Detecting manuscripts written by generative AI and AI-assisted technologies in the field of pharmacy practice

Generative AI can be a powerful research tool, but researchers must employ it ethically and transparently. This commentary addresses how the editors of pharmacy practice journals can identify manuscripts generated by generative AI and AI-assisted technologies. Editors and reviewers must stay well-informed about developments in AI technologies to effectively recognise AI-written papers. Editors should safeguard the reliability of journal publishing and sustain industry standards for pharmacy practice by implementing the crucial strategies outlined in this editorial. Although obstacles, including ignorance, time constraints, and protean AI strategies, might hinder detection efforts, several facilitators can help overcome those obstacles. Pharmacy practice journal editors and reviewers would benefit from educational programmes, collaborations with AI experts, and sophisticated plagiarism-detection techniques geared toward accurately identifying AI-generated text. Academics and practitioners can further uphold the integrity of published research through transparent reporting and ethical standards. Pharmacy practice journal staffs can sustain academic rigour and guarantee the validity of scholarly work by recognising and addressing the relevant barriers and utilising the proper enablers. Navigating the changing world of AI-generated content and preserving standards of excellence in pharmaceutical research and practice requires a proactive strategy of constant learning and community participation.

Validation of the Arabic version of the general medication adherence scale in patients with type 2 diabetes mellitus in Jordan

Background: Medication adherence is a major challenge for patients with diabetes. Adherence rates are often low, and this can lead to poor glycaemic control and increased risk of complications. There are a number of tools available to measure medication adherence, but few have been validated in Arabic-speaking populations. Aim: This study aimed to validate the Arabic version of the General Medication Adherence Scale in patients with type 2 diabetes in Jordan. Methods: A cross-sectional study was conducted for 3 months among patients attending diabetes mellitus outpatient clinic in Irbid, Jordan. The validation procedure included confirmatory factor analysis (CFA) and equation modelling (SEM). Fit indices, namely, goodness of fit index (GFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were observed. Corrected item-total correlation (ITC) was reported. Reliability was assessed using Cronbach's alpha (α) and α value based on item deletion was also carried out. Intraclass correlation coefficient (ICC) was reported. Data were analyzed using IBM SPSS v23 and IBM AMOS v25. Results: Data from 119 participants were gathered. The mean adherence score was 27.5 (±6) ranging from 6 to 33. More than half of the patients were adherent to their therapy (n = 79, 66.4%). The reliability of the scale (n = 11) was 0.907, and ICC ranged from 0.880-0.930: 95% CI. The following values were observed in CFA; χ2 = 62.158, df = 41, χ2/df = 1.516, GFI = 0.913, AGFI = 0.860, TLI = 0.960, CFI = 0.971 and RMSEA = 0.066. A total of 10 out of 11 items had corrected ITC >0.5. The α remained between 0.89-0.92 during item deletion. Conclusion: The results obtained in this study suggest that the scale is valid and reliable in measuring adherence to medications in the studied sample of patients with diabetes. This scale can be used by clinicians in Jordan to assess adherence and may further aide in evaluating interventions to improve adherence rates in persons with type 2 diabetes.

Community pharmacists' skills and practice regarding dispensing fiscalized substances: a cross-sectional survey

Background: The use of drugs containing fiscalized substances is essential in different medical areas, including pain management, obstetric emergencies, and the treatment of mental disorders. However, due to their potential for abuse and negative health effects, the dispensing of these substances demands pharmacists with the requisite skills and practice. Objective: This study assesses the skills and practices of pharmacy personnel in the United Arab Emirates (UAE) regarding the dispensing of tramadol, a medication containing fiscalized substances, in community pharmacies. Methodology: A cross-sectional study was conducted. Community Pharmacies were chosen via random sampling, and seven well-trained final year pharmacy students visited them and conducted face-to-face interviews. The survey tool covered items highlighting the demographic data of the subjects, and items on the practice and skills regarding dispensing the fiscalized substances. The content validity ratio values of all tool questions were more than 0.78, suggesting acceptable validity and the Cronbach's α of 0.75 showed as acceptable internal reliability. The primary outcome measures of interest were the skills and practice regarding dispensing Fiscalized substances. Results: A total of 612 pharmacists were recruited in the study. The average practice score was 80%. There was a statistically significant association (p < 0.05) between practices about dispensing fiscalized substances and gender, age group, pharmacy type, work experience, university of graduation, and receiving training on epilepsy and antiepileptic drugs. Conclusion: The results implied that competency and experience are vital factors for the dispensing of tramadol. Contextually, the majority of the pharmacists evidently have the requisite competencies to provide high-quality and proper medical care, with regards to dispensing tramadol, which will minimize drug abuse and medication errors, and assist outpatients to manage their drugs containing fiscalized substances.

A qualitative assessment of the adverse effects associated with COVID-19 vaccines: a study from Jordan

OBJECTIVES

The current study aimed to qualitatively explore the side effects reported by participants who received the COVID-19 vaccine among the Jordanian population.

METHODS

Between April 18th and May 12th, 2022, an in-depth interview was conducted with a purposive sample of vaccinated individuals to assess the side effects of the COVID-19 vaccine in this study. Thematic analysis was used to identify themes and sub-themes within the current qualitative data.

RESULTS

A total of 20 participants were interviewed. They had a mean age of 41.3 (SD = 14.3) years. Half of the participants were females (n = 10, 50.0%). The study revealed six main themes: first, most of the respondents believed that COVID-19 vaccines were safe. Second, the vaccines are not equivalent in their safety. The third there showed that participants follow preventive measures to decrease the possibility of experiencing side effects. The fourth theme showed that reporting of side effects by the participants is dependent on the experienced side effects. Moreover, the next theme revealed that participants showed hesitancy to take more than one type of vaccine. Finally, participants were willing to take the vaccine annually, because they believed that the vaccine is better than the disease itself and decreases the aggressive effects of the disease.

CONCLUSIONS

This study found that the majority of participants believed in the safety of the COVID-19 vaccines and emphasized the responsibility of the healthcare providers in increasing awareness among the population about the importance of the vaccines. Enhancing such awareness is essential to improve the acceptance of receiving different types of vaccines.

Access to Medicines and Pharmaceutical Policy in Saudi Arabia: A Scoping Review

Introduction

This scoping review includes studies on pharmaceutical access, shortages, generics, availability, pharmacoeconomics, and pricing restrictions. The study's findings may aid in developing excellent pharmaceutical and access policies in the country.

Objective

To conduct a scoping review documenting access to medicines and Pharmaceutical Policy in Saudi Arabia.

Methodology

The PRISMA-ScR guidelines were used to perform a scoping review. The articles were screened using databases from Google Scholar, EBSCO, Science Direct, and the University of Huddersfield Library. The selection, aims, results, and conclusion of each original research publication published between 2010 and 2022 were evaluated. To categorize the articles, a theme analysis was done.

Results

This study includes nineteen publications. The chosen articles revealed four themes. Among these topics were: Access to medications 36.84% Pharmacoeconomic 36.84%), which were the predominant theme followed by Generic Medicines 15.80%, and Cancer drug financing 10.54%. There are myriad challenges related to high-cost medicines. Access restrictions to medications have significant effects on patient morbidity and mortality; as a result, policy decision-makers frequently consider this issue. Access to medicines suffers budgetary limitations and the increasing cost of innovative medicines. Access to medicines for all patients could be significantly impacted by delays in patient access to new therapies.

Conclusion

The available evidence revealed that Saudi Arabia's healthcare system has numerous issues ranging from cancer drug financing, medicine shortages, and access issue. In order to achieve the highest health standards possible, it is crucial that each individual has access to medicines and has the financial, physical, and social means to do so. However, the price of some medications can be prohibitive for people who need to obtain them. The study's outcomes could help the country develop pharmaceutical and access policies related to medicines.

