Pharmacy Technicians, Stigma, and Compassion Fatigue: Front-Line Perspectives of Pharmacy and the US Opioid Epidemic

Round 1

Reviewer 1 Report

Dear Sirs/Mesdames, Your study addresses a relativelyobscure medical/dental problem and heightens awareness about it. I believe it will make a useful contribution to the literature. Before it is ready to be published, I recommend that you expand your conclusions to give examples from your findings to support them. Additionally, review and change the English throughout the paper. Some examples that need attention are:          -Line 10 - Abstract - data were not was                                                              -Line 143 - an interesting "one"                                                                          -Line 150 - issue(s)                                                                                              -Line 173 - interesting study                                                                              -LIne 200 - the middle                                                                                        I look forward to seeing your article in a future issue of IJERPH.

Author Response

-Line 10 - Abstract - data were not was   Done                                                           -Line 143 - an interesting "one"   Done                                                                       -Line 150 - issue(s)     Done                                                                                         -Line 173 - interesting study     Done                                                                         -LIne 200 - the middle       Done                                                                                 I look forward to seeing your article in a future issue of IJERPH.

Thank you for these recommendations. We amended the manuscript.

Reviewer 2 Report

Dear Authors,

Manuscript entitled " The characteristics of patients with oral lichen planus and malignant transformation" is well drafted. Earlier research works are captured and discussed clearly in the discussion section. Authors could have discussed the results in detailed in the discussion section. Addition of alcohol in the confounding factors is suggestable.  Tabular information of basic characteristics of all patients, comparison of subgroups of patients, and description of the cases with malignant transformation are very informative.

Author Response

Manuscript entitled " The characteristics of patients with oral lichen planus and malignant transformation" is well drafted. Earlier research works are captured and discussed clearly in the discussion section. Authors could have discussed the results in detailed in the discussion section. Addition of alcohol in the confounding factors is suggestable.  Tabular information of basic characteristics of all patients, comparison of subgroups of patients, and description of the cases with malignant transformation are very informative.

Response: Thank you for these suggestions. However, this study did not assess alcohol addiction. Consequently, the data cannot include alcohol. Furthermore, this study was a qualitative study where comparison of subgroups is not possible.

Reviewer 3 Report

General remark: The article is not prepared in accordance with the requirements of IJERPH.

Introduction

After lines 38-39 some more recent data on this subject would have been useful.

Methodology

I did not find essential information:

• How many focus groups took place?
• How many FGD were conducted in person and how many online?
• How participants were recruited? How they were recruited?
• How many people took part? What was they gender? Maybe authors can present table with the information about focus groups participants?  
• Did authors have any script for focus groups? If yes, was it the same for all groups?
• How long was FGD on average?
• Are the transcripts of FGD available in any public repository?
• Are there any other articles from this study?

Lines 124-125 are quite misleading – I thought for a moment that there were only 2 FGD.

Results

I think that lines 147-148 should be a part of Methodology.

My biggest objection to the results is that they resemble a results from IDIs rather than FGDs. During FGDs, people tend to disagree, discuss. The authors in the manuscript present only the statements of individual people. Were there any discussions?

I miss a better introduction to term no. 2.

I would prefer information such as gender, state, FGD no. after each quote rather then P1, P7. For examlpe  (F, PA, FDG2).

Author Response

I did not find essential information:

• How many focus groups took place? Response: Thank you for this suggestion. We included the total number of focus groups conducted (8). The text was amended.
• How many FGD were conducted in person and how many online? Response: Thank you for this valuable recommendation. We made the changes in the text to reflect the number of FG conducted online (7) and one in-person.
• How participants were recruited? How they were recruited? Response: Thank you for this suggestion. The information was provided into the text: Participants for this study were recruited via the primary institution’s Continuing Education email listserv. Participants self-selected their participation and inclusion criteria for were 1) adults, 2) active pharmacy technicians working in the community/retail pharmacy setting, 3) English speakers, 4) familiarity with the topic and 5) willingness to discuss their opinion. Participants received a $50 gift card as compensation for their participation.
• How many people took part? What was they gender? Maybe authors can present table with the information about focus groups participants?  Response: We value your suggestions. We collected limited demographic information such as gender, the type of pharmacy practice, certification, and the state where the pharmacy technician was practicing.
• Did authors have any script for focus groups? If yes, was it the same for all groups? Response: Thank you for asking for this clarification. We developed a focus group guide, that was used for all the groups.
• How long was FGD on average? Response: We value your recommendation. The text was amended.
• Are the transcripts of FGD available in any public repository? Response: Thank you for this clarifying question. In accordance with the IRB requirements and respecting the participants anonymity, the data is not available in any public repository.
• Are there any other articles from this study? Response: At this stage, this is the first article from this study.

Lines 124-125 are quite misleading – I thought for a moment that there were only 2 FGD. Response:

Results

I think that lines 147-148 should be a part of Methodology. Response: we are grateful to this recommendation. The manuscript was revised and amended.

I would prefer information such as gender, state, FGD no. after each quote rather then P1, P7. For examlpe  (F, PA, FDG2).

Response: Thank you for this suggestion. The main reasons why we used P1, P2, etc was to keep the data as anonymous as possible. Some participants might know each other and we do not want anyone to be identified.

Round 2

Reviewer 3 Report

I do not feel fully convinced by the authors' answers. They were kind of an escape not to make changes to the manuscript, which could just get a little better.