Ophthalmic drops abuse in community pharmacy setting: A cross-sectional study from Jordan

Cutting-edge HPLC and MCR techniques for synchronically quantifying anticholinergic drugs in the presence of C12 and C14 homologs: Robust application to green and white chemistry

Green and white chemistry are vital to revolutionizing the chemical industry through their unparalleled potential to enhance sustainability and efficiency. In this study, nine sustainability tools of both green and white metrics, including green analytical procedure index (GAPI), ComplexGAPI, analytical greenness, analytical greenness metric for sample preparation, Analytical Eco-Scale (ESA), analytical method greenness score, high-performance liquid chromatography- environmental assessment tool (HPLC-EAT), analytical method volume intensity, and blue applicability grade index (BAGI), have been developed for appraising environmental friendliness for both innovative and straightforward mean centering of ratio spectra (MCR) and reversed-phase high-performance liquid chromatography (RP-HPLC) strategies utilized for concurrent analysis and separation of cyclopentolate (CYC) and C12 and C14 homologs of benzalkonium chloride (BNZ) in pure and ophthalmic solution. The mobile phase, formed of buffer phosphate and acetonitrile (35:65, v/v), was adjusted to pH 6.3, and 215-nm UV detection was used. The experimental flow rate was 2.0 mL min-1, and the analytical column was L11 Inertsil Ph-3 (150 mm × 4.6 mm, 5 µm). All sequences were run at 25°C in the column oven. The MCR approach effectively resolved the drug's spectral overlapping. CYC and BNZ employed this approach at 227.5 and 220.4 nm, respectively. As part of the HPLC analysis, an isocratic method was employed with phosphate buffer and acetonitrile in the mobile phase at 35:65. A correlation coefficient greater than 0.999 was observed between the calibration curves for the HPLC and MCR methods in the ranges of 20-320 µg mL-1 and 5-30 µg mL-1 for all drugs. The technique yields excellent primary recovery rates, ranging from 97.2% to 100.5%. The recommended approach has been validated according to International Council for Harmonization guidelines.

Assessment of A new Strategy to Prevent Prescribing Errors Involving COVID-19 Patients in Community Pharmacies

Background: Because COVID-19 patients are vulnerable to prescribing errors (PEs) and adverse drug events, designing and implementing a new approach to prevent prescribing errors (PEs) involving COVID-19 patients has become a priority in pharmacotherapy research. Objectives: To investigate whether using WhatsApp to deliver prescribing error (PE)-related clinical scenarios to community pharmacists could enhance their ability to detect PEs and conduct successful pharmaceutical interventions (PIs). Methods: In this study, 110 community pharmacies were recruited from different regions across Jordan and equally allocated to 2 groups. Over the course of 4 weeks, WhatsApp was used to send PEs-related clinical case scenarios to the active group. The second group was controlled with no clinical scenarios. After completion of the 4-week phase, pharmacists from both groups were asked to document PEs in COVID-19 patients and their interventions using a data-collection form. Results: The incidence of PEs in COVID-19 patients documented in the active group (18.54%) was higher than that reported in the control group (3.09%) (P = .001). Of the 6598 and 968 PIs conducted by participants working in the active and control group pharmacies, 6013 (91.13%) and 651 (67.25%) were accepted, respectively. The proportions of wrong drug (contraindication), wrong drug (unnecessary drug prescribed/no proof of its benefits), and omission of a drug between the active and control groups were 15.30% versus 7.21% (P = .001), 11.85% versus 6.29% (P = .03), and 17.78% versus 10.50% (0.01), respectively. Additionally, the proportions of lethal, serious, and significant errors were 0.74% versus 0.35% (P = .04), 10.52% versus 2.57% (0.002), and 47.88% versus 9.57% (0.001), respectively. Addition of drug therapy interventions (AOR = 0.62; 95% CI, 0.21-0.84) and errors with significant clinical seriousness (AOR = 0.32; 95% CI, 0.16-0.64). Conclusions PEs involving COVID-19 patients in community settings are common and clinically significant. The intervention assessed in this study could be promising for designing a feasible and time-efficient interventional tool to encourage pharmacists' involvement in identifying and correcting PEs in light of COVID-19.

Patterns of Substance Use among Patients in Addiction Rehabilitation in Jordan

Background: This study aimed to identify pattern of substance use among patients at two public addiction rehabilitation centers in Amman. It provided a description of substance use career and assessment of addiction severity, quality of life and quality of sleep among participants.Methods: A quantitative cross-sectional study using a structured data collection form consisting of 4 parts: 1. General data including the demographic characteristics, medical history and career of drug abuse. 2. Severity of addiction using the severity of dependence scale (SDS). 3. Quality of life measured by the EQ-5D and 4. Quality of sleep measured by the insomnia severity index (ISI) scale.Results: A total of 93 patients from 2 treatment settings were recruited over 5 months. The total number of actively used substances was 196, with an average of 2 substances per patient. Alcohol and synthetic cannabinoids were the two most commonly used substances (39.8% and 38.7% respectively) followed by benzodiazepines (33.4%). A notable drop in heroin use was observed (5.4%, 5 out of 23 opioid user) compared to the years 2007-2009. The mean SDS score among patients was 11.43 (SD ± 3.48) indicating high dependence. Sleep problems were reported by 45% of patients. Data showed a significant role of community pharmacies in supplying drugs of abuse for users.Conclusion: Pattern of substance use changed significantly in Jordan with synthetic cannabinoids being of the top substances used and heroin use dropping. Actions should be taken to reframe the legalization of dispensing certain drugs by pharmacists without a prescription.

Evaluation of antibiotic dispensing practice in community pharmacies in Jordan: A cross sectional study

It is well known that the emergence of antibiotic resistance is linked to the misuse and overuse of antibiotics. Misuse includes self-medication and the inappropriate use of antibiotics because of improper dosage or improper duration than recommended. This study investigated three patterns of dispensing antibiotics in a sample of community pharmacies in Jordan. This included dispensing antibiotics by prescription or over-the-counter either by direct request or upon a pharmacist’s recommendation. The antibiotics dispensed were evaluated in terms of indication, appropriateness of dose, and duration of treatment based on the empirical treatment suggested by selected references: Lexicomp (2017) and UptoDate (2017) and the manufacturer’s recommendations. Of the 457 antibiotics dispensed, almost one third were without prescription. Of the antibiotics dispensed with prescription or without prescription, 31.5% and 24.6% respectively were appropriate dosage and duration (p = 0.002). In the three patterns of dispensing, beta lactam antibiotics were the most commonly dispensed. In addition, it was noticed that there was a tendency to prescribe or dispense higher generations of antibiotics to cases that could have been treated with lower generation or safer antibiotics. Furthermore, 12.2% of the antibiotics were dispensed to treat infections that are not indicated for them. In conclusion, a significant proportion of antibiotics are dispensed without prescription in Jordan. Moreover, a considerable proportion of prescribed antibiotics were inappropriate for the conditions concerned. This indicates the importance of enforcing the Jordanian regulations prohibiting the dispensing of nonprescription antibiotics and the implementation of continuous education to physicians and pharmacists to increase awareness about the emergence of antibiotic resistance.