Jordanians' knowledge, attitude and practice regarding adverse drug reactions reporting

Objectives

The purpose of the current study was to evaluate the general public knowledge, attitudes, and practice regarding Adverse Drug Reactions (ADRs) reporting and pharmacovigilance in Jordan.

Methods

A cross-sectional study was conducted between July 16, 2022, and July 30, 2022, in Jordan. During the study period, an electronic survey consisting of 4 sections was administered to a convenience sample of Jordanians (aged 18 or above) using 2 social media platforms (Facebook and WhatsApp). Logistic regression analysis was used to screen the predictors of ADRs reporting by the participants.

Results

A total of 441 participants completed the survey. The majority of the participants (67.6%) were females, 53.1% between 26 and 45 years old. Almost all participants (96.3%) were always aware of the indication of the medications they take, the time and frequency (87.8%), and the duration of medications (84.4%). Nearly one-third of the participants (37.4%) asked about their medications' ADRs. However, the drug information leaflet was the most frequently used source of ADR information (33.3%). The majority of responders believed that both healthcare providers and consumers should report ADRs (93.4% and 80.3%, respectively). Only one-quarter of respondents (27.2%) believed that consumers could directly report ADRs through the Jordan pharmacovigilance program. The majority of patients who had experienced ADRs (70.3%) were aware that ADRs should be reported, and among them, 91.9% had reported the ADRs to healthcare providers. Furthermore, few participants (8.1%) reported it to the Jordan National Pharmacovigilance Centre (JNCP). Linear regression revealed that none of the demographic characteristics (age, gender, education, job, and social status) were affecting public reporting practice of the ADRs (P > 0.05 for all).

Conclusion

Respondents showed fair knowledge about adverse drug reactions and their reporting. However, there is a need to initiate educational activities and intervention programs to raise awareness about the JNPC, which will have a positive impact on public health and ensure safe medication use in Jordan.

Are pharmacists' knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes

OBJECTIVES

Deprescribing is a novel strategy whereby medical professionals aim to optimize a patient's prescription program by removing redundant medications. Few studies have looked at the viewpoints of community pharmacists and other healthcare professionals on deprescribing in daily practice. This study's objectives included evaluating community pharmacists' deprescribing knowledge, attitudes and practices, as well as identifying the obstacles to and enablers of deprescribing in daily practice.

METHODS

Five pharmacy students in the last year of their studies polled employees of neighbourhood pharmacies in Abu Dhabi, Dubai, and the Northern Emirates from April 2022 to July 2022. The study's questionnaire was divided into two sections: questions that inquired about the respondents' demographic data and questions that evaluated the respondents' understanding and usage of the deprescribing of potentially harmful medications for patients. The original Bloom's cutoff points were revised and modified to assess the general knowledge and deprescribing practices of United Arab Emirates (UAE) community pharmacists. Multivariate logistic regression identified the variables influencing respondents' deprescribing knowledge and practice.

KEY FINDINGS

The average age of the participants was 30.8 ± 6.4 SD. Of the total, 255 (37.7%) were male and 422 (62.3%) were female. Pharmacists from independent pharmacies constituted 52.9% of the study sample and 47.1% were from Chain pharmacies. Among the participants, 58.8% (n = 398) had 1-5 years of experience and 41.2% (n = 279) had more than 5 years. Nearly three-quarters of the pharmacists (72.1%, 488) graduated from local universities and 27.9% (n = 189) graduated from regional/international universities. The vast majority of the study sample (84.8%, 574) were bachelor's degree holders and 88.3% (n = 598) were pharmacists in charge. Of the total, 69.3% (n = 469) received deprescribing training to treat patients with multimorbid diseases. The knowledge and practice score was 71.3% with a 95% confidence interval [70.2%, 72.4%]. Of the total participants, 113 (16.7%) had poor knowledge and practice about deprescribing, 393 (58.1%) had moderate knowledge and practice and 171 (25.3%) had good knowledge and practice.

CONCLUSION

This study highlights the level of understanding of community pharmacists about deprescribing in the UAE. Although most of the respondents in this study received training on deprescribing, less than half of the community pharmacists were unaware of certain classes (long-acting sulfonylureas, anti-diabetic, antihyperlipidemic and psychotropic drugs) of drugs that are candidates for potential deprescribing. This finding indicates that their knowledge about deprescribing was insufficient. Several barriers community pharmacists face in deprescribing were also identified, with patients' resistance and insufficience being the most prevalent. Therefore, there is a need for improved deprescribing practices to ensure drug safety.

The impact of educational interventional session on healthcare providers knowledge about pharmacovigilance at a tertiary Jordanian teaching hospital

OBJECTIVE

A limited number of educational interventions among health care providers and students have been made in Jordan concerning the pharmacovigilance. Therefore, the main aim of this study was to evaluate how an educational workshop affected the understanding of and attitudes toward pharmacovigilance among healthcare students and professionals in a Jordanian institution.

METHODS

A questionnaire was used before and after an educational event to evaluate the pre- and post-knowledge and perception of pharmacovigilance and reporting of adverse drug reactions (ADRs) among a variety of students and healthcare professionals at Jordan University Hospital.

RESULTS

The educational workshop was attended by 85 of the 120 invited healthcare professionals and students (a response rate of 70.8%). The majority of respondents were capable of defining ADRs (n = 78, 91.8%) and pharmacovigilance accurately (n = 74, 87.1%) in terms of their prior understanding of the topic. Around 54.1% of the participants (n = 46) knew the definition of type A ADRs while 48.2% of them (n = 41) knew the definition of type B ADRs. Additionally, around 72% of the participants' believed that only serious and unexpected ADRs should be reported (n = 61, 71.8%), also, 43.5% of them (n = 37) believed that ADRs should not be reported until the specific medication that caused it is known. The majority of them (n = 73, 85.9%) agreed that reporting of ADRs was their responsibility. The interventional educational session has significantly and positively impacted participants' perceptions (p value ≤ 0.05). The most reason for not reporting ADRs as stated by the study participants was the lack of information provided by patients (n = 52, 61.2%) and the lack of enough time to report (n = 10, 11.8%).

CONCLUSION

Participants' perspectives have been greatly and favorably impacted by the interventional educational session. Thus, ongoing efforts and suitable training programs are required to assess the effect of bettering knowledge and perception on the practice of ADRs reporting.

Exploring the factors impacting physicians' attitudes toward health information exchange with patients in Jordanian hospitals

BACKGROUND

The uniqueness of the physician-patient relationship and the latter's lack of medical experience and knowledge necessitate providing patients with accurate and timely information necessary to engage them in treatment decision-making. Without detailed information from their physicians, patients cannot understand their medical condition, assess treatment options, and participate meaningfully in their care.

OBJECTIVES

The present research determines the main factors influencing physicians' attitudes toward health information exchange with patients in Jordanian hospitals. The fundamental question addressed by this paper is why Jordanian physicians are reluctant to provide their patients with detailed health information about the potential risks, complications, and benefits of proposed treatments and other recognised alternative therapies.

METHOD

This study is qualitative in nature, adopting face-to-face interviews as the key instrument of data collection in two hospitals in Jordan. The chief consideration of the sampling process was to select direct informants whose input would generate accurate results that might be generalised or translated to other contexts or settings. Thematic analysis was then used, and all participants' opinions, answers, and interactions were transcribed and then reduced into themes and patterns for research, as per similarities and relationships, through coding and representing the data.

KEY FINDINGS

The findings show that most patients in government hospitals, especially those elderly, poorly educated, or inexperienced, choose practitioners based solely on medical service fees and costs rather than quality and convenience. On the other hand, the large number of patients attending public hospitals and the insufficiency of physicians' financial incentives in such hospitals may discourage physicians from providing patients with detailed health information. Matters, however, take a different turn in private hospitals, in which many physicians improve the patient experience to keep him and attract others by sharing information with patients about their health and treatment. However, it was noted that some physicians at such hospitals still rely heavily on their relations with health insurance companies to attract patients rather than on meaningful communication with their patients. Finally, the present findings reveal that the absence of a clear legal duty of medical disclosure negatively influences the amount of information received during the clinic visit.

