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Hamadouk RM, Alshareif EM, Ibrahim OM, Albashair ED, Yousef BA. The Extent of Antibiotic Dispensing in Self-Medication Encounters in Sudan: A Simulated Patient Study Focusing on Cefixime Sale. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2023; 12:227-237. [PMID: 38033381 PMCID: PMC10683652 DOI: 10.2147/iprp.s440010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
Background Antibiotics play an important role in decreasing morbidity and mortality worldwide. However, inappropriate use of them by patients or healthcare professionals contributes to their resistance rendering them less efficacious. Community pharmacists (CPs) have a significant part in reducing antibiotic resistance. Therefore, this study aimed to investigate the dispensing of antibiotics without prescription in community pharmacies with an emphasis on cefixime dispensing. Methods A cross-sectional, simulated patient (SP) study was conducted in the Khartoum locality. A total of 238 community pharmacies were randomly chosen using simple random sampling. One scenario of uncomplicated urinary tract infection was designed, and six female pharmacy students who were trained to act as SPs presented the scenario. Descriptive statistics were applied to report the study outcomes. Results In the 238 pharmacy visits, at least one antibiotic was dispensed without a prescription in 69.3% of the simulated visits. Among the dispensed antibiotics, ciprofloxacin was the most dispensed antibiotic followed by cefixime representing 51.5% and 41.8%, respectively, of total dispensed antibiotics. Cefixime was dispensed as a first choice by CPs in 29% of the visits, and in the rest of the visits, only 37.3% of CPs refused to dispense cefixime after SP demand. Conclusion The findings revealed a high rate of antibiotics dispensing without prescription by CPs in Khartoum state, and cefixime was obtained with ease before and after the patient's demand. Urgent corrective actions such as imposing strict regulations, monitoring pharmacists' practice, and endorsing educational programs for pharmacists are needed to prevent inappropriate antibiotic dispensing practices.
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Affiliation(s)
- Riham M Hamadouk
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Almughtaribeen University, Khartoum, Sudan
| | - Einass M Alshareif
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | | | - Esra D Albashair
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | - Bashir A Yousef
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
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2
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Yaacoub S, Zmeter C, Abou Abbas L, Leresche E, Kdouh O, Hammoud R, Leaning J, Hamadeh R, Truppa C. Has the COVID-19 pandemic changed the utilization and provision of essential health care services from 2019 to 2020 in the primary health care network in Lebanon? Results from a nationwide representative cross-sectional survey. PLoS One 2023; 18:e0288387. [PMID: 37440540 DOI: 10.1371/journal.pone.0288387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
There is limited research soliciting the patient and staff perspectives on the overall effects of COVID-19 on the utilization and provision of primary care in Lebanon. The present study was part of a larger study on the overall effect of COVID-19 on both utilization and provision of essential health care services within the Lebanese primary health care network (PHCN). Here, we present the patient and staff perspectives on continuity of service provision, adherence to infection prevention and control measures, and the role of the PHCN in epidemic preparedness and response. We conducted a cross-sectional survey between June and July 2021 among patients who had received a health care service in 2019 or 2020 from registered primary healthcare centers (PHCs) in the network and among the respective PHC staff working during the same period. A total of 763 patients and 198 staff completed the surveys. Services were reported as interrupted by 15% of the total patients who used services either in 2020 only or in both 2019 and 2020. Access to chronic (67%) and acute medications (40%) were reported as the main interrupted services. Immunization also emerged as a foregone service in 2020. Among the staff, one third (33%) reported interruptions in the provision of services. Financial barriers rather than fear of COVID-19 were reported as main reasons for interruption. Both groups considered that the facilities implemented adequate infection prevention and control measures. They perceived that the PHCN maintained some essential healthcare services and that it should have played a bigger role in the response to the pandemic. There was a continuity in utilization and provision of services in the PHCN that was higher than expected, with non-communicable diseases and immunizations suffering more than other services.
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Affiliation(s)
- Sally Yaacoub
- International Committee of the Red Cross, Lebanon Delegation, Beirut, Lebanon
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), Paris, France
| | - Carla Zmeter
- International Committee of the Red Cross, Lebanon Delegation, Beirut, Lebanon
| | - Linda Abou Abbas
- International Committee of the Red Cross, Lebanon Delegation, Beirut, Lebanon
| | - Enrica Leresche
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Ola Kdouh
- Global Health Team of Experts, Ministry of Public Health Lebanon, Baabda, Lebanon
| | - Rawan Hammoud
- Global Health Team of Experts, Ministry of Public Health Lebanon, Baabda, Lebanon
| | - Jennifer Leaning
- Harvard FXB Center for Health and Human Rights, Boston, MA, United States of America
| | - Randa Hamadeh
- Global Health Team of Experts, Ministry of Public Health Lebanon, Baabda, Lebanon
| | - Claudia Truppa
- International Committee of the Red Cross, Lebanon Delegation, Beirut, Lebanon
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
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3
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Haseeb A, Saleem Z, Maqadmi AF, Allehyani RA, Mahrous AJ, Elrggal ME, Kamran SH, AlGethamy M, Naji AS, AlQarni A, Alhariqi KW, Khan MA, Ibrahim K, Raees F, Azmat A, Cook A, Campbell SM, Lorenzetti G, Meyer JC, Godman B, Moore CE. Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications. Antibiotics (Basel) 2023; 12:827. [PMID: 37237730 PMCID: PMC10215537 DOI: 10.3390/antibiotics12050827] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/22/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception, with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals and assist with the subsequent implementation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate of 98.1%. Published studies ranged in size from a single to 18 hospitals. The most prescribed antibiotics were ceftriaxone, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakeholders, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East.
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Affiliation(s)
- Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Aseel Fayk Maqadmi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Roaa Abdulrahman Allehyani
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
- Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Ahmad J. Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Mahmoud E. Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Sairah Hafeez Kamran
- Institute of Pharmacy, Lahore College for Women University, Lahore 54000, Pakistan;
| | - Manal AlGethamy
- Department of Infection Prevention and Control Program, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia;
| | - Asem Saleh Naji
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Abdullmoin AlQarni
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Khalid W. Alhariqi
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | | | - Kiran Ibrahim
- Primary and Secondary Healthcare Department, DHQ Hospital Khushab, Khushab 41200, Pakistan;
| | - Fahad Raees
- Department of Medical Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aisha Azmat
- Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | - Stephen M. Campbell
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK;
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
| | - Giulia Lorenzetti
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
| | - Johanna C. Meyer
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
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Hatem G, Ghamloush S, Chami AA, Chaheen M, Khachman D, Awada S. Impact of the COVID-19 pandemic on pharmacy practice and on the provision of pharmaceutical care: A cross-sectional study among community pharmacists. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231161145. [PMID: 37025695 PMCID: PMC10067468 DOI: 10.1177/27550834231161145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/14/2023] [Indexed: 04/03/2023]
Abstract
Background: Community pharmacists played an essential role in the control and management of the COVID-19 pandemic; both pharmaceutical care and community pharmacists were affected, given that, patients’ needs and demands increased due to the fear of lockdowns and shortage of medication throughout the pandemic. Objectives: This study was based in Lebanon and aimed to assess the impact of the COVID-19 pandemic on (1) pharmacists, including infection rates, pay, and working hours, and (2) pharmacy practice, including medicine and personal protective equipment (PPE) shortages. Design: A cross-sectional study involving 120 community pharmacists was carried out between August and November 2021. Methods: Data were collected using an online survey filled out by pharmacists working in Lebanon. Results: Most participants (71.7%) reported an increase in their income during the pandemic, and 60% reduced their working hours. A significant association was noted between being previously infected and marital status, level of education, work position, and salary of the participants. Most participants (95.8%) encountered a shortage of medications during the pandemic leading to high home storage of medication, searching for other sources of medicines, and decreased patient/pharmacist interactions. Conclusion: The COVID-19 pandemic imposed new challenges on pharmacists and the provision of pharmaceutical care. It affected pharmacists’ daily routines, putting them at risk of infection with limited availability of medicines and PPE. This study suggests that establishing effective crisis management plans to increase community pharmacists’ resilience during similar outbreaks.
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Affiliation(s)
- Georges Hatem
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, University of
Porto, Porto, Portugal
- Georges Hatem, Faculty of Medicine,
University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Sara Ghamloush
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Aya Al Chami
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Mohammad Chaheen
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Dalia Khachman
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Sanaa Awada
- Clinical and Epidemiological Research
Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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5
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Bou-Saba AW, Kassak KM, Salameh PR. Public views of community pharmacy services during the COVID-19 pandemic: a national survey. J Pharm Policy Pract 2022; 15:76. [PMID: 36309706 DOI: 10.1186/s40545-022-00474-4] [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: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess public opinion about community pharmacy services in Lebanon during the COVID-19 pandemic. METHOD A cross-sectional study using an online questionnaire was conducted between April and August of 2021. A link was shared randomly among the Lebanese population using WhatsApp and Facebook. Public perceptions were explored within 3 different indicators: general services (B) dispensing (C), and storage (D). Chi-square, Student's test and ANOVA tests were used. p < 0.05 was considered statistically significant. RESULTS Out of 491 responses, only 9.6% scored above the 75th percentile (19.3% for the general services, 2.4% for dispensing indicator and 12.6% for storage indicator). The main concerns focused on lack of medication and reduced opening hours; however, 67.1% of respondents preferred consulting the community pharmacist instead of visiting primary health care centers, doctor's private clinic and hospitals. Higher mean values of indicators B, C and in the overall indicator were significantly found in the presence of a pharmacist compared to the support pharmacy workforce. CONCLUSION The overall public perception was inadequate. Significant difference in terms of quality of services was detected in the presence and absence of a community pharmacist during the crisis. It is recommended that the Order of Pharmacist of Lebanon (OPL) and the Ministry of Public Health (MOPH) undergo further steps mainly to enforce the laws concerning dispensing and storage indicators, improve the services in terms of extending the opening hours, ensure the availability of medicines and increase public awareness.
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Affiliation(s)
- Alein W Bou-Saba
- Doctoral School of Science and Technology, Lebanese University, Hadat, Lebanon. .,Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Kassem M Kassak
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Pascale R Salameh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,Epidémiologie Clinique et Toxicologie, Liban (INSPECT-LB), Institut National de Santé Publique, Beirut, Lebanon.,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.,School of Medicine, Lebanese American University, Byblos, Lebanon
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6
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de Souza EV, Vieira LJSC, dos Santos SNP, Cerqueira-Santos S, Rocha KSS, de Lyra DP. Antimicrobial dispensing process in community pharmacies: a scoping review. Antimicrob Resist Infect Control 2022; 11:116. [PMID: 36116000 PMCID: PMC9482305 DOI: 10.1186/s13756-022-01157-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background Antimicrobial resistance remains a major global public health concern, and antimicrobial dispensing in community pharmacies is an important factor in preventing this damage. However, the current literature focuses on the technical and attitudinal aspects related to antimicrobial dispensing, with little emphasis on the interventions provided in this service. Thus, this study aimed to determine the antimicrobial dispensing process in community pharmacies. Methods A scoping review was performed in September 2020 using the PubMed, EMBASE, LILACS, Web of Science, and Cochrane databases. The search terms included words related to dispensing, antibacterial agents, and pharmacies in various combinations. Two reviewers screened the titles, abstracts, and full-text articles according to the eligibility criteria, and extracted the data. The findings were presented in a descriptive form. Results Of the 7713 studies screened, 35 were included, of which 22 (63%) were published in Asia. Most studies followed a cross-sectional design (n = 27), and the simulated patient was the most often used method to assess the antimicrobial dispensing process (n = 22). Moreover, 31 (89%) studies investigated antimicrobial dispensing without prescription, and only four (11%) studies evaluated antimicrobial dispensing with prescription. In the 35 studies, the most frequently asked questions were about drug allergies (n = 19) and patient symptoms (n = 18), and counseling mainly focused on the side effects (n = 14), precautions (n = 14), how to take the medication (n = 12), and duration of medication use (n = 11). Another common intervention was referral (n = 15). Among clinical cases, counseling on medication use occurred often in cases of urinary tract infection (51%) and otitis media (50%). Conclusions Antimicrobial dispensing processes have been primarily investigated in low- and middle-income countries, with a focus on dispensing antimicrobials without prescriptions. During the dispensing process, pharmacists mostly posed minimal questions and counseling, highlighting the deficiencies that persist in this practice. Our results indicate the need for multifaceted strategies, such as implementing educational, regulatory or administrative strategies and changes in cultural background, especially in low- and middle-income countries, that aim to reduce indiscriminate use of antimicrobials. Therefore, qualifying the antimicrobial dispensing process is a fundamental factor for improving the rational use of antimicrobials and reducing microbial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01157-0.
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Boura F, Al-Tabakha M, Hassan N, Darwich M. Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review. Pharm Pract (Granada) 2022; 20:2701. [PMID: 36733522 PMCID: PMC9851829 DOI: 10.18549/pharmpract.2022.3.2701] [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] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
Background The use of simulated patient (SP) methodology in pharmacy practice settings has increased recently. However, its applications can vary significantly within a region, hence affecting the quality of the SP methodology. Objective The purpose of this systematic review is to critically assess the use of the SP methodology for assessing the practice of community pharmacists (CP) in the Middle East and North Africa (MENA) region. Methods A comprehensive literature search was conducted using EMBASE, MEDLINE, ProQuest, and SCOPUS to identify articles published from 2011 to 2022. The selection of relevant studies for inclusion in the systematic review was based on the pre-determined inclusion criteria. The Mixed Method Appraisal Tool (MMAT) was used to assess the methodological quality of the included studies. Results Electronic search yielded 478 publications. A total of 45 studies were reviewed. The studies were conducted in 12 countries of the MENA region. The sample size between the reviewed articles ranged from 20 to 1000 (median= 129). A greater number of the included studies measured the adequacy of skill (pre-dispensing and/or post-dispensing) 38 (84.4%). The vast majority of the studies reported unsatisfactory results regarding the competencies of CP. The number of the SP ranged from 1 to 37 (median= 2). Most of the studies recruited only one SP per pharmacy 35 (77.8%). The most common data collection method was written data collection form 42 (93.3%). Few studies only had a detection system for SP visits 11 (24.4%), and only six studies incorporated performance feedback (13.3%). More than two-thirds of the studies provided a training session for SP 37 (82.2%). There was variation in the symptoms and drugs used in the SP scenarios in the studies. Conclusion Although the results demonstrate the growth in the use of the SP method in MENA region countries, studies showed high variability in the level of reporting the study methodology. Consequently, we argue the need for standardized reporting of these studies.
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Affiliation(s)
- Fatima Boura
- BSc, MSc. Department of Clinical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Moawia Al-Tabakha
- BPharm, PhD. Department of Pharmaceutical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Nageeb Hassan
- MBBS., MSc, PhD. Department of Clinical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Mohamad Darwich
- MD, MRCPH. Department of pediatrics. Medcare Hospital, Sharjah, United Arab Emirates.
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Sabra R, Safwan J, Dabbous M, Rida A, Malaeb D, Akel M, Sakr F. Assessment of knowledge, attitude and practice of Lebanese pharmacists in providing patient counseling on urinary tract infection and its treatment. Pharm Pract (Granada) 2022; 20:2653. [PMID: 35919798 PMCID: PMC9296090 DOI: 10.18549/pharmpract.2022.2.2653] [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: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
Background Urinary tract infection (UTI) is the second most common type of infections, accounting for about 7 million annual visits to health-care providers. Pharmacists have an important role in counseling patients about this disease. Objectives The study explored the Lebanese pharmacists' knowledge, attitudes and counseling practices (KAP) around UTI. The aim was to provide a better understanding on the pharmacist role in this context, and improve the patient care process and the health of the public. Methods A cross-sectional knowledge attitudes practice study was conducted and enrolled pharmacists who were practicing in the community setting. The questionnaire collected data about the sociodemographic characteristics, pharmacist's knowledge about UTIs, their attitudes and practice in providing patient counseling. Results A sample of 450 pharmacists was reached, the majority (>90%) of which had good knowledge about UTIs. Moreover, greater than 90% of pharmacists believe that UTIs are serious, and that being unhygienic is one of its causes (93.6%). The majority reported educating patients about the most common causes (90.4%), risk factors (88.4%) and preventive measures (95.1%) of UTIs. A mean score of 8.44 was reported for the knowledge score and multivariable linear regression has shown that female pharmacists have higher knowledge score than males. A significant association between having a PhD degree and believing that men are more prone to UTI. Furthermore, the province of the pharmacists' practice, being in Beirut, was positively and significantly correlated with better practice. Conclusions Lebanese pharmacists are well knowledgeable about UTIs and showed good attitude and practice in this field. This study provides insight for discussion with policy makers to upgrade legislation to enable pharmacists to legally prescribe antibiotics for uncomplicated UTIs, similar to other countries, to improve the patient care process and minimize the burden of the disease.
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Affiliation(s)
- Riham Sabra
- RPh, PharmD. Clinical Pharmacist, MSc. Lebanese International University, School of Pharmacy, Beirut, Lebanon.
| | - Jihan Safwan
- RPh, PharmD. Clinical Associate Professor and Assistant Dean, Lebanese International University, School of Pharmacy, Beirut, Lebanon.
| | - Mariam Dabbous
- RPh, PharmD. Clinical Associate Professor and Chairperson Pharmacy Practice Department, Lebanese International University, School of Pharmacy, Beirut, Lebanon.
| | - Ahmad Rida
- RPh, MSc. Clinical Pharmacist, Lebanese International University, School of Pharmacy, Beirut, Lebanon, University of Strasbourg, Institute of Molecular and Cell Biology, CNRS UPR9002, Strasbourg, France.
| | - Diana Malaeb
- RPh, PharmD, MSc, PhD. Clinical Associate Professor, Lebanese International University, School of Pharmacy, Beirut, Lebanon, INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon, Gulf Medical University, College of Pharmacy, Ajman, United Arab Emirates.
| | - Marwan Akel
- RPh, PharmD, MPH, PhD. Clinical Associate Professor, Lebanese International University, School of Pharmacy, Beirut, Lebanon, INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon, International Pharmaceutical Federation, The Netherlands.
| | - Fouad Sakr
- RPh, PharmD, MPH. Clinical Associate Professor, Lebanese International University, School of Pharmacy, Beirut, Lebanon, Université Paris-Est Créteil, Institut Mondor de Recherche Biomédicale, INSERM U955, Créteil, France.
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9
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Li L, Yang M, Zhu WC, Liu XJ, Peng XX, Li H. Functionally ampicillin-stressed proteomics reveals that AdhE regulates alcohol metabolism for antibiotic resistance in Escherichia coli. Process Biochem 2021. [DOI: 10.1016/j.procbio.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Al-Tannir M, Altannir Y, Altannir M, AlFayyad I. Community pharmacy sales of non-prescribed antibiotics in Riyadh, Saudi Arabia: a simulated patient study. Int J Clin Pharm 2020; 42:341-346. [PMID: 32301067 DOI: 10.1007/s11096-020-01033-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 04/08/2020] [Indexed: 01/30/2023]
Abstract
Background The increased dispensing of non-prescribed antibiotics increases the public health problem of antimicrobial resistance. In April 2018, the Saudi Ministry of Health reinforced the disciplinary regulations of banning pharmacies from selling antibiotics without a medical prescription. Objective To assess the rate of non-prescribed antibiotic sales by community pharmacies and compare it with the findings from our 2011 study. Setting Community pharmacies, Riyadh City, Saudi Arabia. Methods A cross-sectional, simulated patient study was conducted between August and November 2018. Six simulated clinical scenarios were presented at stratified samples of community pharmacies. Main outcome measure The primary study outcome was the proportion of community pharmacies dispensing non-prescribed antibiotics. Results Of 327 pharmacies, 41 (12.5%) dispensed antibiotics without a prescription upon explicit request for antibiotics. Antibiotics sales decreased significantly in 2018 compared to 2011 (77.6%), (p value < 0.05) after the implementation of disciplinary regulations. Only 6.25% of pharmacists enquired about drug allergies, pregnancy status (urinary tract infection scenario), and drug-drug interactions. Conclusion Given the recent implementation of disciplinary regulations, the findings of this study demonstrate a significant decline in the proportion of pharmacies dispensing non-prescribed antibiotics. Measures to augment the enforcement of regulations and to ensure community pharmacy adherence and compliance are warranted.
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Affiliation(s)
- Mohamad Al-Tannir
- Research Center, King Fahad Medical City, Kingdom of Saudi Arabia, P.O. Box. 59046, Riyadh, 11525, Saudi Arabia.
| | - Youssef Altannir
- College of Medicine, Alfaisal University, Takhasusi Road, P.O. Box 50927, Riyadh, 11533, Saudi Arabia
| | - Mustafa Altannir
- College of Medicine, Alfaisal University, Takhasusi Road, P.O. Box 50927, Riyadh, 11533, Saudi Arabia
| | - Isamme AlFayyad
- Research Center, King Fahad Medical City, Kingdom of Saudi Arabia, P.O. Box. 59046, Riyadh, 11525, Saudi Arabia
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Yaacoub SG, Koyess V, Lahoud N, Rahme D, Francis N, Saleh N, Maison P. Antibiotic prescribing for acute uncomplicated cystitis in Lebanese community pharmacies using a simulated patient. Pharm Pract (Granada) 2019; 17:1604. [PMID: 31897255 PMCID: PMC6935547 DOI: 10.18549/pharmpract.2019.4.1604] [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: 06/26/2019] [Accepted: 11/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Urinary tract infections are considered as one of the most frequent bacterial infections in the community and hospital settings. In this era of increasing antimicrobial resistance, antimicrobial stewardship has become highly important in the struggle to preserve the effectiveness of available drugs. One the main causes of antibiotic resistance is the inappropriate prescribing of antibiotics; which evidence show that community pharmacists contribute to. OBJECTIVE This study aims to evaluate antibiotic prescribing rate and responses of the contact persons in community pharmacies and to assess the conformity of the prescribed antibiotics with international guidelines. It also aims to evaluate the responses with sociodemographic characteristics. METHODS A cross-sectional, nationwide study conducted between February and May 2017 using a simulated patient case of acute uncomplicated cystitis. Two hundred fifty pharmacies were included. Descriptive data was reported for the medications prescribed, conformity, questions asked and counseling. Bivariate analysis using the Pearson chi-squared, Fisher's exact and Student's t-tests were used to identify possible factors affecting the prescribing rates and responses in community pharmacies. RESULTS The prescribing rate of antibiotics was 83.6% (n=209) with ciprofloxacin being the most prescribed (50.2%, n=105). The global conformity to international guidelines was 3.8% (n=8) with the highest conformity rate for the antibiotic choice (91.4%, n=191). Counseling about what to do in case symptoms persist was 12.8% (n=32) and that of non-pharmacological management was 53.6% (n=134). Male participants (88.1%) had a higher prescribing rate than female participants (77.6%) (p<0.05). The number of questions asked was higher in pharmacists and in female participants (p<0.05). Other results showed non-significant differences in diagnosis, antibiotic prescribing, conformity rates, referral rates and counseling points between the pharmacists and assistants. CONCLUSIONS The high antibiotic prescribing rate in Lebanese community pharmacies is alarming and calls for action. This should be tackled by legislative bodies, which should enforce laws that restrict such practices.
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Affiliation(s)
- Sally G Yaacoub
- Faculty of Public Health, Lebanese University. Fanar (Lebanon).
| | - Valerie Koyess
- Faculty of Public Health, Lebanese University. Fanar (Lebanon).
| | - Nathalie Lahoud
- Clinical Epidemiology and Toxicology, National Institute of Public Health (INSPECT-LB); & Faculty of Pharmacy, Lebanese University. Hadat (Lebanon).
| | - Deema Rahme
- Department of Pharmacy Practice, Faculty of Pharmacy, Beirut Arab University. Beirut (Lebanon).
| | - Nicole Francis
- Faculty of Public Health, Lebanese University. Fanar (Lebanon).
| | - Nadine Saleh
- Clinical Epidemiology and Toxicology, National Institute of Public Health (INSPECT-LB); & Faculty of Pharmacy, Lebanese University. Hadat (Lebanon).
| | - Patrick Maison
- Paris-Est Health-Work Institute (IST-PE), Créteil Intercommunal Hospital Center (CHIC). Créteil (France).
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