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Craske ME, Hardeman W, Steel N, Twigg MJ. Components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review and narrative synthesis. BMJ Qual Saf 2024:bmjqs-2024-017283. [PMID: 39013596 DOI: 10.1136/bmjqs-2024-017283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/30/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Pharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as 'a consultation between a pharmacist and a patient to review the patient's total medicines use with a view to improve patient health outcomes and minimise medicines-related problems'. It is not known how varying approaches to medication reviews lead to different outcomes. AIM To explore the common themes associated with positive outcomes from pharmacist-led medication reviews. METHOD Randomised controlled trials of pharmacist-led medication reviews in adults aged 18 years and over were included. The search terms used in MEDLINE, EMBASE and Web of Science databases were "medication review", "pharmacist", "randomised controlled trial" and their synonyms, time filter 2015 to September 2023. Studies published before 2015 were identified from a previous systematic review. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Descriptions of medication reviews' components, implementation and outcomes were narratively synthesised to draw out common themes. Results are presented in tables. RESULTS Sixty-eight papers describing 50 studies met the inclusion criteria. Common themes that emerged from synthesis include collaborative working which may help reduce medicines-related problems and the number of medicines prescribed; patient involvement in goal setting and action planning which may improve patients' ability to take medicines as prescribed and help them achieve their treatment goals; additional support and follow-up, which may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems. CONCLUSION This systematic review identified common themes and components, for example, goal setting, action planning, additional support and follow-up, that may influence outcomes of pharmacist-led medication reviews. Researchers, health professionals and commissioners could use these for a comprehensive evaluation of medication review implementation. PROSPERO REGISTRATION NUMBER CRD42020173907.
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Affiliation(s)
| | - Wendy Hardeman
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Nicholas Steel
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Michael J Twigg
- School of Pharmacy, University of East Anglia, Norwich, UK
- Research Design and Development, NHS Norfolk and Waveney ICB, Norwich, UK
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Sallom H, Abdi A, Halboup AM, Başgut B. Evaluation of pharmaceutical care services in the Middle East Countries: a review of studies of 2013-2020. BMC Public Health 2023; 23:1364. [PMID: 37461105 DOI: 10.1186/s12889-023-16199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient's safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe. OBJECTIVE The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations. METHOD The Arkesy and O'Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research. RESULTS There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year. CONCLUSION Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.
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Affiliation(s)
- Hebah Sallom
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Cyprus, Turkey.
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, University of Science and Technology, Sana'a, Yemen.
| | - Abdikarim Abdi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Cyprus, Turkey
- Department of Clinical Pharmacy, Faculty of Pharmacy, Yeditepe University, İstanbul, Turkey
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, University of Science and Technology, Sana'a, Yemen
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Bilgen Başgut
- Department of Pharmacology, Faculty of Pharmacy, Başkent University, Ankara, Turkey
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Alharthi M, Wright D, Scott S, Blacklock J. Terms used to describe and define activities undertaken as a result of the medication review process: Do they require standardisation? A systematic review. Int J Clin Pharm 2023; 45:304-319. [PMID: 36414823 PMCID: PMC10147810 DOI: 10.1007/s11096-022-01494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Medication review (MR) is the systematic assessment of a patient's medications by a healthcare practitioner. It is necessary to compare such MR interventions to rationalise differences between them and assess their impact. The development of an international taxonomy for terms used to describe activities undertaken within the MR process would facilitate quality of reporting, and the comparison of different interventions. AIM To identify overarching and individual MR activity terms and definitions reported within studies where MR was the main intervention. METHOD A systematic review of the literature was performed using search terms for 'Intervention' and 'Outcome'. Papers with empirical data reporting and describing MR activities in English were included. The Mixed Method Appraisal Tool was used to assess research quality. Two researchers reviewed all included literature independently. Data extraction was performed using Cochrane Effective Practice and Organisation of Care to report study characteristics, and terms and definitions used to describe MR activities. RESULTS Twenty-one papers were included: eight quantitative non-randomised trials (38%), eight randomised controlled trials (38%), and five quantitative descriptive studies (24%). Overarching interventions such as 'Clinical', 'Education' and 'Technical' were identified with no standardised definitions. Terms used to describe the medication review activities, such as stop, start and change, varied with significant potential for ambiguity. CONCLUSION The literature reports a variety of overlapping, ambiguous and undefined MR terms. As a result, comparing process evaluations from MR interventions may be difficult. A standardised taxonomy to describe, define and report MR activities is required.
