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Samorinha C, Saidawi W, Duncan P, Alzoubi KH, Alzubaidi H. Translation, cross-cultural adaptation and validation of the Arabic multimorbidity treatment burden questionnaire (MTBQ-A): A study of adults with multimorbidity. Res Social Adm Pharm 2024; 20:411-418. [PMID: 38267315 DOI: 10.1016/j.sapharm.2024.01.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Studies internationally have found that a high treatment burden is associated with several long-term conditions and poor quality of life. OBJECTIVES To translate, culturally adapt, and provide evidence of reliability, validity, and factor structure of the Multimorbidity Treatment Burden Questionnaire for use among Arabic-speaking adults with multimorbidity. METHODS Standard guidelines for the cross-cultural adaptation of self-report measures were followed. The original 10-item MTBQ was translated into Arabic by professional translators using forward-backward translation. An expert group, including the creator of the MTBQ, participated in the cultural adaptation and content validity, followed by cognitive interviewing and pilot testing. The questionnaire was then tested on 177 Arabic-speaking patients with multimorbidity recruited from community pharmacies in the United Arab Emirates. The distribution of responses, dimensionality, internal consistency reliability, and construct validity were examined. RESULTS The content validity of the MTBQ-A was good (Content Validity Index = 0.94), and cognitive interviews found that the items were well understood. The scale showed positive skewness and high floor effects. Factor analysis supported a two-dimensional structure (factor loadings >0.4): factor one was named "Self-management and social support," and factor two was named "Burden of visiting health care services and health care professionals". The questionnaire had good internal consistency (α = 0.83). As predicted, a higher MTBQ score in both factors was associated with poor health-related quality of life in all dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (p values < 0.05); and negatively correlated with self-efficacy in taking medication (p < 0.01) and in learning about medication (p < 0.01). CONCLUSIONS The Arabic MTBQ is a valid and reliable measure of treatment burden with good construct validity and internal consistency. This easy-to-understand questionnaire can be used to assess the perceived treatment burden among Arabic-speaking patients with multimorbidity.
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Affiliation(s)
- Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Ward Saidawi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Polly Duncan
- Centre for Academic Primary Care, University of Bristol, Bristol, United Kingdom.
| | - Karem H Alzoubi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
| | - Hamzah Alzubaidi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
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Alzubaidi H, Oliveira VH, Samorinha C, Mc Namara K, Shaw JE. Acculturation and glycaemic control in Arab immigrants with type 2 diabetes in Australia. Diabetologia 2024; 67:663-669. [PMID: 38214713 PMCID: PMC10904404 DOI: 10.1007/s00125-023-06081-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024]
Abstract
AIMS/HYPOTHESIS This study aimed to investigate acculturation's direct and mediated effects on HbA1c levels in individuals with type 2 diabetes from Arabic-speaking countries that are members of the Arab League who have emigrated to Australia. METHODS In this multicentre cross-sectional study, we recruited 382 Arabic-speaking immigrants who were born in any of the 22 countries of the Arab League and who had type 2 diabetes from different healthcare settings in Australia. HbA1c levels were retrieved from medical records. A validated self-report questionnaire was used to assess behavioural and psychosocial outcomes. Acculturation was measured using the General Acculturation Index and the Adherence to Traditional Values tool. We used structural equation modelling to test mediation hypotheses. RESULTS Participants had a mean HbA1c value of 63.9 mmol/mol (8.0%), a low acculturation level (mean±SD: 1.9±0.6; range: 1-5) and highly adhered to traditional values (mean General Acculturation Index value: 3.7±0.7; range: 1-5). Higher HbA1c was associated with lower acculturation levels (Pearson correlation coefficient [r] = -0.32, p<0.01) and higher adherence to traditional values (r=0.35, p<0.01). Self-efficacy, health literacy and self-care activities partially mediated the relationship between acculturation and HbA1c. CONCLUSIONS/INTERPRETATION Among Arab immigrants in Australia with type 2 diabetes, the degree of acculturation is related to glycaemic control, suggesting possible avenues for new interventions.
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Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, VIC, Australia.
| | - Vitor H Oliveira
- inED Centre for Research and Innovation in Education, School of Education, Polytechnic of Porto, Porto, Portugal
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, VIC, Australia.
| | - Jonathan E Shaw
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Alzubaidi H, Saidawi W, Goldstone L, Saddik B, Abduelkarem AR, Abu-Gharbieh E, Alzoubi KH, Samorinha C. A roadmap beyond dispensing for educating and training community pharmacists on key mental health competencies: A mixed-methods national study. Res Social Adm Pharm 2024:S1551-7411(24)00087-1. [PMID: 38503576 DOI: 10.1016/j.sapharm.2024.03.001] [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: 05/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Including pharmacists in collaborative mental healthcare models has yielded positive results. Establishing processes to enhance pharmacists' mental health care capabilities is crucial for addressing the increasing burden and improving access to mental health services. OBJECTIVES This study evaluated community pharmacists' mental health competencies and analyzed associated factors using a rigorous international framework. Additionally, it sought to identify pharmacists' training needs and support requirements as the first stop in creating a roadmap for enhancing mental healthcare through community pharmacies. METHODS A large-scale national study employing a mixed-methods approach was conducted with community pharmacists in United Arab Emirates. Semi-structured individual interviews and a cross-sectional survey were conducted. Pharmacists' core competencies were assessed using the Core Mental Health Competencies Framework for all Pharmacy Professionals. Generalized linear models were utilized to identify predictors of pharmacists' competency levels. Thematic analysis was used to analyze qualitative data. RESULTS In total 650 community pharmacists completed the survey (93.7% response rate). Eight pharmacists participated in semi-structured interviews. Nearly two-thirds (63.7%) received general communication skills training, while training in motivational interviewing (44.7%), shared decision-making (37.2%), and mental illness stereotyping/stigma (23.9%) were less common. Pharmacists reported lower perceived competence in their relationship with multidisciplinary teams (M = 3.02, SD = 0.89), stigma recognition (M = 3.02, SD = 1.04), and identifying mental health crises and aiding in the person's safety (M = 3.01, SD = 1.05). Poor communication skills (p < 0.001) and working in pharmacies that do not stock psychotropic medications (p = 0.023) were associated with lower perceived competence. Qualitative analysis identified training needs in various domains, including attitudes, values, and beliefs about mental health; relationships with multidisciplinary teams; communication skills; pharmaceutical knowledge; and personal and service development. CONCLUSIONS Mental health-related training is needed for community pharmacists. Addressing these needs through an intentional roadmap approach will enable pharmacists to better engage with patients with mental illness and increase access to care.
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Affiliation(s)
- Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, Victoria 3216, Australia.
| | - Ward Saidawi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Lisa Goldstone
- USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, United States.
| | - Basema Saddik
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; Department of Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; School of Population Health, Faculty of Medicine and Health, UNSW Australia, Australia.
| | - Abduelmula R Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road, University City, PO Box, 27272, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, University City, PO Box, 27272, Sharjah, United Arab Emirates.
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Speight J, Holmes-Truscott E, Garza M, Scibilia R, Wagner S, Kato A, Pedrero V, Deschênes S, Guzman SJ, Joiner KL, Liu S, Willaing I, Babbott KM, Cleal B, Dickinson JK, Halliday JA, Morrissey EC, Nefs G, O'Donnell S, Serlachius A, Winterdijk P, Alzubaidi H, Arifin B, Cambron-Kopco L, Santa Ana C, Davidsen E, de Groot M, de Wit M, Deroze P, Haack S, Holt RIG, Jensen W, Khunti K, Kragelund Nielsen K, Lathia T, Lee CJ, McNulty B, Naranjo D, Pearl RL, Prinjha S, Puhl RM, Sabidi A, Selvan C, Sethi J, Seyam M, Sturt J, Subramaniam M, Terkildsen Maindal H, Valentine V, Vallis M, Skinner TC. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol 2024; 12:61-82. [PMID: 38128969 DOI: 10.1016/s2213-8587(23)00347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.
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Affiliation(s)
- Jane Speight
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Elizabeth Holmes-Truscott
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Renza Scibilia
- Diabetogenic, Melbourne, VIC, Australia; JDRF International, New York, NY, USA
| | - Sabina Wagner
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Victor Pedrero
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
| | - Sonya Deschênes
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Kevin L Joiner
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ingrid Willaing
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Institute of Public Health, Department of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Katie M Babbott
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bryan Cleal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jane K Dickinson
- Department of Health Studies & Applied Educational Psychology, Teachers College Columbia University, New York, NY, USA
| | - Jennifer A Halliday
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Eimear C Morrissey
- Health Behavior Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Giesje Nefs
- Department of Medical Psychology, Radboudumc, Nijmegen, Netherlands; Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands; Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Shane O'Donnell
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | - Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bustanul Arifin
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | - Emma Davidsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Kamlesh Khunti
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Karoline Kragelund Nielsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Tejal Lathia
- Department of Endocrinology, Apollo Hospitals, Navi Mumbai, India
| | | | | | - Diana Naranjo
- Department of Pediatrics, Division of Endocrinology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Suman Prinjha
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts & Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Chitra Selvan
- Department of Endocrinology, Ramaiah Medical College, Bengaluru, India
| | - Jazz Sethi
- The Diabesties Foundation, Ahmedabad, India
| | - Mohammed Seyam
- Faculty of Medicine, Al-Quds University, Abu Dis, Palestine
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Mythily Subramaniam
- Institute of Mental Health Singapore, Singapore; Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Helle Terkildsen Maindal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Hasan S, Alzubaidi H, Samorinha C, Al Radhaideh A. Validation and Psychometric Evaluation of Diabetes Literacy, Numeracy, and Knowledge Tools in the Arabic Context. Sci Diabetes Self Manag Care 2023; 49:449-461. [PMID: 37899625 DOI: 10.1177/26350106231207349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
PURPOSE The purpose of this study was to validate the Literacy Assessment for Diabetes (LAD), the Diabetes Numeracy Test (DNT), and the Simplified Diabetes Knowledge Test (DKT) in the Arabic language and context. METHODS Three hundred eighty four, ≥18-year-old patients with type 1, type 2, or gestational diabetes mellitus were recruited from 3 endocrinology clinics in the United Arab Emirates. Exploratory factor analysis using principal component was performed. Achieved scores were compared using Pearson bivariate correlation. RESULTS All 60 LAD items loaded on 1 factor accounting for 66.7% of the variance, with internal consistency α = .991. Average score = 68.7%. Nineteen out of 26 items were retained on the DNT and grouped into 4 factors, prescription reading and directions, proper dose coverage, nutrition, and insulin, with good internal consistency (α = .721). Average score = 73.2%. All 20 DKT items loaded on 3 factors accounting for 41.2% of the variance, causes and consequences of the high blood sugar level, prevention of the disease, and misconceptions about diabetes self-management, with good internal consistency (α = .799). Average score = 71.9%. A moderate and significant correlation between the DKT and DNT (r = .56, P < .001) was observed. CONCLUSIONS Three tools to assess diabetes literacy, numeracy, and knowledge were psychometrically tested to establish their validity and reliability in the Arabic language and context. The tools could be used to assess patient skills and competence in navigating the health care system and managing their diabetes.
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Affiliation(s)
- Sanah Hasan
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed Al Radhaideh
- College of Humanities and Sciences, University of Science & Technology of Fujairah, Fujairah, United Arab Emirates
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Alzubaidi H, Saidawi W, Alzoubi KH, Franson KL, Samorinha C, Goldstone LW. Mental Health Care Education and Training in Pharmacy Programs in Arabic-Speaking Countries. Am J Pharm Educ 2023; 87:100039. [PMID: 37534929 DOI: 10.1016/j.ajpe.2022.12.007] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/13/2022] [Accepted: 12/02/2022] [Indexed: 08/04/2023]
Abstract
OBJECTIVE This study aimed to assess how entry-level pharmacy programs in Arab countries prepare graduates to provide mental health care, specifically examining the didactic curricula and experiential training in psychiatry in bachelor and PharmD programs. METHODS An electronic survey was sent to all entry-level pharmacy programs in the 22 Arab countries asking to report on the 2021-2022 academic year. The survey assessed teaching and learning (eg, psychiatric diseases taught and extent of the coverage; contact hours dedicated to psychiatric therapeutics, pharmacology, and medicinal chemistry), experiential training in psychiatry and its challenges, and graduates' preparedness to provide mental health. A descriptive analysis of the data was undertaken, and data were reported for bachelor and PharmD programs separately. RESULTS Overall, 35 pharmacy programs completed the survey. All PharmD programs and 80% of bachelor programs covered psychiatric therapeutics, and most contact hours were dedicated to pharmacology, followed by psychiatric therapeutics and medicinal chemistry. Over half of the faculty considered that depression and anxiety disorders were covered sufficiently, and 56.2% of programs did not offer experiential training in psychiatry. Common challenges in psychiatry experiential training included a lack of sites and qualified preceptors. Overall, 26.4% of faculty positively rated graduates' preparedness to provide mental health care. Graduates who completed experiential training in psychiatry and PharmD graduates were rated higher. CONCLUSION Pharmaceutical education in Arab countries could be improved by enhancing the teaching and assessment of mental health topics and expanding psychiatry experiential training. Such changes would improve entry-level pharmacists' competencies in mental health care provision.
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Affiliation(s)
- Hamzah Alzubaidi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates; University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates; Deakin University, Faculty of Health, School of Medicine, Deakin Rural Health, Victoria, Australia.
| | - Ward Saidawi
- University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Karem H Alzoubi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates; University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Kari L Franson
- University of Southern California, School of Pharmacy, Los Angeles, CA, USA
| | - Catarina Samorinha
- University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Lisa W Goldstone
- University of Southern California, School of Pharmacy, Los Angeles, CA, USA
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Alzubaidi H, Namara KM, Samorinha C, Versace V, Saidawi W, Speight J. Impact of diabetes stigma in diabetes distress and diabetes self-care: the moderating role of diabetes social support and general self-esteem in Arabic-speaking adults with type 2 diabetes. Diabet Med 2023:e15109. [PMID: 37035962 DOI: 10.1111/dme.15109] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/06/2023] [Accepted: 04/08/2023] [Indexed: 04/11/2023]
Abstract
AIMS There is increasing evidence that diabetes stigma has negative impacts on behavioural and psychological outcomes among people with type 2 diabetes (T2D). However, research has focused largely on Caucasian and certain Asian groups. The aim of this study was to examine associations of diabetes stigma with diabetes distress and self-care, and investigate the moderating effects of self-esteem and social support, in Arabic-speaking communities. METHODS A cross-sectional study was conducted at 21 outpatient clinics and diabetes-specialist centres in United Arab Emirates. Beside the Arabic Type-2 Diabetes Stigma Assessment Scale, participants completed other validated questionnaires assessing distress, self-care, social support, and self-esteem. General linear models were used to estimate the mean difference in diabetes-specific distress and self-care for every 1-point increase in diabetes stigma total score. RESULTS Among 327 adults with T2D, the mean total score of diabetes stigma was 43.55±13.95. Every 1-point increase in diabetes stigma was associated with significantly increased diabetes distress (β=0.113, 95% CI: 0.078 to 0.147; p=0.003) and decreased self-care behaviours: diet (β=-0.029, 95% CI: -0.048 to -0.009; p=0.008), physical activity (β=-0.022, 95% CI: -0.038 to -0.006; p=0.013) and foot care (β=-0.043, 95% CI: -0.059 to -0.026; p<0.001). Self-esteem mitigated the effect of diabetes stigma on diabetes distress. CONCLUSIONS Perceived and experienced diabetes stigma was independently associated with increased diabetes distress and decreased engagement in diabetes self-care among Arabic-speaking adults with T2D. These findings are crucial to help clinicians provide more effective assessment and counselling and guide public health interventions to decrease diabetes stigma in these communities.
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Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, PO, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, Victoria, Australia
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, PO, Sharjah, United Arab Emirates
| | - Vincent Versace
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, Victoria, Australia
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Jane Speight
- Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
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Vakil K, Desse TA, Manias E, Alzubaidi H, Rasmussen B, Holton S, Mc Namara KP. Patient-Centered Care Experiences of First-Generation, South Asian Migrants with Chronic Diseases Living in High-Income, Western Countries: Systematic Review. Patient Prefer Adherence 2023; 17:281-298. [PMID: 36756536 PMCID: PMC9899934 DOI: 10.2147/ppa.s391340] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/07/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND First-generation migrants from South Asia account for a considerable proportion of the immigrant populations in high-income, western countries and are at a high risk of developing complex, chronic diseases such as cardiovascular disease and diabetes. Yet, previous systematic reviews have not synthesized information about the healthcare needs and preferences of such migrants and the best ways for health services to provide them with appropriate, culturally sensitive, patient-centered care. The aim of this study is to systematically review the international evidence about first-generation, South Asian migrants' healthcare experiences from the patients' perspectives. METHODS Five databases were searched for qualitative, quantitative, and mixed methods studies published between January 1990 and April 2020. Fourteen thousand, six hundred and forty-four papers were retrieved and screened using pre-determined eligibility criteria. Sixty-one papers were included in this narrative synthesis. Relevant qualitative findings from the included papers were thematically analyzed, and quantitative findings were summarized. RESULTS Five themes emerged from findings: 1) Healthcare services engaged; 2) the language barrier; 3) experiences and perceptions of healthcare advice; 4) the doctor-patient relationship; and 5) the role of patients' families in supporting access and delivery of healthcare. CONCLUSION The findings indicate that communication barriers reduce the cultural and linguistic appropriateness of healthcare. Potential solutions include employing healthcare staff from the same cultural background, training healthcare professionals in cultural competence, and proactively including first-generation, South Asian migrants in decision-making about their healthcare. Future research should explore South Asian migrants' experiences of multimorbidity management, continuity of care, interdisciplinary collaboration, the formation of treatment plans and goals as little to no data were available about these issues.
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Affiliation(s)
- Krishna Vakil
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
- Correspondence: Krishna Vakil, Deakin Rural Health, Building D Level 2, Deakin University, Princes Hwy (PO Box 423), Warrnambool, Victoria, 3280, Australia, Tel +61 422 365 879, Email
| | - Tigestu Alemu Desse
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Hamzah Alzubaidi
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research – