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Al Meslamani AZ, Abdel-Qader DH, Kassem AB, Al Mazrouei N. Disparities in drug safety practices in developing nations: focusing on underlying factors and implications for global health. Expert Opin Drug Saf 2024; 23:393-397. [PMID: 38436276 DOI: 10.1080/14740338.2024.2326488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | | | - Amira B Kassem
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates
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Al Meslamani AZ, Abdel-Qader DH. The Abuse and Misuse of Over-the-Counter Medicines During COVID-19. Hosp Pharm 2023; 58:437-440. [PMID: 37711408 PMCID: PMC9988622 DOI: 10.1177/00185787231158777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The abuse and misuse of OTC medicines is a common problem in community pharmacies and is expected to escalate during the COVID-19 pandemic. However, there is limited research on the patterns, causes, and consequences of these incidents during the pandemic. This article aims to provide evidence-based insights into the potential impact of COVID-19 on the abuse and misuse of OTC medicines, and suggest strategies for reducing these occurrences for pharmacy practitioners and healthcare managers.
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Al Meslamani AZ, Jarab AS, Abdel-Qader DH, Mohamed Ibrahim O, Al Mazrouei N. Adoption of electronic patient medication records in community pharmacies in the United Arab Emirates: A cross-sectional survey. HEALTH INF MANAG J 2023:18333583231190744. [PMID: 37551925 DOI: 10.1177/18333583231190744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Access to accurate and relevant patient health information is crucial for community pharmacists to deliver high-quality care. The use of electronic patient medication records (e-PMR) in the United Arab Emirates (UAE) is currently limited to hospital settings, and community pharmacists do not have access to patient records. OBJECTIVE To evaluate the perceptions of community pharmacists regarding the potential benefits, barriers, and concerns associated with the implementation of the e-PMR system in community pharmacies in the UAE. METHOD A validated questionnaire was administered to a sample of licensed community pharmacists using proportionate random sampling. The survey was structured and consisted of 40 questions in four sections: characteristics of community pharmacists and pharmacies; perceived usefulness of e-PMR; perceived barriers; and concerns about the use of e-PMR. RESULTS In total, 552 pharmacists filled out the questionnaire (82.1% response rate). The majority of participants somewhat or strongly agreed that e-PMR would reduce drug abuse (71.6%), dispensing errors (64.4%) and prescribing errors (69.0%), and believed that e-PMR would enhance pharmacists' ability to perform medication reviews (76.0%). Pharmacists in charge (adjusted odds ratio (AOR) = 2.5; 95% confidence interval (CI): 1.6-3.6), facing difficulty tracking the medical history of patients (AOR = 3.2; 95% CI: 2.8-3.9) and working in pharmacies providing telepharmacy services (AOR = 3.4; 95% CI: 2.7-3.8) were more likely to consider e-PMR useful. IMPLICATIONS The implementation of the e-PMR system in community pharmacies has potential benefits for patient safety and medication therapy management in the UAE.
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Affiliation(s)
| | - Anan S Jarab
- Al Ain University, UAE
- Jordan University of Science and Technology, Jordan
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Abdel-Qader DH, Abdel-Qader H, Silverthorne J, Kongkaew C, Meslamani AZA, Hayajneh W, Alwahadneh AM, Hamadi S, Abu-Qatouseh L, Awad R, Al Nsour M, Alhariri A, Shnewer K, Da'ssan M, Obeidat NM, Nusair KE, Jalamdeh MS, Hawari F, Asad M, AbuRuz S. Real-World Effectiveness of Four Types of COVID-19 Vaccines. Vaccines (Basel) 2023; 11:vaccines11050985. [PMID: 37243089 DOI: 10.3390/vaccines11050985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND There is a scarcity of evidence regarding the real-world effectiveness of coronavirus disease 2019 (COVID-19) vaccines. This was the first study to evaluate the effectiveness of four types of vaccines against asymptomatic and symptomatic infection, and COVID-19 outcomes among the general population. METHODS This was a matched comparison group quasi-experimental study conducted in Jordan between 1 January and 29 August 2021. In the first part of the study, 1200 fully vaccinated individuals were matched with 1200 unvaccinated control participants. In order to measure vaccine effectiveness, the infection rates of both vaccinated and unvaccinated groups were calculated. The second part of the study included measuring specific anti-SARS CoV-2 immune cells and antibodies. RESULTS BNT162b2 (Pfizer, New York, NY, USA) showed a significantly higher effectiveness against asymptomatic COVID-19 infection (91.7%) and hospitalization (99.5%) than BBIBP-CorV (Sinopharm, Beijing, China) (88.4% and 98.7%, respectively) and ChAdOx1 nCoV-19 (AstraZeneca, Cambridge, UK) (84.3%, and 98.9%, respectively). The effectiveness rates of the Sputnik V (Gamaleya Research Institute, Moscow, Russia) vaccine against asymptomatic, symptomatic, and