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Affiliation(s)
- Mohammed Alharthi
- School of Allied Health Professions, University of Leicester, Leicester, UK.
- College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia.
| | - David Wright
- School of Allied Health Professions, University of Leicester, Leicester, UK
| | - Sion Scott
- School of Allied Health Professions, University of Leicester, Leicester, UK
| | - Jeanette Blacklock
- School of Allied Health Professions, University of Leicester, Leicester, UK
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Filmer T, Ray R, Glass BD. Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review. Res Social Adm Pharm 2023; 19:977-988. [PMID: 36868911 DOI: 10.1016/j.sapharm.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. OBJECTIVE The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. METHODS A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. RESULTS A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. CONCLUSIONS While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..
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Affiliation(s)
- Tamara Filmer
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
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5
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Alalawneh M, Berardi A, Nuaimi N, Basheti IA. Improving Syrian refugees' knowledge of medications and adherence following a randomized control trial assessing the effect of a medication management review service. PLoS One 2022; 17:e0276304. [PMID: 36240214 PMCID: PMC9565448 DOI: 10.1371/journal.pone.0276304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Syrian refugees living in Jordan have many chronic conditions and use many medications. Pharmacists delivering the Medication Management Review (MMR) service can have a role in improving this growing global refugees' problem. OBJECTIVES To assess the effect of the MMR service on adherence to treatment therapy and knowledge of chronic medications for Syrian refugees residing in Jordan. METHODS This randomized intervention control single-blinded study was conducted in Jordan. Syrian refugees were recruited and randomized into intervention and control groups. Two home visits were delivered to each participant, at baseline and three months later. All participants completed questionnaires regarding adherence and knowledge. As a part of the MMR service, treatment-related problems (TRPs) were recognized for all patients; recommendations to resolve these TRPs were only delivered to intervention group refugees' physicians; TRPs were corrected. At follow-up, TRPs assessment, adherence and medication knowledge were assessed for all refugee participants. RESULTS Participants (n = 106; intervention n = 53, control n = 53) had a number of medications and diagnosed chronic diseases of 5.8 ± 2.1 and 2.97 ± 1.16 per participant respectively. A significant improvement in the adherence and knowledge scores were noted in the intervention (P < 0.001 for both) but not the control group (P = 0.229, P = 0.07 respectively). CONCLUSION The MMR service can significantly improve refugees' TRPs, adherence to therapy and knowledge of chronic medications. If this approach was extended to the large scale, many refugees in need would be able to access a quality essential health-care service; a step towards achieving universal health coverage. TRIAL REGISTRATION Registry: ClinicalTrials.gov Identifier: NCT04554810.
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Affiliation(s)
- Majdoleen Alalawneh
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Alberto Berardi
- Department of Pharmaceutical Sciences and Pharmaceutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Nabeel Nuaimi
- Department of Clinical Pharmacy, College of Pharmacy, AlNoor University College, Mosul, Iraq
| | - Iman A. Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Sciences Private University, Amman, Jordan
- School of Pharmacy, The University of Sydney, Sydney, Australia
- * E-mail:
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Basheti IA, Ayasrah SM, Ahmad MM, Abu-Snieneh HM, Abuadas FH. Medications adherence and associated factors among patients with stroke in the Kingdom of Saudi Arabia. Pharm Pract (Granada) 2022; 20:2736. [PMID: 36793903 PMCID: PMC9891775 DOI: 10.18549/pharmpract.2022.4.2736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022] Open
Abstract
Background Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients' adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients' adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient's details and medications was done via the patient's hospital file. Results The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients' adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. Conclusion Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in focusing the efforts to improve adherence and health outcomes for stroke patients in the future.
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Affiliation(s)
- Iman A Basheti
- Faculty of Pharmacy, Applied Science Private University, 11931, Amman, Jordan; Faculty of Pharmacy, The University of Sydney, 2006, Sydney, Australia.
| | - Shahnaz M Ayasrah
- PhD. Associate professor, Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt - Jordan.
| | - Muayyad M Ahmad
- PhD. Professor, Clinical Nursing Department, School of Nursing, University of Jordan, Amman 11942 - Jordan.
| | - Hana M Abu-Snieneh
- RN, PhD. Assistant professor, Faculty of Nursing/ The University of Jordan/ Aqaba Campus Aqaba- Jordan. ;
| | - Fuad H Abuadas
- Assistant professor, College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, 72388, Saudi Arabia.
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A systematic review of effective strategies for chronic disease management in humanitarian settings; opportunities and challenges. Prev Med 2022; 161:107154. [PMID: 35817161 DOI: 10.1016/j.ypmed.2022.107154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022]
Abstract
Large number of people with non-communicable diseases (NCDs) face barriers to adequate healthcare in humanitarian settings. We conducted a systematic literature review in MEDLINE/PubMed, Web of Science, EMBASE/DARE, Cochrane, and grey literature from 1990 to 2021 to evaluate effective strategies in addressing NCDs (diabetes, cardiovascular diseases, COPD, cancer) in humanitarian settings. From 2793 articles, 2652 were eliminated through title/abstract screening; 141 articles were reviewed in full; 93 were eliminated for not meeting full criteria. Remaining 48 articles were reviewed qualitatively to assess populations, settings, interventions, outcome, and efficacy and effectiveness; 38 studies addressed treatments, 9 prevention, and 7 epidemiology. Prevention studies broadly addressed capacity-building. Treatment and epidemiology studies largely addressed hypertension and diabetes. Interventions included web-based/mobile health strategies, pharmacy-level interventions, portable imaging, and capacity building including physical clinics, staff training, forging collaborations, guideline development, point-of-care labs, health promotion activities, EMR, and monitoring interventions. Collaboration between academia and implementing agencies was limited. Models of care were largely not well-described and varied between studies due to contextual constraints. Barriers to interventions included financial, logistical, organizational, sociocultural, and security. Cancer care is significantly understudied. Simplified care models adapted to contexts and program evaluations of implemented strategies could address gaps in applied research. Inherent challenges in humanitarian settings pose unavoidable perils to evidence generation which requires a shift in research mindset to match aspirations with practicality, research collaborations at the inception of projects, reworking of desired conventional level of research evidence considering resource-intense constraints (HR, time, cost), and adapted research tools, methods, and procedures.
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Bajis D, Daifi M, Amin MEK. Pharmacy-related research for health in the Arab region: An analysis informed by WHO's global strategy on research for health. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100099. [PMID: 35478511 PMCID: PMC9032015 DOI: 10.1016/j.rcsop.2021.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/27/2022] Open
Abstract
In 2012, WHO (the World Health Organisation) published a strategy on research for health based on the premise that policies and practices in support of health worldwide should be grounded in the best scientific knowledge derived from high-quality research. This strategy focuses attention on five interrelated goals: organisation, capacity, priorities, standards, and translation.1 Whilst knowledge production and publication in many Arab countries have been on the rise, the overall global share of the Arab region in health research publication is smaller than its global share of population or wealth.2 Inspired by the five WHO goals on research for health, this commentary shares factors and recommendations for consideration to enhance pharmacy-related research in the Arab region. These recommendations include establishing strategies for pharmacy-related research to address the context and local needs of the host country, creating intranational and intraregional collaborative research avenues, investing in research capacity, and fostering a culture of research in the workplace.
