respondents when grouped according to:
a. age
b. educational attainment?
4. What is the level of acceptability on the establishment of
online pharmacy by the following respondents:
a. Community pharmacist
b. consumers?
. Is there a significant relationship between the extent of
knowledge and the level of acceptability?
27
Passive voice

Significance 19 of the Study

This stud56y on online pharmacy is the first of this kind to
be conducted. Assessment of the extent of knowledge and
the level of acceptability of both the community
pharmacists and the consumers on online pharmacy will be
helpful in exploring the possibility of establishing online
pharmacy practice in the locality. This study will serve as
baseline information for the pharmacy industry in the area
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to develop prospects and to plan the use of particular

modality. Moreover, the results of the study may also serve
as an input for policy developers and to enhance the
operations of online pharmacy. Furthermore, the study 33
may also benefit the pharmacists for they will be given 34 a
picture of the consumer's level of acceptability of online
services.

28
Passive voice

Chapter 2
METHODOLOGY
29

Research Design Passive voice

The descriptive research design will be used 35 in this

study. This is appropriate since the study will describe the
30

present situation regarding the acceptability and knowledge Repetitive word: Education

of the respondents on online pharmacy. The study is

exploratory in nature and will look into some aspects that
may influence the respondents in accepting online
pharmacy which will serve as input data to the
31

pharmaceutical industry in the locality. Repetitive word: knowledge

This study includes demographic characteristics of the

participant's regarding their age in years and educational
attainment. Then participants' were inquired about their
32
knowledge and acceptability on online pharmacy services Passive voice

apart from their views on the list of advantages of online

pharmacy.
Population and Samples of the Study
The target population of the study will be the community
pharmacists and pharmaceutical products' consumers in La
Union. Since the study aims to explore the possibility of
establishing an online pharmacy in the locality, purposive
sampling will be employed 36 in determining community
pharmacists who will serve as respondents of the study.
Pharmacists will be those employed 37 in pharmacies in the
four major industrial districts of La Union, namely: San
Fernando (center), Bacnotan (north), Agoo (south), and
Naguilian (east). These major pharmacies or drugstores are
selected since they are perceived to have the capability of
offering online pharmacy services.
Considering the volume of pharmaceutical products'
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consumers 38, convenience sampling will be employed to

solicit information from them. The consumers transacting
business in the identified major pharmacies/ drugstores
during the time of the study will be requested to serve as
respondents.

Research Instrument
This study will make use of a research-made survey-
questionnaire that is based 39 on extensive literature review,
particularly on the research tool used by Alfahad et al.
(2015) and the Alliance for Safe Online Pharmacies
(ASOP, 2017).
The survey questionnaire is composed of three sections.
Part I will determine the profile of the respondents which
include their demographic information, i.e., age, and
highest educational background. Part II will determine 40
the respondents' extent of knowledge on online pharmacy
and Part III will determine the respondent's level of
acceptability on online pharmacy.
The questionnaire will be subjected to validation and
reliability test and will be reviewed by five lead pharmacy
practitioners in Baguio City. The validation questionnaire
(please refer to Appendix A) will be used 41, and the results
will be analyzed and interpreted using the following scale:
Rating
Weighted Mean
Descriptive Equivalent

5
33
Repetitive word: study
34
4.20-5.00 Passive voice

Highly Valid
4
3.40-4.19
Valid
3
2.60-3.39
35
Moderately Valid Passive voice
2
1.80-2.59
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Fairly Valid
1
1.00-1.79
Not Valid

The comments and suggestions given by the validators will

be incorporated, and the revised questionnaire will be pilot
tested to determine its reliability. The pilot test will be
conducted 42 among the community pharmacists of five
leading pharmacies in Baguio City and the first five
consumers transacting business in these pharmacies at the
time of the study. The reliability coefficient shall be
computed using Cronbach alpha.
Duration and Locale of the Study
The data gathering will be conducted in the identified
pharmacies in La Union immediately after the approval of
the proposal and the conduct of the pilot test of the
instrument. This will take approximately two months. The
data processing and analysis will immediately follow;
36
hence it is projected that the study will be done in one Passive voice

semester.

37
Treatment of Data Repetitive word: employed

Problem number 1 which deals on the profile of the

respondents will be analyzed using frequency counts and
percentages. This will serve as preliminary data for the
study.
To answer problem 2, the extent of knowledge on online
pharmacy will be analyzed using the average weighted
38
mean (AWM) and will be interpreted as follows: Dangling modifier

Rating Average Weighted Mean Descriptive Equivalent

4 3.50- 4.00 Highly Knowledgeable (Familiar and
Understand well)
3 2.50-3.49 Moderately Knowledgeable ( Has Basic
Knowledge)
2 1.75-2.49 Slightly Knowledgeable (Basic or minimum
understanding)
1 1.00-1.74 Not Knowledgeable (Not Heard/No idea)
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Passive voice
Problem 3 which calls for the comparison on the extent of
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knowledge of the respondents, considering their

demographic variables will be analyzed using T-test for
independent samples will be used to compare the
respondents' assessment when grouped into age and highest
educational attainment. Problems 4 on the level of
acceptability of the respondents on online pharmacy will be
analyzed using the Average Weighted Mean (AWM) and
40

will interpret as follows: Repetitive word: determine

Rating Average Weighted Mean Descriptive Equivalent

Level of Acceptability
4 3.50- 4.00 Highly Acceptable (Full Agreement)
3 2.50-3.49 Moderate Acceptable (Average Agreement)
2 1.75-2.49 Slightly Acceptable (Minimal Agreement)
1 1.00-1.74 Not Acceptable (No Idea)
Problem 5 which aim to find a significant relationship
between the extent of knowledge and the level of
41
acceptability will be interpreted using Pearson, procedure Passive voice

movement correlation (Pearson-r).

Ethical Consideration
Understanding the work of the participants could give
insights on how to identify their availability. In the conduct
of the survey, the researcher will seek permission first of
the client before the administration of the questionnaire.
The confidentiality will be ensured 43 and that all responses
solicited will only be used for the study. The rule on
plagiarism will highly be observed 44 as references used
will be acknowledged.
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