hospitalization were 100%, 100%, and 66.7%, respectively. The highest median anti-spike (S) IgG values were seen in individuals who received BNT162b2 (2.9 AU/mL) and ChAdOx1 nCoV-19 (2.8 AU/mL) vaccines. The levels of anti-S IgG were significantly decreased after 7 months of vaccination with BNT162b2 and BBIBP-CorV. There were significant decreases in the median number of neutralizing antibodies one month and seven months after receiving BNT162b2 (from 88.5 to 75.2 4 Bioequivalent Allergen Unit per milliliter/mL), BBIBP-CorV (from 69.5 to 51.5 BAU/mL), and ChAdOx1 nCoV-19 (from 69.2 to 58.BAU/mL) vaccines. The highest percentage of T cells specific to COVID-19 vaccine was found in individuals who received BNT162b2 (88.5%). CONCLUSION All four vaccines evaluated in this study showed effectiveness against asymptomatic COVID-19 infection, symptomatic infection, hospitalization, and death. Furthermore, BNT162b2, BBIBP-CorV, and ChAdOx1 nCoV-19 induced high levels of immunology markers within one month of vaccination.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
- Al Rashid Hospital Center, Amman 11623, Jordan
| | | | - Jennifer Silverthorne
- Division of Pharmacy & Optometry, The University of Manchester, Manchester M13 9PL, UK
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Naresuan University, Phitsanulok 65000, Thailand
| | - Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
- College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
| | - Wail Hayajneh
- School of Medicine, St. Louis University, St. Louis, MO 63104, USA
- School of Medicine, Jordan University of Science & Technology, Irbid 3030, Jordan
| | | | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Luay Abu-Qatouseh
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Riad Awad
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Mohannad Al Nsour
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | | | | | | | - Nathir M Obeidat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | - Mohammad Asad
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, The United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Abdel-Qader DH, Al Meslamani AZ, Albassam A, Al Mazrouei N, El-Shara AA, El Sharu H, Ebaed SBM, Ibrahim OM. Assessment of A new Strategy to Prevent Prescribing Errors Involving COVID-19 Patients in Community Pharmacies. Hosp Pharm 2022; 57:654-665. [PMID: 36081535 PMCID: PMC9445540 DOI: 10.1177/00185787211073506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
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.
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Affiliation(s)
| | - Ahmad Z. Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | | | | | | | - Husam El Sharu
- Indiana University Center for Health Innovation and Implementation Science, Indianapolis, IN, USA
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Abdel-Qader DH, Hazza Alkhatatbeh I, Hayajneh W, Annab H, Al Meslamani AZ, Elmusa RA. IgA nephropathy in a pediatric patient after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Vaccine 2022; 40:2528-2530. [PMID: 35339305 PMCID: PMC8942577 DOI: 10.1016/j.vaccine.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Wail Hayajneh
- Department of Pediatrics, Saint Louis University, USA
| | - Hassan Annab
- Nephrology Department, Jordan Hospital, Amman, Jordan
| | - Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.
| | - Reem A Elmusa
- Department of Pediatrics, Jordan University Hospital, Jordan
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Abdel-Qader DH, Hayajneh W, Albassam A, Obeidat NM, Belbeisi AM, Al Mazrouei N, Al-Shaikh AF, Nusair KE, Al Meslamani AZ, El-Shara AA, El Sharu H, Mohammed Ebaed SB, Mohamed Ibrahim O. Pharmacists-physicians collaborative intervention to reduce vaccine hesitancy and resistance: A randomized controlled trial. Vaccine X 2022; 10:100135. [PMID: 34977553 PMCID: PMC8712432 DOI: 10.1016/j.jvacx.2021.100135] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine. Methods After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group. Pharmacists-physicians collaborative coaching intervention was delivered to active group subjects over two months through Facebook live sessions. The outcome measures were assessed in both groups before coaching, directly after coaching, and a month after coaching. Results The proportions of hesitancy and resistance for a COVID-19 vaccine among subjects in the active group were significantly reduced from 64.3% and 35.7% before coaching to 20.1% and 7.8% directly after coaching, respectively. These proportions were further reduced to 11.1% and 3.3% a month after coaching, respectively. Furthermore, the mean scores for knowledge on, and attitude towards COVID-19 vaccine were significantly increased from 4.6 ± 1.8 and 4.1 ± 1.7 before coaching to 7.5 ± 3.1 and 8.9 ± 3.8 directly after coaching, respectively. However, the change in mean score of beliefs about COVID-19 vaccines among active group subjects was not significant. Conclusion High rates of hesitancy and resistance for a COVID-19 vaccine were found in Jordan. These rates can be significantly reduced through online pharmacists-physicians collaborative coaching, which can also improve knowledge of and attitude towards COVID-19 vaccines.