CONCLUSIONS

The fact that the level of communication in Jordanian healthcare settings has not been determined in detail opens the door to unnecessary healthcare expenditure and creates uncertainty concerning the amount of information that patients need to know in order to be involved in their treatment decision-making. The lack of proper control and quality monitoring may also negatively affect the interests of patients and their rights to receive adequate information about their health status.

Knowledge about, acceptance of and willingness to use over-the-counter COVID-19 self-testing kits

Objectives

Early investments in new diagnostic technologies that allow for rapid and decentralized testing were critical in reducing SARS-CoV-2’s detrimental health and economic effects. This study evaluates public knowledge about, acceptance of and willingness to use COVID-19 self-testing kits.

Methods

An online descriptive cross-sectional questionnaire was used in this study. The final study population included all contacted national and resident adults, age 18 and over, who were willing to engage in the study. The survey was divided according to participants’ demographic information and 11 questions assessed the respondents’ understanding of and willingness to use COVID-19 self-testing kits. The statistical analysis was carried out using SPSS version 24. Multivariate linear regression models were used to identify the factors influencing respondents’ knowledge of and attitudes toward the acceptability of self-testing kits for COVID-19 and their willingness to use these kits.

Key findings

A total of 876 respondents participated in the study and completed the whole questionnaire. The average knowledge score on the acceptability of and willingness to use self-testing kits for COVID-19 was 70.2%, with a 95% confidence interval (CI) [69.1%, 71.4%]. Participants who were postgraduate, female and vaccinated against COVID-19, as well as employees and older participants, were jointly highly associated with higher levels of knowledge about, acceptance of and willingness to use self-testing kits for COVID-19. Moreover, participants who had been infected with COVID-19, were vaccinated against COVID-19 or were female, employees, older, Western or Arabic were jointly highly associated with positive attitudes about the acceptability of and willingness to use self-testing kits for COVID-19.

Conclusions

The majority of the respondents have acceptable levels of knowledge about, acceptance of and willingness to use self-testing kits for COVID-19. Nonetheless, future studies should consider the issues of pre- and post-test counselling, false negative results and the sale of unregulated testing kits. Additional information should be communicated so that people can make informed decisions and be protected from possible abuse of COVID-19 self-testing kits when they become available in pharmacies.

Attitude and perception of pharmacists and healthcare professionals about the criteria used in drug formulary selection in the United Arab Emirates

Background

There is lack of both resources and expertise explains the limited extent to which pharmacoeconomic evidence is used in formulary decision-making.

Objectives

The present study aims to assess attitude and perceptions toward the criteria used to select formulary drugs among UAE healthcare organizations.

Methods

A descriptive cross-sectional study was conducted amongst the licensed physicians in all specialties, all pharmacists and other healthcare professionals with a minimum of 3 month experience those registered with Ministry of health and prevention and those working in the private sector in the UAE. Participants are sent an email containing a validated web-based electronic link to access the questionnaire. The questionnaire composed of two sections is used to assess the healthcare professionals’ attitude and perceptions regarding the criteria used to select formulary drugs. Data analysis were done using SPSS Version 24.

Results

A total of 866 respondents participated in the study and completed the whole questionnaire. The average attitude score about the criteria used in drug formulary selection was 84.5% with a 95% confidence interval (CI) of [83.9%, 85.4%]. Of the total participants, 27 (3.1%) had poor attitude about the criteria used in drug formulary selection, 240 (27.7%) had moderate attitude and 599 (69.2%) had good attitude. The results of statistical modeling showed that education level, area of expertise and age were jointly highly associated with attitude about the criteria used in drug formulary selection.

Conclusions

The study revealed that pharmacists and Healthcare professionals had a good attitude about the criteria used in drug formulary selection in the United Arab Emirates. This study purposed to provide Emirate pharmacy and therapeutics policy makers with a clear criterion of best practice related to methodological recommendations to help in increasing the utilization and implementation of pharmacoeconomic evidence in the drug formulary selection process.

Awareness and preparedness of human monkeypox outbreak among university student: Time to worry or one to ignore?

BACKGROUND

The growing number of human monkeypox cases worldwide illustrates the importance of early detection, prevention, management and quick action from healthcare authorities. The WHO confirmed a hundred of Monkeypox cases worldwide and disclosed Monkdypox as a worldwide emergency situation OBJECTIVES: To assess the knowledge about human monkeypox' source, signs/symptoms, transmission, prevention and treatment among Al Ain university students in the UAE.

METHODS

This descriptive cross-sectional study aimed to assess Al Ain University students' knowledge of Human Monkeypox. A validated questionnaire was distributed to students between lectures. The respondents' knowledge of human Monkeypox was assessed by 21 questions that examined the participants' knowledge of Monkeypox as follows: 5 items examined knowledge of the source, definition, and incubation time; 2items assessed the mechanism of transmission of human Monkeypox, 7 items assessed the signs and symptoms; 7 items assessed the preventative measures; and 6 items assessed the treatment modalities. A multivariate logistic regression model was used to identify the factors influencing respondents' knowledge of human Monkeypox among university students.

RESULTS

A total of five hundred and fifty-eight (558) students participated in the study. The average knowledge score was 70.1%, with a 95% confidence interval (CI) of 68.9 - 71.3. Of the total participants, 111 (19.9%) had poor knowledge about human Monkeypox, 320 (57.3%) had moderate knowledge, and 127 (22.8%) had good knowledge. The results of the statistical modelling showed that Old age (OR 0.681; 95% CI 1.005-1.016), female gender (OR 1.26; 95% CI 0.813 -0.961), participants from medical colleges (OR 1.22; 95% CI 1.13 -1.32) having a history of human chickenpox infection (OR 2.6; 95% CI 2.3-2.9) and receiving information on human Monkeypox during education (OR 1.14; 95% CI 1.05-1.2) were strong determinants for good knowledge about human Monkeypox.

CONCLUSION

knowledge of Monkeypox among the participants is relatively low, particularly regarding the epidemiology, symptoms and treatments. Therefore, increasing knowledge of Monkeypox will be key to enhancing the capacity to respond to human monkeypox cases and to relay pertinent data to a disease surveillance system.

Analysis of cancer drug prices: a narrative review of literature

Objectives

The objective of the literature review is to collect data on how cancer medication pricing affects affordability and availability around the world.

Key findings

A literature search was carried out between 12 October 2020 and 2 December 2020, articles were selected based on them being available as full texts online and written in English. The keywords used were: ‘cancer’, ‘medicines’, ‘drug’, ‘drugs’, ‘pharmaceuticals’, ‘price’, ‘prices’, ‘pricing’. The collective search produced a total of 10 725 articles. After a refining process, any articles considered unnecessary and potential duplications were eliminated, and 16 research articles were included in the final analysis. The results were included in the following categories: (a) high-income countries, (b) low- and middle-income countries (LMICs), (c) originator cancer drug prices, (d) generic drug prices, (e) breast and colorectal cancer drug pricing. The expensive pricing of oncology medications is typically expected to be an obstacle for developing nations; however, the soaring prices have been found increasingly challenging for high-income countries. Within Europe, variations exist between countries in government expenditure and cancer drug prices. Originator cancer drug prices tend to be most expensive in Sweden, Denmark, Switzerland and Germany whereas Greece, Spain, Portugal and the UK had among the lowest recorded prices. The high cost of cancer drugs coupled with low availability rates have resulted in restricted access for many LMICs as monthly medicinal costs are often greater than yearly incomes.

Summary

The literature has shown the increasing trend of cancer drug pricing. The synthesis has also shown that cancer treatments are unaffordable in many developing countries resulting in most cancer deaths occurring in LMICs. Furthermore, governments cannot effectively challenge patented drug prices until the expiry of the patent.

Development and Validation of a Tool to Improve Community Pharmacists’ Surveillance Role in the Safe Dispensing of Herbal Supplements

Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements.

Objectives: Developed a new questionnaire that can potentially help community pharmacists identify the extent of falsified herbal supplements.

Methods: A 9-month cross sectional study was conducted among 500 community pharmacies across United Arab Emirates. A new 5-factor, 24-itmes scale was developed based on current labelling requirements across countries and piloted. This included seven items on identified uses and contraindication, seven items on hazard identification, four items on product identity, three items on packaging and product insert and three items on product handling and storage. The face and content validity of the scale was assessed via the content validity index (CVI). Its construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was subsequently confirmed through partial confirmatory factor analysis (PCFA). Its reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs).

Results: The CVI of the finalized questionnaire was 0.843. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.891, and Bartlett’s test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using maximum likelihood analysis with oblimin rotation. The PCFA obtained values was 0.962 for NFI, 0.977 for CFI, and 0.987 for the Tucker Lewis Index. All values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach’s alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥0.40. The instrument presented good ICC statistics of 0.940 (0.928–0.950) as well as statistical significance (p < 0.001). Community pharmacists with more than 10 experience years were more likely to identify falsified herbal supplements compared to those with 1–10 years experience (p < 0.001).

Conclusion: This study developed and validated a new instrument to identify safe herbal supplements, which should enhance the role of the community pharmacists in the safe and effective treatment of suitable patients with herbal supplements.

Pharmacy practice and clinical pharmacy research in the Middle East: a scoping review of studies from Bahrain, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen

Background

Pharmacy practice research publications has increased significantly in the last decade. This is also true for Middle Eastern countries.

Aims

The aim of this study was to document and review pharmacy practice literature in the Middle Eastern Arab countries.

Materials and methods

A scoping review was conducted using PRISMA-ScR guidelines. Medline/PubMed and Scopus were used to screen the articles. All published original research articles concerning any facet of pharmacy practice in 12 Arabic Middle Eastern countries during 2009–2019 were included. A thematic analysis was performed to classify the articles.

Results

Nine hundred and eighty-one articles were included in this study. Eight themes emerged from the selected articles. Medication use was the predominant theme 30.78% (302), followed by pharmacy practice and pharmacist services 22.94% (225), and then pharmacy education and professional development 16.31% (160). The KSA, Jordan, Qatar, and the UAE were the leading countries to publish pharmacy practice research.

Conclusions

Pharmacy practice research is growing and significantly adding to enhance pharmaceutical health services in the Middle East Region. There is a need to develop a research agenda. This will help in enriching the practice, as well as to avoid repetitive ideas.

Disease-Related Costs Published in The Middle East and North Africa Region: Systematic Review and Analysis of Transferability

BACKGROUND

In the Middle East and North Africa (MENA) the scarcity of local cost data is a key barrier to conducting health economic evaluations. We systematically reviewed reports of disease-related costs from MENA and analysed their transferability within the region.

METHODS

We searched PubMed and included full text English papers that reported disease-related costs from the local populations of Algeria, Bahrain, Egypt, Iraq, Jordan, Saudi Arabia, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Syria, Tunisia, United Arab Emirates and Yemen between 1995 and 2019. Screening, study selection and data extraction were done in duplicate. Study-related variables, costing methods, all costs and their characteristics were extracted and analysed via descriptive methods. From multi-country studies of MENA employing homogenous costing methods, we estimated the ratio (cost transfer coefficient) between the relative differences in direct medical costs and macroeconomic indicators via robust regression. We predicted each cost via the estimated cost transfer formula and evaluated prediction error between true and predicted (transferred) costs.

RESULTS

The search yielded 1646 records, 206 full text papers and 3525 costs from 84 diagnoses. Transferability was analysed involving 144 direct medical costs from eight multi-country studies. Adjusting the average of available foreign costs by 0.28 times the relative difference in GDP per capita provided the most accurate estimates. The correlation between true and predicted costs was 0.96; 68% of predicted costs fell in the true ± 50% range. Predictions were more accurate for costs from studies that involved the largest number of countries, for countries outside the Gulf region and for drug costs versus unit or disease costs.

CONCLUSION

The estimated cost transfer formula allows the prediction of missing costs in MENA if only GDP per capita is available for adjustment to the local setting. Input costs for the formula should be collected from multiple sources and match the decision situation.

Diverging levels of COVID-19 governmental response satisfaction across middle eastern Arab countries: a multinational study

BACKGROUND

Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic has been limited and may have affected the impact of governmental strategies to control the spread of COVID-19. This study aimed to evaluate and compare public opinion on the governmental COVID-19 response of high and LMICs in the Middle East and benchmark it to international countries.

METHODS

An online, self-administered questionnaire was distributed among different Middle Eastern Arab countries. Participants' demographics and level of satisfaction with governmental responses to COVID-19 were analyzed and reported. Scores were benchmarked against 19 international values.

RESULTS

A total of 7395 responses were included. Bahrain scored highest for satisfaction with the governmental response with 38.29 ± 2.93 on a scale of 40, followed by the Kingdom of Saudi Arabia (37.13 ± 3.27), United Arab Emirates (36.56 ± 3.44), Kuwait (35.74 ± 4.85), Jordan (23.08 ± 6.41), and Lebanon (15.39 ± 5.28). Participants' country of residence was a significant predictor of the satisfaction score (P < 0.001), and participants who suffered income reduction due to the pandemic, had a history of SARS-CoV-2 infection, and held higher educational degrees had significantly lower satisfaction scores (P < 0.001). When benchmarked with other international publics, countries from the Gulf Cooperation Council had the highest satisfaction level, Jordan had an average score, and Lebanon had one of the lowest satisfaction scores.

CONCLUSION

The political crisis in Lebanon merged with the existing corruption were associated with the lowest public satisfaction score whereas the economical instability of Jordan placed the country just before the lowest position. On the other hand, the solid economy plus good planning and public trust in the government placed the other countries of the Gulf Cooperation Council on top of the scale. Further investigation is necessary to find out how the governments of other low-income countries may have handled the situation wisely and gained the trust of their publics. This may help convey a clearer picture to Arab governments that have suffered during the pandemic.

Assessing public knowledge, attitudes and determinants of third COVID-19 vaccine booster dose acceptance: current scenario and future perspectives

Background

People with weakened immune systems may not develop adequate protection after taking two doses of the mRNA-combined COVID-19 vaccine. The additional dose may improve the level of protection against Covid-19.

Objectives

Current study aimed to evaluate the knowledge, attitude and determents of third COVID-19 vaccine booster dose acceptance among population in the UAE.

Methods and materials

This is online descriptive cross-sectional community-based study conducted among the students and faculty of Ajman University from 25 August to 20 October 2021. The questionnaire, which was in the English language, encompassed two sections containing 22 items. Section one gathered the demographic details of the respondents, while Section two used 13 questions to evaluate the respondents’ knowledge of and attitude to the third COVID-19 vaccine booster dose.

Results

614 respondents participated in this study. The average knowledge score was 44.6% with a 95% confidence interval (CI) of [41%, 49%]. Better knowledge scores were observed in postgraduates (OR 4.29; 95% CI 2.28–8.11), employees in the healthcare sector (OR 1.62; 95% CI 1.05–2.51), participants who had relatives infected with the Covid-19 (OR 1.46; 95% CI 1.05–2.02), participants who had infected with Covid-19 (OR 2.21; 95% CI 1.43–3.43) and participants who had received first two doses of the COVID-19 vaccine (OR 2.08; 95% CI 1.40–3.11). The average attitude score was 70.2% with a 95% confidence interval (CI) of [69.2%, 71.2%].

Conclusion

Necessary steps should be taken by the government and public health authorities, in line with the local culture, to increase vaccination acceptance and foster positive attitudes towards the vaccine. A suitable approach to this would be to develop an educational framework that could demonstrate the risks of vaccine avoidance or delay to the general population. Moreover, health authorities should pay more attention to the false information being disseminated across the internet, especially social media. Also, healthcare workers should be trained in vaccinology and virology to make sure that they are able to understand important developments in these fields and convey the findings to their patients.

Over-the-counter counseling in community pharmacies and job satisfaction among pharmacy professionals: A reflection of current scenario and possible solutions

Objectives:

This study assessed community pharmacist counseling and dispensing practices to determine their relationship with job satisfaction among pharmacists.

Methods:

A cross-sectional study was conducted between January 2021 and September 2021on a random sample of community pharmacists. The inclusion criteria were licensed community pharmacists with at least3months of professional experience. The researchers conducted face-to-face interviews using a developed structured questionnaire. The research instrument was comprised of two sections: demographic information and dispensing practices. Data were analyzed using SPSS Version 24.

Results:

a total of 543pharmacists participated in this study. The average age of respondents was 31 ± 7 SD. The average dispensing practice score was 75% with a 95% confidence interval (CI) of [73.3%, 76.7%]. Better dispensing practices were common among older participants (odds ratio (OR)1.010; 95% CI 1.001–1.020), postgraduates (OR 1.191; 95% CI 1.055–1.344), pharmacists from pharmacy chains (OR 1.452; 95% CI 1.285–1.640), participants with more than 10 years of experience (OR 1.286; 95% CI 1.089–1.520), pharmacists who graduated from regional universities (OR 1.200; 95% CI 1.129–1.497), and pharmacists who graduated from international universities (OR 1.413; 95% CI 1.212–1.648). However, poor dispensing practices were common among participants who were not satisfied with their current community pharmacist job (OR 0.487; 95% CI 0.410–0.577).

Conclusion:

Patient-centered management strategies oriented toward creating a counseling-friendly environment would open more space to achieve professional self-realization through cognitive services. This could benefit patients via consistent counseling services and increase pharmacists’ satisfaction with their job and profession.

Antibiotics duration guided by biomarkers in hospitalized adult patients; a systematic review and meta-analysis

BACKGROUND

The impact of using biomarkers to determine the duration of antibiotics therapy has been studied. However, the question remains in clinical practice whether these biomarkers are reliable to determine antibiotics duration.

AIM

This study is aimed to see if employing c-reactive protein (CRP) and Procalcitonin (PCT) to determine the duration of antibiotic use in hospitalized adult patients is both effective and safe.

METHODS

Search databases that were used are Pubmed, Cochrane library, and Embase. Only randomized controlled trials conducted in adult (≥18 years) hospitalized patients were included. The primary outcome assessed is the duration of antibiotics used. Secondary outcomes assessed are the length of hospitalization, recurrence of infection/rehospitalization, in-hospital mortality, and 28-day mortality.

RESULTS

For the primary outcome, which is the duration of antibiotics use, PCT guided therapy significantly decreased the duration of antibiotics used in both sepsis and respiratory tract infections. For the secondary outcomes, there was no statistically significant difference in the outcomes of length of hospitalization, recurrence of infection/rehospitalization, and 28-day mortality. However, in-hospital mortality was significantly reduced (p = .02). CRP guided reduced antibiotic use duration, but there was no statistically significant difference in other outcomes including length of hospital stay, 28-day mortality, and infection recurrence.

CONCLUSION

Procalcitonin-guided antibiotics therapy was shown to be effective and safe in the reduction of antibiotics duration in both sepsis and respiratory tract infections. More research is needed to prove that CRP-guided therapy is safe and effective to determine the antibiotic duration in adult hospitalized patients.

REVIEW REGISTRATION NUMBER

PROSPERO (CRD42021264167).

Dietary supplements intake during the second wave of COVID-19 pandemic: A multinational Middle Eastern study

Introduction

Despite the controversy about the benefits of dietary supplements in treating or preventing COVID-19, their use has increased worldwide even with the introduction of relevant vaccines. Thus, this study aimed to investigate the perception of the Middle Eastern Arab public of dietary supplements as prophylactic or therapeutic agents against COVID-19, and their consumption during the second wave of the COVID-19 pandemic.

Methods

A validated, pilot tested online survey was distributed through social networking platforms in Lebanon, the Kingdom of Saudi Arabia, Palestine, Jordan, and the United Arab Emirates. Responses underwent various statistical analyses.

Results

A total of 2,100 responses were included. Around 44% of participants reported changes in their dietary behavior during COVID-19, and 70% believed that healthy habits may prevent the infection. Moreover, 21% believed that dietary supplements surely protect against COVID-19 and 45% thought they aid in treating it. Users of supplements during the second wave of the pandemic counted for 47%, who declared they were influenced by the media, healthcare providers, or close contacts. Most used supplements included Vitamins C and D and zinc. Only 34% of participants read supplement leaflets. The use of supplements was significantly correlated with being female and exercising, as revealed by the odds ratio and logistic regression analysis.

Conclusions

In line with other areas of the world, the use of dietary supplements in the Middle East against COVID-19 is not evidence-based. Competent health authorities should play their role in spreading sound awareness among the public regarding this issue.

Combatting Substandard and Falsified Medicines: Public Awareness and Identification of Counterfeit Medications

Objectives: The objective of this study was to determine the identification rate of substandard and falsified medications and its association with knowledge among public.

Methods: This descriptive cross-sectional study was conducted in different geographic areas among a convenient sample of people aged 18 or older. A validated web-based electronic questionnaire was used for data collection tool. The questionnaire contained three sections assessing the following: (1) Sociodemographic data; (2) Knowledge regarding counterfeit medicines; and (3) Ability to identify counterfeit medicines, according to 12 questions rated on a five-point Likert scale. Univariate and multivariate logistic regression analyses were used to assess the association between sociodemographic factors and counterfeit medication identification rate.

Results: A total of 320 people participated in the study. Only 98 participants (30.6%, 95% CI 25.6–35.7%) identified the counterfeit medications. Ability to correctly identify counterfeit medications was significantly higher in participants who were older (p = 0.016), single (p = 0.001), Asian (p = 0.001), or American (p = 0.019), as well as those who indicated that they would check the certification of the medications (p = 0.015) and report counterfeit medications to the authorities (p < 0.0001).

Conclusions: These results underscore the need for greater public awareness of the hazards associated with counterfeit medicines.

Potentially inappropriate medications in older adults according to Beers criteria 2019: Prevalence and risk factors

AIM

Older patients are more prone to receive potentially inappropriate medications (PIMs) that are better to be avoided or dose adjusted to protect them from their unnecessary or harmful use. This study aims to detect the prevalence of PIMs among older patients discharged from Tawam hospital according to Beers criteria 2019. Moreover, the common risk factors of the older patients may subject them to PIMs use.

METHODS

A retrospective charts review study of older patients ≥65 years who were prescribed 5 or more medications and were discharged from Tawam hospital from 1 October 2018 to 31 December 2018. Each patient's medical record was scanned to detect PIMs. (PIMs) were classified according to Beers criteria 2019, and the predictors of PIMs were also assessed.

RESULTS

A total of 502 older patients (51.6% females and 48.4% males) medical charts were reviewed. The prevalence of PIMs among the study population was 34.7%. Antipsychotics (27.5%) and sulphonylurea's (16.8%) were among the most common avoided PIMs. Anticoagulants (40%) and ranitidine (35%) were the most PIMs based on the kidney function of the patient. Female gender [OR 1.8; 95% CI (1.22-2.66), P < .05] and increasing number of medications [OR 1.08; 95% CI (1.03-1.14), P < .05] were the independent predictors of PIMs.

CONCLUSION

Based on the prevalence of PIMs among older patients, it is recommended to revise each patient's medications prescription to avoid inappropriate prescribing and hence decrease the prevalence of PIMs.

The impact of clinical pharmacy services on patients with hypertension

AIMS

Globally, hypertension is a major concern in all health care systems. The role of clinical pharmacists in managing hypertension is essential not only in dispensing drugs but also in actively participating in managing treatment regimens. The goal of this study was to support the role of clinical pharmacists in managing patient hypertension therapy.

METHODS

This study was designed as a pragmatic, prospective, quasi-experimental study. In this study, 160 patients were enrolled, but seven patients withdrew from the study. The effects of the intervention were studied on the remaining 153 participants. Blood pressure, MINICHAL score, and DAI-10 score were measured at the beginning and at the end of the study. The patients received different medication counselling sessions that included medication education. The counselling sessions were conducted three times, with each session 4 months apart from the previous session. The first session was conducted at the beginning of the study following the enrolment of the patients. Only the first session was carried out in person for all the participants, while the other two sessions were conducted either in person or via a phone call.

RESULTS

Ninety-three male participants (60.8%) and 60 female participants were included (39.2%), and the mean age was 44.18 (±8.385). Most patients enrolled in the study were diagnosed with hypertension within the previous 12 months from the beginning of the study. The mean changes in SBP and DBP between the baseline and final readings were 13.1 and 5.4 mmHg, respectively P < .001). In addition, the DAI-10 positive score improved from 33.3% of the study population at the beginning of the study to 86.3% of the population at the end of the study.

CONCLUSION

The interventions of clinical pharmacists were found to be significantly important in improving the outcomes of hypertensive patients. Therefore, legislation making clinical pharmacy services compulsory in Middle Eastern health care systems, and particularly the UAE, is needed to expand the roles of pharmacists within the health care system.

Recommendations to improve pharmacy practice research in the Middle Eastern Arab countries

The expansion of the pharmacist-led services has resulted in increased demand to have evidence in terms of necessity, efficacy, and cost. Evidence-based practice is crucial to provide the best patient health outcomes and pharmacy practice research can play a key role in this regard. This commentary provides a background of pharmacy practice research, and then, it highlights three key recommendations based on a systematic review of the literature. The systematic review of the literature on pharmacy practice research has been conducted in 12 Middle Eastern Arab Countries. The three key recommendations include (a) identification of research priorities by health authorities in each country; (b) pharmacy practice research culture to be nurtured and promoted with academic researchers and practitioners; and (c) shifting pharmacy practice research towards applied, interventional, and implementation studies

Exploring the factors that influence healthcare providers care quality in Jordanian hospitals: the perspectives of nurses, pharmacists and physicians

Objectives

The key point of this investigation is to explore factors that influence healthcare providers’ quality care in government hospitals in Jordan, from the perspective of nurses, pharmacists and physicians.

Method

A qualitative technique (case study) was executed in this project. Semi-structured interviews (face-to-face) were used. The thematic analysis was applied in this study. The interviews were conducted with five physicians, five pharmacists and five nurses at different levels, including different specialists from Jordanian government hospitals.

Key findings

Four vital factor influencing of nu healthcare providers’ quality care were recognised in the sampled hospitals: manager ability and leadership support of staff, adequate and qualified hospital nurses and physicians, building a trusting work environment and good salaries and incentive.

Conclusions

This examination attempted to offer an in-depth comprehending factor that impacts healthcare providers’ quality care. Furthermore, it contributes to healthcare theory and practice by developing a conceptual framework that offers policymakers and managers a practical understanding of factors that influence healthcare providers’ quality care.

Suboptimal Health, Dietary Supplementation, and Public Health Approaches to Regulatory Challenges in Dubai

Objectives: Presently, limited data are available on dietary supplements (DSs) and their associated effects on health status although the consumption of DS continues to expand. This study is aimed to explore the possible relationship between DSs consumption and suboptimal health status (SHS) in Dubai, United Arab Emirates (UAE). Methods: This study was a cross-sectional research held among a sample of citizens and residents in the Emirate of Dubai in the UAE using a well-structured, self-administered, anonymous survey. Frequency tables, odds ratios, and confidence intervals were generated during the data analysis using SPSS version 23. Results: A total of 618 participants were enrolled in this study and fully completed the questionnaire. In this study, 317 participants (51.3%) (95% CI: 47.3%-55.3%) reported the use of DS products. A significant association between DS consumption and suboptimal health status was detected (P < .001). DS consumers had a 1.5-fold increased odds of suboptimal health status when compared with non-DS consumers (95% CI 1.4-1.7). Conclusion: The findings of this study suggest a need to develop policies and programs that will help minimize the risk of possible adverse events that are associated with the utilization of DSs.

Online medication purchasing during the Covid-19 pandemic: potential risks to patient safety and the urgent need to develop more rigorous controls for purchasing online medications, a pilot study from the United Arab Emirates

Background

Since the WHO announced that Covid-19 had become a global pandemic, online pharmacies have emerged as an extremely popular way to purchase medication due to the quarantine measures introduced by numerous countries to prevent the virus's spread.

Aim

The aim of this study was to collect information regarding the extent of online medication purchasing in the UAE and to assess the factors that motivating the purchase of medications from the internet.

Method

A convenience sampling of people living in the UAE was used to conduct an online descriptive cross-sectional study. Respondents were solicited using the social media platforms WhatsApp and Facebook, whereby they were asked to fill in a validated web-based questionnaire. The number of people buying medications from online pharmacies was calculated using a percentage with 95% CIs.

Results

131 respondents (31.2%) [95% CI: 26.7–35.6] stated that they purchased medication via the Internet after Covid-19 was classed as a pandemic. It was found that those respondents most likely to have purchased medication via the Internet were male, single, and older and with a high school education.

Conclusion

More research should be conducted to investigate and compare the self-medication and associated risk factors between online pharmacies and community pharmacies. Moreover, regulatory bodies need to make and implement changes to the regulations that govern the sale and use of medications during COVID-19.

A Quantitative Evaluation of Evidence-Based Beliefs and Implementation Among Community Pharmacists: Findings and Impact from United Arab Emirates

Background

The flux of pharmaceutical data can have a negative impact on the complexity of a pharmacist’s decision-making process, which will demand an extensive evaluation from healthcare providers trying to choose the most suitable therapeutic plans for their patients.

Objective

The current study aimed to assess the beliefs and implementations of community pharmacists in the UAE regarding evidence-based practice (EBP) and to explore the significant factors governing their EBP.

Setting

Community pharmacies in Dubai and the Northern Emirates, UAE.

Methods

A descriptive cross-sectional study was conducted over six months between December 2017 and June 2018. Community pharmacists who had three months’ professional experience or more and were registered with one of three regulatory bodies (Ministry of Health, Health Authority Abu Dhabi, or Dubai Health Authority) were interviewed by three trained final-year pharmacy students. Face-to-face interviews were then carried out and a structured questionnaire was used.

Metrics

The average beliefs score was 36% (95% CI: [34%, 39%]) compared to an implementation score of 35% (95% CI: [33%, 37%]).

Results

A total of 505 subjects participated in the study and completed the entire questionnaire. On average, participants scored higher in beliefs score than implementation score. The results of the statistical modelling showed that younger, female, higher-position pharmacists with more experience and with low percentages of full-time working, and graduates from international/regional universities were more likely to believe in and implement the concept of EBP.

Conclusion

A gap was identified between the beliefs and implementation of EBP. Developing educational EBP courses in undergraduate pharmacy curricula is of high importance, not only to increase knowledge levels but also to encourage commitment in those pharmacists to strive for professionalism and to support the provided patient care with evidence.

Cost considerations of dermatological care in Jordan: a cross-sectional study

Background: Physicians play a key role in improving patient adherence, specifically in dermatological care. Expensive medications are associated with poor patient adherence and worsening clinical outcomes. This study aims to explore the cost estimation interest of patients with dermatological conditions, the influence of the cost on their drug use behavior, and cost communication practices by dermatologists.Method: A cross-sectional study was conducted between October 2019 and January 2020 in Jordan. Logistic regression was conducted to explore the predictors of patient behavior.Results:A total of 1,022 patients participated in the study. Around 27.7% of them reported that their dermatologist does not discuss the cost of medications with them. About 71.4% reported that it is important for them to receive cost estimates for out of pocket medication costs. Patients with an income of 300 JD to 700 JD were more likely to be interested in cost estimations. Employed patients and males were less likely to be interested in cost estimations (p < 0.05).Conclusion: There is a considerable proportion of dermatologists who do not adhere to communicate about cost with their patients. Such communication should be considered necessary with all patients to enhance adherence to their prescribed therapy.

Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries

Very few studies exist of legal interventions (national laws) for essential medicines as part of universal health coverage in middle-income countries, or how the effect of these laws is measured. This study aims to critically assess whether laws related to universal health coverage use five objectives of public health law to promote medicines affordability and financing, and to understand how access to medicines achieved through these laws is measured. This comparative case study of five middle-income countries (Ecuador, Ghana, Philippines, South Africa, Ukraine) uses a public health law framework to guide the content analysis of national laws and the scoping review of empirical evidence for measuring access to medicines. Sixty laws were included. All countries write into national law: (a) health equity objectives, (b) remedies for users/patients and sanctions for some stakeholders, (c) economic policies and regulatory objectives for financing (except South Africa), pricing, and benefits selection (except South Africa), (d) information dissemination objectives (ex. for medicines prices (except Ghana)), and (e) public health infrastructure. The 17 studies included in the scoping review evaluate laws with economic policy and regulatory objectives (n = 14 articles), health equity (n = 10), information dissemination (n = 3), infrastructure (n = 2), and sanctions (n = 1) (not mutually exclusive). Cross-sectional descriptive designs (n = 8 articles) and time series analyses (n = 5) were the most frequent designs. Change in patients' spending on medicines was the most frequent outcome measure (n = 5). Although legal interventions for pharmaceuticals in middle-income countries commonly use all objectives of public health law, the intended and unintended effects of economic policies and regulation are most frequently investigated.

Scale validation for the identification of falsified hand sanitizer: public and regulatory authorities perspectives from United Arab Emirates

Background

Since the time of declaration of global pandemic of COVID-19 by World Health Organization (WHO), falsified hand sanitizers surfaced regularly in markets, posing possible harm to public due to unlisted inclusion of methanol. The current research is an attempt to develop and validate a tool to document falsified hand sanitizer in the UAE community.

Method

A descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.

Results

A total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p < 0.001). Our factor analysis revealed a 3-component model. The 3-factor solution was confirmed by PCFA analysis and had associations with good fit values. The PCFA for NFI was 0.970, CFI 0.978, and TLI 0.967. All values were in excess of 0.95, with RMSEA values below 0.06 at 0.03; all of these values indicated a good model fit. The Cronbach’s alpha was good overall (0.867). All factors had a Cronbach’s alpha value in excess of 0.70. The instrument demonstrated that every item met the IIC correlation standard ≥0.40. The scale displayed good overall ICC statistics of 0.867 (95% CI 0.856–0.877) with statistical significance (p < 0.001). The scale’s test-retest reliability was assessed through correlation of the falsified hand sanitizer identification score of respondents at the two time points. The test-retest correlation coefficient was 0.770 (p value < 0.01). Participants with post-graduate education were more likely to identify the falsified hand sanitizer compared to those with high school education. (p < 0.001).

Conclusions

This study developed and validated a new scale for the measurement of falsified hand sanitizer. This is expected to improve and promote collaboration between the health regulators and the public and hereby encourage customer satisfaction and participation.

Understanding the factors influencing healthcare providers' burnout during the outbreak of COVID-19 in Jordanian hospitals

Abstract

Background

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. The nature of healthcare providers’ occupation puts them at an increased risk of getting any contagious disease, including COVID-19. They are on the front line of the COVID-19 outbreak response and as such are at risk of contracting this virus. The infectious disease started from China in December 2019 and spread rapidly throughout countries, including Jordan. Especially, recent studies indicated that Jordanian healthcare providers’ work conditions and demographic are significant factors for healthcare providers’ burnout. Additionally, burnout has been increased among healthcare providers in Jordanian hospital.

Aim

The present investigation aims to better understand the factors affecting pharmacists’, physicians’, and nurses’ burnout during the outbreak of COVID-19 to provide basic information for lowering and preventing the level of burnout in Jordanian hospitals.

Method

This study is qualitative in nature, adopting face-to-face interviews as the key instrument of data collection in one hospital in Jordan. The sample interviewed consisted of 30 healthcare providers in total (10 nurses, 10 physicians. and 10 pharmacists).

Result

Three key factors to healthcare providers’ burnout were identified in the sampled hospitals: job stress, staff and resource adequacy, fear of COVID-19 infection, and interprofessional relationships in healthcare practice. The examination also offers recommendations for lowering and preventing healthcare providers' burnout in Jordanian hospitals.

Conclusion

This study explored the main factors of healthcare providers’ burnout during the outbreak of COVID-19 in Jordanian hospitals, thereby making an original contribution to existing knowledge, as it is the first empirical exploration of healthcare providers' burnout during the outbreak of COVID-19. As such, it has attempted to offer an in-depth understanding of the factors impacting this issue.

Risk management in community pharmacy practice in Abu Dhabi Region: a cross-sectional study

Objectives

Pharmacy risk factors impose a major threat to general healthcare outcomes. Risks that can directly affect patients are known as clinical risk factors, and other, non-clinical risk factors may also affect a pharmacist's performance and pharmaceutical profession. This study aims to evaluate the risks, which occur in community pharmacies in Abu Dhabi, and to investigate the protective plans followed in such incidence.

Methods

A self-administrated online questionnaire was distributed to community pharmacists in Abu Dhabi. The questionnaire items were tested by content and face validity in a panel of experts and pilot study. The Statistical Package for the Social Sciences (SPSS) program was used for the data analysis.

Key findings

Medication errors and computer system malfunction occur monthly, as reported by 40% of the participants (n = 131). Theft cases were reported by 37.6% (n = 121) of the pharmacists. Violence was categorized as verbal, psychological and physical abuse, and the frequency was 56.8% (n = 183), 30.4% (n = 98) and 14.3% (n = 46) respectively. Almost all the participants belief that communication skills, alertness and experience are the most important internal factors affecting performance. Environmental factors such as the availability of restrooms were cited as important external factors enhancing performance. Chain pharmacies were found to address electrical failure and dealing with look-alike sound-alike/high-alert medication efficiently.

Conclusions

Different types of clinical and non-clinical risk in pharmacy practice were identified, and risk mitigation techniques were proposed. A positive attitude of community pharmacists was observed towards identifies risks and on the suggested mitigation techniques. It is necessary to publish a universally referenced validated risk factor list for evaluating current risk management plans to maintain safe pharmacy practices and include management courses within pharmacy curriculum.

Identification of the awareness level by the public of Arab countries toward COVID-19: cross-sectional study following an outbreak

BACKGROUND

The novel coronavirus disease 2019 (COVID-19) pandemic is a global challenge. Improving public awareness about preventive measures and disseminating appropriate information about COVID-19 has a critical role in containing the disease.

AIM

To evaluate and determine the factors that may affect the level of awareness and responses toward COVID-19 in Arab countries. The study could be helpful in identifying where more public education about COVID-19 is needed.

METHOD

This cross-sectional, online descriptive questionnaire-based study was conducted in February and March 2020. A total of 485 participants from Arabic-speaking countries (Jordan, United Arab Emirates, the Kingdom of Saudi Arabia, Qatar, Palestine, and Egypt) were asked to complete this Arabic-translated survey using social media platforms (Facebook and WhatsApp).

RESULT

In general, there was a good level of awareness of the participants regarding COVID-19. Higher awareness scores were significantly correlated with older participants [odds ratio (OR) 1.019; 95% CI 1.012-1.026], those who attended awareness campaigns [OR 1.212; 95% CI 1.081-1.358], secondary school education holders [OR 1.740; 95% CI 1.096-2.763], higher education diploma holders [OR 2.090; 95% CI 1.297-3.368], university degree holders [OR 1.969; 95% CI 1.265-3.066], those who have post-graduate education [OR 2.206; 95% CI 1.393-3.493], and healthcare employees [OR 1.259; 95% CI 1.025-1.547].

CONCLUSIONS

The COVID-19 pandemic is causing global panic; thus, awareness and practices of preventive measures of COVID-19 should be increased through public educational campaigns, which should be planned in accordance with communities' and countries' attitudes toward COVID-19. Collaborative efforts between ministries of heath and residents of every country should be implemented.

Impact of community-based educational intervention on antibiotic use and resistance awareness among the people living in Ras Al Khaimah, United Arab Emirates

Objectives

Antibiotic resistance is a major global public health concern today. We explored the usefulness of an educational intervention in increasing antibiotic-related awareness of the public.

Methods

This community-based interventional study was conducted among 100 people living in Ras Al Khaimah, UAE. Preintervention awareness regarding antibiotics and antibiotic resistance was assessed using the World Health Organization antibiotic resistance: multicountry public awareness survey. After the baseline assessment of the knowledge, educational intervention was given to the study participants. The same questionnaire was used to assess the impact of this intervention after 4 weeks.

Key findings

The study participants had low baseline knowledge of antibiotics and the phenomenon of antibiotic resistance. A high proportion of study participants (54%) took antibiotics in the past 6 months. Our intervention significantly improved antibiotic-related knowledge and behaviours. Postintervention majority of study participants realized that full course of antibiotics should be taken (% change: 50.0, P &lt; 0.001), leftover antibiotics from family and friends should not be used (% change: 40.0%, P = 0.004), antibiotics are of no use in viral infections (% change: 72.0%, P &lt; 0.001), infections are becoming increasingly resistant to antibiotics (% change: 37%, P &lt; 0.001), bacteria resistant to antibiotics can be spread from person to person (% change: 73%, P &lt; 0.001) and infections from resistant bacteria are difficult to treat (% change: 38%, P &lt; 0.001).

Conclusion

Following the intervention, antibiotic-related awareness was significantly improved among study participants. Further efforts should be made to ensure that this improved awareness is converted to necessary health behaviour changes in the long term.

Translation, cultural adaptation and psychometric validation of the SF-6D measure of health-related quality of life for use in Arabic-Speaking countries

BACKGROUND

The SF-6D is a generic, six-dimensional health-related quality of life (HRQoL) measure derived from a selection of items from the SF-36.

OBJECTIVES

To translate, culturally adapt and validate the SF-6D for use in Arabic-speaking countries.

METHODS

The International Quality of Life Assessment (IQOLA) methodology was followed. Two forward translations, one consensus and one backward translation were undertaken. Difficulties encountered were categorized as grammatical, idiomatic, semantic/conceptual, and cultural. The content validity of the final version was tested and Cronbach's alpha test of internal consistency was used for assessing reliability. Confirmatory factor analysis (CFA), was also used to assess construct validity and to test a pre-specified relationship of observed measures.

RESULTS

Minor changes were made to the forward translation to improve cultural appropriateness. The Backward translation did not reveal major problems and equivalence to the original was confirmed following committee review. A total of 470 participants from Jordan, Egypt, UAE, Qatar and Palestine completed the translated SF-6D. All the incremental indices values are ≥0.90 and close to 1. Item loading values ranged from 0.52 to 0.87. The measurement model weight for those with chronic health conditions ranged from 0.68 to 0.91, and from 0.42 to 0.73 for those without. The percentage of variation in self-reported health state was about 55%. The measurement weight of SF-6D on self-reported health state among chronic responders was 0.87 while among responders reporting no chronic disease was 0.61. The t-value for the difference in measurement weight was -8.93 (p ≤ 0.01).

CONCLUSION

Arabic translation and cultural adaptation of SF-6D has resulted in an acceptable and culturally-adapted version that can be used in Arabic-speaking countries. Reliability and validity have been confirmed as well as ability to assess the difference in quality of life between patients with chronic health conditions and healthy individuals.

Herbal medicines: a cross-sectional study to evaluate the prevalence and predictors of use among Jordanian adults

Introduction

Understanding why adults resort to herbal medicine can help in planning interventions aimed at increasing awareness regarding herbal use. This study sought to investigate the prevalence and to determine factors for predicting the use of herbal medicine among Jordanian adults.

Methods

A cross-sectional study was conducted involving 378 older adults who were randomly selected from two different areas of Jordan. A questionnaire was used to gather data and validation criteria for validity and reliability of the content were tested by content and face validity in a panel of experts.

Results

From a total of 500 invited participants, 378 completed the questionnaire. The prevalence of the use of of herbal products in this study was high at 80.2%. Herbal medicines use was not associated with any demographic factors other than age (p < 0.05). Moreover, the only associated health-related characteristic was the patient’s disease state including, notably, hypertension (p < 0.05). Reasons for not using herbal medicines as reported by nonusers included mainly a lack of belief in their efficacy (52.2%). Another two important reasons were that the individuals believed themselves to healthy and have no need for their use (31.3%) and the unavailability of enough information about the herbal medicines (29.7%). Finally, the most common side effects as reported by patients in this study were nausea and vomiting (9.3%), and, to a lesser extent, skin rash (2.1%).

Conclusion

There is a high rate of use of herbal medicines in Jordan, especially among hypertensive patients. Therefore, there is a need to establish effective herbal medicine policies and health education programs to discuss the benefits and risks of herbal medicine use, with the aim of maximizing patient-desired therapeutic outcomes.

The sunshine under our skin: public knowledge and practices about vitamin D deficiency in Al Ain, United Arab Emirates

This cross-sectional study among members of public showed that people generally had good knowledge and awareness about vitamin D. However, inconsistencies between awareness and attitudes were observed. Our findings reinforce the need of educating people to improve attitude and practices toward vitamin D consumption.

INTRODUCTION

Owing to its hot and dry climate, United Arab Emirates (UAE) is one of the top ranked vitamin D deficient countries. However, little is known about people's awareness surrounding this topic.

METHODS

A descriptive cross-sectional survey to assess people's knowledge, awareness, and attitude toward vitamin D deficiency was conducted in Al Ain city of UAE. A 25-item validated self-administered questionnaire was used for data collection. Differences among demographic groups were analyzed using chi-square test, and simple binary logistic regressions were used to investigate the association between vitamin D awareness and other significant risk factors.

RESULTS

More than 90% of the total 346 participants showed awareness toward vitamin D and its deficiency. Doctors were reported as the most common source of information. More than one-third of the participants claimed to have vitamin D deficiency with significantly more females than males. More than 70% of the sample considered sunlight as the best source of vitamin D and avoiding going out in sun as the major risk for vitamin D deficiency. Nearly half (43%) of the participants did not consume milk and only 24% claimed to be using vitamin D supplements. Females were found to be applying sunscreen and consuming vitamin supplements significantly more than their male counterparts. Participants aged 24-35 years, having bachelor degree and those who were tested for vitamin D, were found to score better for awareness questions.

CONCLUSIONS

Our findings demonstrate a mismatch between knowledge and awareness, and attitude implying the need of educating people to improve their attitude toward consuming vitamin D rich food and supplements.