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Affiliation(s)
- Dalia Bajis
- International Pharmaceutical Federation, Andries Bickerweg 5, 2517 JP, The Hague, the Netherlands
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW 2006, Australia
- Corresponding author at: International Pharmaceutical Federation, Andries Bickerweg 5, 2517 JP, The Hague, the Netherlands.
| | - Magda Daifi
- Mohamed Al Mana College for Medical Sciences, Pharmacy Department, Dammam, Saudi Arabia
| | - Mohamed Ezzat Khamis Amin
- Beirut Arab University, Faculty of Pharmacy, P.O. Box: 11 5020, Beirut, Lebanon
- AlAlamein International University Faculty of Pharmacy, AlAlamein City Main Road, Matrouh, Egypt
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Abu-Farha R, Alzoubi KH, Rizik M, Karout S, Itani R, Mukattash T, Alefishat E. Public Perceptions About Home Delivery of Medication Service and Factors Associated with the Utilization of This Service. Patient Prefer Adherence 2022; 16:2259-2269. [PMID: 36034332 PMCID: PMC9416318 DOI: 10.2147/ppa.s377558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/26/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Home medication delivery service is a major service for the public. It reduces overcrowding and unnecessary visits to health centers. This study aims to investigate the public perception of home delivery of medication service in Jordan and evaluate factors affecting the use of this service. METHODS The study was conducted in March 2022 using an online survey. Participants were asked to fill out a validated questionnaire to evaluate their perception of home delivery of medication service. RESULTS Among the 1032 adult participated in this study, the majority reported that they had heard of home delivery of medication service (n = 832, 80.6%). However, only 30.9% of them have used this service before. Results showed that 71.4% of the participants (n = 737) believe that home delivery of medication service is more convenient and accessible than in-store drug refill. In addition, 65.6% of the participants (n = 677) believed that home delivery of medication service is suitable only for refill-prescription drugs (65.0%). The main pros of the service as perceived by the study participants were to serve sick patients, elderly, and disabled people (n = 822, 79.7%). In contrast, the inability of patients to build a professional relationship with pharmacists using home delivery of medications service was the most perceived con of this service (n = 627, 60.8%). Finally, regression analysis revealed that older participants, those with chronic diseases, and those who visit community pharmacies two times or more per month revealed higher use of the service (P = <0.05). CONCLUSION This study has shown that most participants showed positive perceptions toward the home delivery of medication services. However, participants believed that this service may decrease pharmacist's patient contact time, thus affecting the quality of medication counseling. More comprehensive future studies are necessary to examine the financial aspects of such a service and its associated drawbacks.
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Affiliation(s)
- Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Mai Rizik
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Samar Karout
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Rania Itani
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Tareq Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
- Correspondence: Eman Alefishat, Email
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Abu Farha R, Elayeh E, Zalloum N, Mukattash T, Alefishat E, Suyagh M, Basheti I. Perception of pharmacy students towards their community pharmacy training experience: a cross-sectional study from Jordan. BMC MEDICAL EDUCATION 2021; 21:161. [PMID: 33731106 PMCID: PMC7967969 DOI: 10.1186/s12909-021-02596-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The fact that pharmacists are in the front line of patients' care gives a great responsibility to focus on education and training of pharmacy students to build a 'patient-centered' clinicians. Unfortunately, pharmacy education in the developing countries, have been lagging behind actual practice delivered by pharmacists. This highlighted the need to evaluate the perceptions of undergraduate pharmacy students regarding their current pharmacy training practices and experiences. METHODS This is a cross-sectional study that was conducted in Jordan during the period from August 2018 to October 2018. During the study period, a questionnaire was distributed to pharmacy students to collect information regarding 1) pharmaceutical care services provided by them during their experiential training, 2) their perceptions towards training sites, 3) their perceptions of the outcomes of their training experience, 4) information about their training site and 5) their demographics characteristics. RESULTS A total of 202 pharmacy students responded to the questionnaire. The majority of them reported having the opportunity to dispense refill or new prescriptions (73.8%, n = 149), and conduct patient interviews (69.8%, n = 141, but they were not provided good opportunities to create electronic patient profiles using the information obtained (53.0%, n = 107), perform required dose calculations based on patient information (37.6%, n = 76), and interact with other healthcare professionals (34.6%, n = 70). In addition, students showed positive attitudes toward training sites, positive feedback about the outcomes of their training experience (median scores range between 4 and 5 for all statements (IQR = 1 for all)). CONCLUSION Students showed positive feedback about the outcomes of their training experience, but they felt that the selected training sites do not have adequate resources to meet their training competencies. Memorandums of understanding development is needed to specify the purpose of training and define the responsibility for both parties of the training process.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, P.O. 11931, Amman, Jordan
| | - Eman Elayeh
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Needa Zalloum
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Tareq Mukattash
- Department Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Alefishat
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, P O Box 127788, Abu Dhabi, United Arab Emirates.