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Affiliation(s)
| | | | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | | | | | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates
| | | | | | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | | | - Husam El Sharu
- Indiana University Center for Health Innovation and Implementation Science, Indianapolis, IN, USA
| | | | - Osama Mohamed Ibrahim
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Egypt.,Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates
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Abdel-Qader DH, Saadi Ismael N, Al Meslamani AZ, Albassam A, El-Shara' AA, Lewis PJ, Hamadi S, Al Mazrouei N. The Role of Clinical Pharmacy in Preventing Prescribing Errors in the Emergency Department of a Governmental Hospital in Jordan: A Pre-Post Study. Hosp Pharm 2021; 56:681-689. [PMID: 34732922 DOI: 10.1177/0018578720942231] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Clinical pharmacists have a vital role in intercepting prescribing errors (PEs) but their impact within a Jordanian hospital emergency department (ED) has never been studied. Objective: To evaluate the impact of clinical pharmacy services on PEs and assess predictors of physicians' acceptance of clinical pharmacists' interventions. Setting: This study was conducted in the ED of the largest governmental hospital in Jordan. Method: This was a pre-post study conducted in October and November 2019 using a disguised observational method. There were 2 phases: control phase (P0) with no clinical interventions, and active phase (P1) where clinical pharmacists prospectively intervened upon errors. The clinical significance of errors was determined by a multidisciplinary committee. The SPSS software version 24 was used for data analysis. Main Outcome Measure: PEs incidence, type, severity, and predictors for physicians' acceptance. Results: Of 18003 patients, 8732 were included in P0 and 9271 in P1. PEs incidence decreased from 24.6% to 5.4%. Contraindication, drug selection, and dosage form error types were significantly reduced from 32.6%, 9.1%, and 3.7% (P0) to 12.6%, 0.0%, and 0.0% (P1), respectively. Albeit not statistically significant, drug-drug interaction, drug frequency, and allergy error types were reduced from 4.9%, 3.1%, and 0.1% to 4.5%, 2.5%, and 0.0%, respectively. Significant and serious errors were significantly reduced from 68.7% and 3.0% (P0) to 8.9% and 1.8% (P1), respectively. During P1, most errors were minor (89.3%, 1574/1763), and lethal errors ceased. Predictors for physicians' acceptance were: significant errors (OR 3.1; 95% CI 2.6-4.3; P = 0.03) and non-busy physicians (OR 2.1; 95% CI 1.6-2.7; P = 0.04). Conclusion: Clinical pharmacists significantly reduced PEs in the ED by 76%; most of interventions were significant. Policymakers are advised to implement active clinical pharmacy in the ED.
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Affiliation(s)
- Derar H Abdel-Qader
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | | | - Ahmad Z Al Meslamani
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | | | - Asma' A El-Shara'
- Department of Clinical Sciences, Philadelphia University, Amman, Jordan
| | - Penny J Lewis
- Division of Pharmacy & Optometry, The University of Manchester, UK
| | - Salim Hamadi
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, UAE
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Abdel-Qader DH, Al Meslamani AZ, Al Mazrouei N, El-Shara AA, El Sharu H, Merghani Ali E, Mohammed Ebaed SB, Mohamed Ibrahim O. Virtual Coaching Delivered by Pharmacists to Prevent COVID-19 Transmission. Hosp Pharm 2021; 57:300-308. [PMID: 35601726 PMCID: PMC9117773 DOI: 10.1177/00185787211032354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: While the role of pharmacists in the current pandemic control has been recognized worldwide, their coaching efforts to improve public’s behaviors that could prevent COVID-19 transmission has been rarely investigated. Objectives: To assess whether pharmacist-based virtual health coaching sessions could increase the proportion of people who practised healthy social behaviors, to test whether this model can increase the public acceptance of COVID-19 vaccines, and to measure whether these behaviors could actually prevent contracting COVID-19. Method: In this randomized controlled trial, adults who matched specific criteria were randomly allocated into 2 arms. The active arm received 12 pharmacist-based virtual coaching sessions delivered via Zoom® over a month. Participants allocated to the control arm received no coaching. At the end of the last coaching session, both groups were asked to complete a structured questionnaire for outcome assessment. Participants in the active group were followed up to 2 weeks after the end of the last coaching session to check if they contracted COVID-19 or not. The SPSS software version 26.0 (IBM Corp., Chicago, IL) was used for statistical analysis. Results: Of the 300 participants who gave consent for participation, 295 completed the study (147 from the active arm and 148 from the control arm). The proportion of those using face masks, avoiding crowds, and willing to be isolated if infected in the active arm was increased from 51.70%, 53.74%, and 59.86% at baseline to 91.83%, 80.27%, and 96.59% at the end of coaching, respectively (all with P < .05). In addition, the proportion of behaviors, such as disinfecting surfaces, not touching the T-zone, and avoid sharing personal belongings with colleagues at work was increased from 36.05%, 27.89%, and 46.93% at baseline to 63.94%, 52.38%, and 87.75% at the end of coaching, respectively (all with P < .05). Avoid touching the T-zone (OR = 0.43; 95% CI, 0.24-0.89) and using disposable tissues (OR = 0.30; 95% CI, 0.18-0.77), each versus using face masks appropriately were more likely to get COVID-19. Conclusion: Pharmacist-based virtual health coaching could be a potential strategy to increase the proportion of behaviors that could curtail the spread of COVID-19.
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Affiliation(s)
| | | | | | | | - Husam El Sharu
- Indiana University Center for Health Innovation and Implementation Science, Indianapolis, Indiana, USA
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Abdel-Qader DH, Ismael NS, Albassam A, El-Shara’ AA, Aljamal MS, Ismail R, Abdel-Qader HA, Hamadi S, Al Mazrouei N, Ibrahim OM. Antibiotics use and appropriateness in two Jordanian children hospitals: a point prevalence study. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Although inappropriate antibiotics prescribing in hospitals is a key factor in accelerating antibiotic resistance, inadequate data are available about antibiotics prescribing rate and appropriateness. Our study aimed to measure antibiotics prescribing rate, indications, appropriateness and predictors.
Methods
The study was conducted in two public children hospitals (five wards) in Jordan using one-week point prevalence survey to prospectively collect the data. Appropriateness of antibiotics therapy was assessed by a multidisciplinary committee and predictors of inappropriate prescribing were studied through multivariate logistic regression.
Key findings
The overall antibiotics prescribing rate was 75.6% (n = 501/663), where the highest rate of antibiotics prescribing was in the Pediatrics ward (82.2%, n = 222/270). However, the lowest rate was in the Pediatric Intensive Care Unit (30.0%, 9/30). The most common antibiotics classes prescribed were: Beta-lactams (57.5%, n = 492/855). The most common underlying condition for antibiotics prescribing was upper respiratory tract infections (25.5%, n = 128/501) followed by pneumonia (20.6%, n = 103/501). Around half of antibiotics were prescribed upon appropriate decision (49.5%, n = 423/855). However, 22.0% (n = 188/855) of antibiotics were wrongly chosen, and 9.5% (n = 81/855) were wrongly applied. Initially inappropriate decision for prescription occurred in 15.3% (n = 131/855) of antibiotics. Ceftriaxone (OR 3.1; 95% CI 2.6–4.1; P = 0.03) and patients with ≥3 medication orders (OR 2.6; 95% CI 1.7–3.5; P = 0.001) significantly predicted inappropriate antibiotics prescribing.
Conclusions
The incidence of antibiotics prescribing in Jordanian children hospitals was high compared to other countries. Further multi-centric studies are required to enhance the generalisability of results and better develop effective and efficient antibiotic stewardship programmes.
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Affiliation(s)
| | | | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | | | | | - Rami Ismail
- Faculty of Pharmacy, Philadelphia University, Amman, Jordan
| | - Hasan A Abdel-Qader
- Consultant Pediatrician and Neonatologist, Ministry of Health, Amman, Jordan
| | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah., Sharjah, UAE
| | - Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah., Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Al Mazrouei N, Ibrahim RM, Al Meslamani AZ, Abdel-Qader DH, Sadeq AS, Mohamed Ibrahim O. The evolving role of community pharmacists during COVID-19 in the UAE; assessing preparedness and knowledge. Int J Pharm Pract 2021; 29:137-144. [PMID: 33729523 PMCID: PMC7799105 DOI: 10.1093/ijpp/riaa003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/07/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate community pharmacists' knowledge about COVID-19 and their preparedness for the pandemic. METHODS This cross-sectional online survey was conducted (in community pharmacies in the United Arab Emirates) over 3 weeks (24 May 2020 to 14 June 2020). A proportionate random sample of 491 participants was invited to take part. The SPSS version 26 was used for data management and analysis. KEY FINDINGS The majority of participants (n = 400) had good knowledge about COVID-19 and high level of preparedness for the pandemic control. Most pharmacists agreed (212, 53.0%) or strongly agreed (91, 22.8%) that they have a major role in the management of the ongoing crisis. Most participants had good awareness about the most common methods of COVID-19 transmission (359, 89.7%) and symptoms encountered (368, 92.0%). However, approximately a quarter of participants (103, 25.7%) incorrectly thought COVID-19 was caused by a DNA virus. Participants who had 5-10 and >10 years of experience were 3.95 (P = 0.03) and 1.59 (P = 0.01) times, respectively, were more likely to have good knowledge compared to participants with less than 2 years of experience. Those with good knowledge were more likely to have a specific area for customers with suspected COVID-19 symptoms compared to those with poor knowledge (P = 0.031). CONCLUSION This study indicates that years of experience and good knowledge on COVID-19 were significant determinants of pharmacists' preparedness for the pandemic control.
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Affiliation(s)
- Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Rana M Ibrahim
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, UAE
| | | | | | - Adel Shaban Sadeq
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, UAE
| | - Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Al Jomaa EE, Abdel-Qader DH, Silverthorne J, Hamadi S, Al Meslamani AZ. Pharmacy students' attitude towards providing pharmaceutical care to patients with anxiety and their knowledge of psychotropic medicines in Jordan. Int J Pharm Pract 2021; 29:196-199. [PMID: 33729530 DOI: 10.1093/ijpp/riaa015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/04/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To describe pharmacy students' attitude towards providing pharmaceutical care (PC) to patients with anxiety and their knowledge of psychotropic medicines (PM). METHODS A cross-sectional emailed survey was sent to all 200 pharmacy students (fourth and fifth year) in one Jordanian university. Statistical analysis included descriptive statistics and chi-square test. KEY FINDINGS A total of 134 responses were received (response rate 67%). About two-thirds of students (87, 64.9%) would like to give enough time to patients with anxiety to discuss their medications. Only half of students knew correctly that alprazolam (53.7%) and diazepam (50.0%) are categorized as anxiolytics. Undertaking a course in psychiatry was significantly associated with better students' knowledge in PM (P < 0.05). CONCLUSION Despite positive attitudes towards providing PC to patients with anxiety, policy makers should include courses on psychiatric pharmacotherapy in pharmacy curricula to improve pharmacy students' knowledge of PM.
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Affiliation(s)
- Esraa E Al Jomaa
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
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Aljamal MS, Abdel-Qader DH, Al Meslamani AZ. Applying medicines reconciliation indicators in two UK hospitals: a feasibility study. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmaa029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objectives
The aim of this study was to apply the Medicines reconciliation (MR) indicators and to assess their feasibility for use with patients on admission.
Methods
This is a mixed-methods study conducted in two large teaching hospitals in the north-west of England. There were two phases: (1) a prospective direct non-participant observational study was conducted on a small sample of five pharmacists in each hospital, who were observed while they conducted the MR process without interference by the investigator and (2) pharmacy staff conducting MR were asked to complete the MR data collection form, comprising various clinical information during the working hours of a selected weekday for all MRs conducted for patients admitted to hospital during that day. SPSS V20 was used for data analysis.
Key findings
In the first phase, five MR indicators were found not to be feasible and three not adequately assessed, while 33 indicators were considered feasible to be used in a hospital setting. In the second phase, 33 indicators were considered feasible to assess MR on admission to the hospital, 14 indicators were found feasible to assess main aspects of the MR process, and 18 indicators were found feasible to assess detailed aspects of the MR process. The majority of admissions were unplanned. Roughly half 45.4% of the patients admitted to hospital A were reconciled, while in hospital B 52% were reconciled.
Conclusion
The use of different methods to collect data was effective in providing valuable information as well as overcoming the potential limitation of each method.
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Affiliation(s)
| | | | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, United Arab Emirates
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Abdel-Qader DH, Al Jomaa EE, Silverthorne J, Shnaigat W, Hamadi S, Al Meslamani AZ. Evaluating psychiatrists’ attitudes and expectations about pharmacists’ role in psychiatry in Jordan. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmab007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective.
Methods
An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression.
Key findings
A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role.
Conclusion
Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Esraa E Al Jomaa
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Ahmad Z Al Meslamani
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
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Al Mazrouei N, Ibrahim RM, Al Meslamani AZ, Abdel-Qader DH, Mohamed Ibrahim O. Virtual pharmacist interventions on abuse of over-the-counter medications during COVID-19 versus traditional pharmacist interventions. J Am Pharm Assoc (2003) 2021; 61:331-339. [PMID: 33676838 PMCID: PMC7879024 DOI: 10.1016/j.japh.2021.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/24/2021] [Accepted: 02/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the frequency, nature, and clinical significance of pharmacist interventions on over-the-counter (OTC) medicines with abuse potential across community pharmacies with and without virtual care. METHODS In this prospective observational study, a trained research team observed the dispensary teams of 12 community pharmacies in the United Arab Emirates (UAE), 6 of which were operating virtual pharmacy care. A standardized data collection form was used to include information about dispensing of OTC medicines and pharmacist interventions on those with abuse/misuse potential. The clinical significance of the interventions was evaluated by a multidisciplinary committee. RESULTS The frequency of pharmacist interventions on OTC medicines with abuse potential across pharmacies with and without virtual services was 83.2% versus 91.0%, respectively, whereas the frequency of pharmacist interventions on OTC medicines with misuse potential across pharmacies with and without virtual services was 79.8% versus 41.2%, respectively. The proportions of clinically significant interventions across pharmacies with and without virtual services were 19.7% versus 10.5%, respectively. Cough medicines were dispensed significantly more across pharmacies with virtual care than across pharmacies without virtual care (25.6% vs. 9.7%, respectively; P = 0.04). Asking the patient to seek the advice of an addiction specialist (adjusted odds ratio = 4.11; P = 0.001) versus refusing to sell the drug was more likely to be associated with pharmacies with virtual services than with pharmacies operating traditional pharmacy services. CONCLUSION Virtual pharmaceutical care is a potential approach to reduce the abuse/misuse of OTC medicines but needs some improvements regarding detection of these cases. The UAE is the first country in the region to implement and regulate virtual pharmacy practice.
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Mohamed Ibrahim O, Ibrahim RM, Abdel-Qader DH, Al Meslamani AZ, Al Mazrouei N. Evaluation of Telepharmacy Services in Light of COVID-19. Telemed J E Health 2020; 27:649-656. [PMID: 33030986 DOI: 10.1089/tmj.2020.0283] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Telepharmacy services are expected to have an important role in increasing access of patients to pharmaceutical care and reducing potential dispensing errors in community pharmacies. Objective: To assess the predictors for effective telepharmacy services on increasing access of patients to care and reducing dispensing errors in community pharmacies. Method: This is a prospective study carried out for 4 months in 52 community pharmacies across the United Arab Emirates (UAE) using disguised direct observation. Multivariable logistic regression was used as a tool to predict factors associated with effective telepharmacy services in improving dispensing safety and increasing access of patients to pharmaceutical care. Data were entered and analyzed using the Statistical Package for Social Science (SPSS) software version 26. Results: Pharmacist recommendations related to COVID-19 at pharmacies with telepharmacy (n = 63,714) versus those without remote services (n = 15,539) were significantly more likely to be (1) contact the nearest testing center (adjusted odds ratio [AOR] = 7.93), (2) maintain home quarantine (AOR = 5.64), and (3) take paracetamol for fever (AOR = 3.53), all were significant results (p < 0.05). Rates of medication dispensing errors (MDEs) and its subcategories, prescription-related errors, and pharmacist counseling errors across pharmacies with telepharmacy versus those without remote services were (15.81% vs. 19.43%, p < 0.05), (5.38% vs. 10.08%, p < 0.05), and (10.42% vs. 9.35%, p > 0.05), respectively. However, pharmacies with telepharmacy were more likely to include wrong patient errors (AOR = 5.38, p < 0.05). Conclusions: Telepharmacy can be used as a tool to reduce the burden on the health care system and improve drug dispensing safety in community pharmacies.
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Affiliation(s)
- Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Rana M Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
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Abdel-Qader DH, Al Meslamani AZ, Lewis PJ, Hamadi S. Incidence, nature, severity, and causes of dispensing errors in community pharmacies in Jordan. Int J Clin Pharm 2020; 43:165-173. [PMID: 32803560 DOI: 10.1007/s11096-020-01126-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Background Medication dispensing is a core function of community pharmacies, and errors that occur during the dispensing process are a major concern for pharmacy profession. However, to date there has been no national study of medication dispensing errors in Jordan. Objective The study aimed to investigate the incidence, nature, severity, causes and predictors of medication dispensing errors. Setting The study was conducted in randomly selected community pharmacies across Jordan. Method A mixed method approach was taken, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee evaluated the severity of errors. Proportionate random sampling was used to include 350 pharmacies from across all regions of Jordan. SPSS (Version 24) was used for data analysis. Main outcome measure Incidence, nature, severity, causes and predictors of medication dispensing errors. Results The overall rate of medication dispensing errors was 24.6% (n = 37,009/150,442), of which 11.5% (n = 17,352/150,442) were prescription related errors and 13.1% (n = 19,657/150,442) pharmacist counselling errors. The most common type of prescription-related errors were wrong quantity (37.9%, n = 6584/17,352), whereas the most common pharmacist counselling error was wrong drug (41.9%, n = 8241/19,657). The majority of errors were caused by poor handwriting (30.7%, n = 75,651/37,009), followed by high workload (17.3%, n = 22,964/37,009). More than half of errors (52.6%) were moderate in severity, followed by minor errors (38.8%), and 8.6% of errors were rated as serious. Predictors of medication dispensing errors were: Sundays (OR 2.7; 95% CI 2.15-3.94; p = 0.02), grade A pharmacies (dispensing ≥ 60 prescriptions a day (OR 3.6; 95% CI 2.89-4.78; p = 0.04)), and prescriptions containing ≥ 4 medication orders (OR 4.1; 95% CI 2.9-6.4; p = 0.001). Conclusion Medication dispensing errors are common in Jordan and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing and independent prescribing for pharmacists.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.
| | | | - Penny J Lewis
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
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Abstract
Electronic nicotine delivery systems were promoted publically as a healthier replacement for conventional cigarettes. Knowledge and beliefs of the public can drive their behaviours to adapt or reject the new habit. No previous research was conducted in Jordan to assess electronic cigarettes (e-cigarettes) prevalence, and limited data are available on public opinions and orientation toward this new habit. To assess prevalence of, knowledge, attitude and beliefs about e-cigarettes, and examine factors associated with plans of quitting or initiating e-cigarettes among adults in Jordan. A large cross-sectional face-to-face survey on a random sample of adult population aged ≥ 18 years was conducted over two months to include 1820 adults in Jordan. A representative sample was collected using proportionate random sampling technique, which enabled us to geographically categorise the study population. Reliability and validity measures were taken to ensure a comprehensive and appropriate study tool. The Statistical Package for Social Science (SPSS®) version 24 was used to conduct descriptive analysis, logistic regression, and Rao-Scott chi-square. Findings were considered statistically significant at p value < 0.05 (with a confidence limit at 95%). Of 2164 adults approached, 1820 completed the questionnaire (84.1% response rate). The prevalence of current e-cigarette smokers and dual smokers were 11.7% and 4.0%, respectively. Quitting conventional smoking (38.8%) and enjoying the flavour (32.5%) were the most common reasons to start vaping. Friends were the major source of information about e-cigarettes. There was evidence that adults aged 45-59 years were less likely to be dual smokers (OR 0.51; 95%CI 0.29-0.66; p = 0.03). Poor knowledge about the content (23.7%) and types of e-cigarettes (14.5%) was reported. Plans to reduce or quit e-cigarettes were significantly associated with three factors: smokers' knowledge about its content, social impression, smokers' satisfaction with e-cigarettes. Social impression was also associated with plans of initiating e-cigarettes. Most participants thought vaping cannot be harmful to children and pregnant women (73.1%) and cannot be addictive (58.2%). Electronic cigarettes were considered helpful in smoking cessation by 69.1% of participants. The proportions of adults who were currently electronic cigarette and dual smokers were 11.7% and 4.0%, respectively. Our research may provide insight to product and individual factors that were associated with plans to sustain, quit or initiate electronic smoking.
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Abdel-Qader DH, Al Meslamani AZ, El-Shara' AA, Ismael NS, Albassam A, Lewis PJ, Hamadi S, Abbas HS, Al Mazrouei N, Mohamed Ibrahim O. Investigating prescribing errors in the emergency department of a large governmental hospital in Jordan. Journal of Pharmaceutical Health Services Research 2020. [DOI: 10.1111/jphs.12376] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Although prescribing errors (PEs) are the most common type of medication errors and cause morbidity and mortality, they have been rarely studied.
Objective
The study aimed to investigate PEs incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.
Setting
This study was conducted in the emergency department of the largest governmental hospital in Jordan.
Method
This was a retrospective observational 4-week study. A validated definition of PEs was adopted, and errors were identified by direct observation of all prescriptions. Structured interviews with doctors to assess the causes of errors were conducted within three days of the prescription date; the severity of PEs was rated by a committee.
Main outcome measure
Prescribing errors incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.
Results
For 1330 patients, 3470 medication orders were recorded. Almost one in five patients had PEs (n = 288, 21.65%), and the total number of medication orders for patients who had errors was 610. The PEs incidence was 12.5% (95% CI 11.4%–3.5% (n = 450/3597)). Analgesics were the most common medications associated with PEs (232/610, 38.03%). The top two types of PEs detected were wrong drug (165/450, 36.6%) and wrong dose (142/450, 31.5%) respectively. Most PEs were clinically significant errors (342/450, 76%). Doctors refused pharmacists' interventions on their orders in 132 (45.8%) prescriptions. The most common cause of errors was poor skills of doctors in electronic prescribing system (266/450, 59%). Predictors of PEs were the following: drug with multiple dosage forms (OR 2.998; 95% CI 1.41–6.34; P = 0.004) and a prescription with polypharmacy (OR 1.685; 95% CI 1.25%–2.26%; P = 0.001).
Conclusion
A national approach for observing, intervening on and correcting PEs is necessary to improve patient safety.
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Affiliation(s)
| | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | | | | | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Penny J Lewis
- Division of Pharmacy & Optometry, The University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Hazim Saleem Abbas
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Abdel-Qader DH, Albassam A, Ismael NS, El-Shara’ AA, Shehri A, Almutairi FS, Al-Harbi DM, Al Zahrani MM, Chen LC, Al Mazrouei N, Mohamed Ibrahim O. Awareness of Antibiotic Use and Resistance in Jordanian Community. J Prim Care Community Health 2020; 11:2150132720961255. [PMID: 32996372 PMCID: PMC7533952 DOI: 10.1177/2150132720961255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The public awareness toward the causes and consequences of antibiotic resistance (AR) is crucial to mitigate the inappropriate use of antibiotics (ABs), particularly in the low- and middle-income countries. There was no previous study that assessed the awareness, attitude, and knowledge about antibiotic use and AR among the Jordanian public in affluent and deprived areas. OBJECTIVE This study aimed to assess the awareness, attitude, and knowledge about antibiotic use and AR in affluent and deprived areas in Jordan. SETTING The survey was conducted in November 2019 in Amman, the capital of Jordan. METHOD A cross-sectional questionnaire was used to survey households in their areas in each of West Amman (affluent region) and East Amman (deprived region), Households were selected using proportionate random sampling method. RESULTS A total of 620 householders (310 per area) completed the questionnaire. Pharmacists were perceived as strong influencers on householders' decision, as 80.32% (n = 465/580) of those who used antibiotics in the last year follow pharmacists' advice. Our results showed poor understanding of antibiotic usage among the Jordanian public, as only 14.2% (n = 44/310) of the sample in West Amman and 2.9% (n = 9/310) in East Amman disagreed with the statement "Antibiotics work on most coughs and colds." Householders in West Amman showed much better understanding of AR compared to those in East Amman; 82.3% (n = 255/310) of West Amman respondents agreed with the statement "Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic." compared to 31.9% (n = 99/310) of East Amman respondents on the same statement (P < .05). CONCLUSION The Jordanian community generally had poor knowledge and awareness toward antibiotics use and AR. Socio-economic factors could influence the public's attitude toward antibiotics use and AR.
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Affiliation(s)
| | | | | | | | - Aisha Shehri
- King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
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Abstract
RATIONALE, AIMS AND OBJECTIVES The accuracy of health care professionals in reporting safety events determines their usefulness for both system improvement and research. The study objectives were to: (1) validate (assess the accuracy of) the reasons recorded by doctors and pharmacists for discontinuing medication orders at discharge in a hospital's electronic patient records (EPR); (2) investigate the causes of any detected recording inaccuracy; and (3) collect preliminary data on the frequency and types of medication discontinuation. METHODS This was a validation study in one English hospital. The study comprised two steps: extraction of discontinued medication orders from the EPR followed by short structured interviews with doctors and pharmacists who made the discontinuation. A total of 104 discontinued orders were discussed during 15 face-to-face and six telephone interviews. The software package spss was used for data analysis. RESULTS Duplication of therapy (27, 25.2%), omission of drug (23, 21.5%) and dosage regimen change (19, 17.8%) were the three most frequent reasons given for discontinuing medications. The majority of recorded discontinuation reasons were correct (100, 96.2%) and complete (101, 97.1%), and hence were judged accurate (97, 93.3%). The difference in accurate recording between doctors (15, 88.2%) and pharmacists (82, 94.3%) was not statistically significant. Potential causes of recording inaccuracy included: slip or lapse, lack of training, carelessness and electronic system rigidity. CONCLUSION This study showed that doctors and pharmacists recorded accurate reasons for the majority of the discontinued medication orders. It also showed that utilizing pharmacists' recorded reasons during clinical interventions using EPR was beneficial in understanding and characterizing prescribing errors. Although they require further research, the reasons identified present preliminary data about the most prevalent types of pharmacists' interventions during hospital discharge.
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Affiliation(s)
- Derar H Abdel-Qader
- School of Pharmacy and Pharmaceutical Sciences, The University of Manchester, Manchester, UK.
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Abdel-Qader DH, Harper L, Cantrill JA, Tully MP. Pharmacists' interventions in prescribing errors at hospital discharge: an observational study in the context of an electronic prescribing system in a UK teaching hospital. Drug Saf 2011; 33:1027-44. [PMID: 20925440 DOI: 10.2165/11538310-000000000-00000] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Pharmacists have an essential role in improving drug usage and preventing prescribing errors (PEs). PEs at the interface of care are common, sometimes leading to adverse drug events (ADEs). This was the first study to investigate, using a computerized search method, the number, types, severity, pharmacists' impact on PEs and predictors of PEs in the context of electronic prescribing (e-prescribing) at hospital discharge. METHOD This was a retrospective, observational, 4-week study, carried out in 2008 in the Medical and Elderly Care wards of a 904-bed teaching hospital in the northwest of England, operating an e-prescribing system at discharge. Details were obtained, using a systematic computerized search of the system, of medication orders either entered by doctors and discontinued by pharmacists or entered by pharmacists. Meetings were conducted within 5 days of data extraction with pharmacists doing their routine clinical work, who categorized the occurrence, type and severity of their interventions using a scale. An independent senior pharmacist retrospectively rated the severity and potential impact, and subjectively judged, based on experience, whether any error was a computer-related error (CRE). Discrepancies were resolved by multidisciplinary discussion. The Statistical Package for Social Sciences was used for descriptive data analysis. For the PE predictors, a multivariate logistic regression was performed using STATA 7. Nine predictors were selected a priori from available prescribers', patients' and drug data. RESULTS There were 7920 medication orders entered for 1038 patients (doctors entered 7712 orders; pharmacists entered 208 omitted orders). There were 675 (8.5% of 7920) interventions by pharmacists; 11 were not associated with PEs. Incidences of erroneous orders and patients with error were 8.0% (95% CI 7.4, 8.5 [n = 630/7920]) and 20.4% (95% CI 18.1, 22.9 [n = 212/1038]), respectively. The PE incidence was 8.4% (95% CI 7.8, 9.0 [n = 664/7920]). The top three medications associated with PEs were paracetamol (acetaminophen; 30 [4.8%]), salbutamol (albuterol; 28 [4.4%]) and omeprazole (25 [4.0%]). Pharmacists intercepted 524 (83.2%) erroneous orders without referring to doctors, and 70% of erroneous orders within 24 hours. Omission (31.0%), drug selection (29.4%) and dosage regimen (18.1%) error types accounted for >75% of PEs. There were 18 (2.9%) serious, 481 (76.3%) significant and 131 (20.8%) minor erroneous orders. Most erroneous orders (469 [74.4%]) were rated as of significant severity and significant impact of pharmacists on PEs. CREs (n = 279) accounted for 44.3% of erroneous orders. There was a significant difference in severity between CREs and non-CREs (χ2 = 38.88; df = 4; p < 0.001), with CREs being less severe than non-CREs. Drugs with multiple oral formulations (odds ratio [OR] 2.1; 95% CI 1.25, 3.37; p = 0.004) and prescribing by junior doctors (OR 2.54; 95% CI 1.08, 5.99; p = 0.03) were significant predictors of PEs. CONCLUSIONS PEs commonly occur at hospital discharge, even with the use of an e-prescribing system. User and computer factors both appeared to contribute to the high error rate. The e-prescribing system facilitated the systematic extraction of data to investigate PEs in hospital practice. Pharmacists play an important role in rapidly documenting and preventing PEs before they reach and possibly harm patients. Pharmacists should understand CREs, so they complement, rather than duplicate, the e-prescribing system's strengths.
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Affiliation(s)
- Derar H Abdel-Qader
- School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK.
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Abdel-Qader DH, Cantrill JA, Tully MP. Satisfaction predictors and attitudes towards electronic prescribing systems in three UK hospitals. ACTA ACUST UNITED AC 2010; 32:581-93. [DOI: 10.1007/s11096-010-9411-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 06/14/2010] [Indexed: 11/29/2022]
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