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
| | - Maysa Suyagh
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Iman Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, P.O. 11931, Amman, Jordan
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Basheti IA, Mhaidat NM, Alqudah R, Nassar R, Othman B, Mukattash TL. Primary health care policy and vision for community pharmacy and pharmacists in Jordan. Pharm Pract (Granada) 2020; 18:2184. [PMID: 33343774 PMCID: PMC7732212 DOI: 10.18549/pharmpract.2020.4.2184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Jordan is considered a low middle-income country with a population of 9.956 million in 2018. It is considered the training center for healthcare professions in the region, as the Jordanian healthcare sector has seen remarkable development. In 2017, the expenditure on health as a percentage of Gross Domestic Product (GDP) was estimated to be around 8%. The healthcare sector is divided into two main sectors; the public and the private sector with both including hospitals, primary care clinics and pharmacies. The Jordanian government has a strong commitment to health and educational programs; hence, an increase in the number of pharmacy schools and pharmacy graduates has occurred in the past few years. Health authorities, such as the Jordan Food and Drug Association (JFDA) and the Jordan Pharmaceutical Association (JPA) have played an important role in ensuring the availability and affordability of medications, and has influenced the practice of pharmacists. Protecting the pharmaceutical market and professional interests, preserving pharmacists’ rights, building needed cooperation with the internal federation, and maintaining professional ethics are some of the objectives for the JPA. Hence, the integration of community pharmacists into the primary healthcare system is considered vital to the different health authorities in Jordan, emphasizing the fact that community pharmacists are the most trusted, accessible, and affordable healthcare providers in the country. There have been many developments in the pharmacy practice in the past recent years, including the establishment of ‘Good Pharmacy Practice’, new curricular development based on the international accreditation (the ACPE), a new immunization program, and health services research aimed to save patients’ lives, influence expenses, and improve patients’ quality of life. Although these developments in pharmacy practice are promising, challenges continue to exist, specifically the establishment of an evidence base for pharmaceutical care services such as the medication management review service.
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Affiliation(s)
- Iman A Basheti
- PhD. Professor in Clinical Pharmacy. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Sciences Private University. Amman (Jordan).
| | - Nizar M Mhaidat
- PhD. Director of Jordan Food and Drug administration. Professor in Oncology, Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. Irbid (Jordan).
| | - Rajaa Alqudah
- MSc. Clinical Lecturer, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Sciences Private University. Amman (Jordan).
| | - Razan Nassar
- MSc. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
| | - Bayan Othman
- MSc. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
| | - Tareq L Mukattash
- PhD. Professor in Clinical Pharmacy, Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. Amman (Jordan).
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AbuNaba'a Y, Basheti IA. Assessing the impact of medication management review service for females diagnosed with depression and anxiety: A randomized control trial. J Eval Clin Pract 2020; 26:1478-1489. [PMID: 31692212 DOI: 10.1111/jep.13314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 01/02/2023]
Abstract
Rationale, aims, and objectives Depression and anxiety are common mental illnesses suffered by females worldwide. Females face treatment-related problems (TRPs), including lack of adherence to their treatment. The Medication Management Review service (MMR) can be effective in identifying and resolving the TRPs. This study sought to assess the impact of the MMR service on identifying and resolving TRPs, improving adherence, depression, and anxiety scores in females diagnosed with depression and anxiety in Jordan. Design and settings Participants were recruited into this single-blind parallel randomized controlled trial and randomized into active and control groups. A clinical pharmacist identified TRPs for all participants. Adherence, depression, and anxiety scores were assessed. Active group patients received the MMR service: pharmacist-delivered counseling and a letter with recommended changes in the patient's treatment plan were sent to the patient's psychiatrist to be applied. Control group participants did not receive the intervention. Follow-up assessments were completed for all patients at 3 months from baseline. Main outcome measures were TRPs, adherence, depression, and anxiety scores. RESULTS: Study participants (n = 73; mean age = 41.8 [SD = 16.27]) had 177 TRPs identified, with 2.42(SD = 1.06) TRPs per patient. At baseline, only 54.8% of the participants reported to be adherent to their treatment, and no significant differences were found between the groups. At follow-up, a significant decline in the number of TRPs was found for the active versus control group (active: 0.58[SD = 0.64], control: 1.78[SD = 1.13], P < .001). A significantly higher proportion of adherent patients was identified in the active (88.9%) versus control group (51.4%), P < .001. Significant improvements in the depression (P < .001) and anxiety (P = .003) scores were detected for the active versus control group. CONCLUSION: The MMR service led to a significant decrease in the number of TRPs, improved adherence, depression, and anxiety scores for females diagnosed with depression and anxiety.
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Affiliation(s)
- Yasmeen AbuNaba'a
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Iman A Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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13
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Alawneh MA, Nuaimi N, Abu-Gharbieh E, Basheti IA. A randomized control trial assessing the effect of a pharmaceutical care service on Syrian refugees' quality of life and anxiety. Pharm Pract (Granada) 2020; 18:1744. [PMID: 32256897 PMCID: PMC7104796 DOI: 10.18549/pharmpract.2020.1.1744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/08/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Syrian refugees residing in Jordan suffer from chronic illnesses, low quality
of life (QoL) and anxiety. Pharmacists delivering the medication review
service can have a role in improving this growing worldwide problem. Objectives: To assess the effect of the medication review service on QoL and anxiety
scores for Syrian refugees living with chronic medical conditions. Methods: This randomized single-blinded intervention control study was conducted in
Jordan. Syrian refugees were recruited and randomized into intervention and
control groups. Two home visits were organized with each participant, at
baseline and three months later. The medication review service was delivered
to the participants and questionnaires regarding QoL and anxiety were
completed by all participants. As a part of the medication review service,
drug-related problems (DRPs) were identified by a clinical pharmacist for
all patients, but recommendations to resolve these DRPs were delivered to
intervention group refugees’ physicians only (control group patients
did not receive this part of the service till the end of the study); DRPs
were corrected and pharmacist-delivered counseling and education were
provided as well. At follow-up, DRPs assessment, QoL and anxiety scores were
assessed for refugees in the intervention and control groups. Results: Syrian refugees (n=106) were recruited and randomized into intervention
(n=53) and control (n=53) groups with no significant difference between both
groups at baseline. The number of medications and diagnosed chronic diseases
per participant was 5.8 (SD 2.1) and 2.97 (SD 1.16), respectively. At
follow-up, a significant decrease in the number of DRPs for refugees in the
intervention group was found (from 600 to 182, p<0.001), but not for
the control group (number stayed at 541 DRPs, p=0.116). Although no
significant difference between the groups was found with regards to QoL at
follow-up (p=0.266), a significant difference was found in the anxiety
scores between the groups (p<0.001). Conclusion: The medication review service delivered by clinical pharmacists can
significantly improve refugees’ DRPs and anxiety scores. As for QoL,
significant improvements can be seen for all refugee patients, regardless of
whether the DRPs identified were resolved or not.
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Affiliation(s)
- Majdoleen Al Alawneh
- MSc. Graduate Teaching Research Assistant. College of Pharmacy, QU Health, Qatar University. Doha (Qatar).
| | - Nabeel Nuaimi
- PhD. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
| | - Eman Abu-Gharbieh
- PhD. Associate Professor. College of Medicine, University of Sharjah. Sharjah (United Arab Emirates).
| | - Iman A Basheti
- PhD. Professor. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
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14
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Basheti IA, Ayasrah SM, Basheti MM, Mahfuz J, Chaar B. The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorder. Pharm Pract (Granada) 2019; 17:1475. [PMID: 31592018 PMCID: PMC6763294 DOI: 10.18549/pharmpract.2019.3.1475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/28/2019] [Indexed: 12/28/2022] Open
Abstract
Background: The United Nations has declared the Syrian crisis as the worst humanitarian
crisis of the twenty-first century. Pharmacists play a vital role in
humanitarian aid and in delivering health advices for refugees. Many Syrian
refugees are in need of psychosocial assessments. Objective: Objective of this study was to investigate the prevalence of post-traumatic
stress disorder (PTSD), assessed by pharmacists among Syrian civilian
refugees residing in Amman, Jordan. Methods: A cross-sectional study involving Syrian civilian refugees living in Amman,
Jordan, was conducted using the published and validated Arabic version of
the Harvard Trauma Questionnaire (HTQ). Pharmacists recruited civilian
Syrian refugees and completed the HTQ. The questionnaire included 45
questions, with the first 16 questions (HTQ-16) intended to assess the
trauma symptoms felt by refugees. Assessments were done by the pharmacists
and refugees were categorized to suffer PTSD if their mean item score for
the HTQ-16 scale was > 2.5. Results: Study participants (n=186; mean age 31.5 years; 51.3% males) had a
HTQ-16 mean score of 2.35 (SD=0.53), with a range of 1.19 - 3.63. Over a
third of participants (38.7%) were categorized as having PTSD. Males
reported significantly worse PTSD symptoms (mean=2.42, SD=0.50) compared to
females (mean=2.26, SD=0.57). Correlation between the mean item score for
the HTQ-16 and characteristics of the study participants showed higher mean
item score correlated with being a male, older in age, a smoker, and if
trauma was experienced. Conclusions: Many Syrian civilian refugees living in Jordan suffer from PTSD. Male
participants were found to be more affected by the severity of the disorder.
Pharmacists are suitably situated to identify civilian Syrian refugees
suffering from PTSD in dire need of help, paving the way for much needed
healthcare resources to be delivered to this particular group of
refugees.
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Affiliation(s)
- Iman A Basheti
- Professor in Clinical Pharmacy. Department of Clinical Pharmacy, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
| | - Shahnaz M Ayasrah
- Department of Applied Science/Nursing, Al-Balqa Applied University a. Al-Salt (Jordan).
| | - Mariam M Basheti
- Faculty of Pharmacy, Jordan University of Science and Technology. Irbid (Jordan).
| | - Judeh Mahfuz
- Professor in human resource management. Applied Science Private University. Amman (Jordan).
| | - Betty Chaar
- Associate Professor in pharmacy practice. School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW a (Australia).
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Basheti IA, Ayasrah SM, Ahmad M. Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study. Saudi Pharm J 2018; 27:208-219. [PMID: 30766431 PMCID: PMC6362176 DOI: 10.1016/j.jsps.2018.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/16/2018] [Indexed: 11/03/2022] Open
Abstract
Background Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. Objectives To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored. Methods This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient's factors were explored through multiple regression analysis.Key findings:Out of 198 stroke patients (mean age: 56.6 ± 14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ± 1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life. Conclusion Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.
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Affiliation(s)
- Iman A Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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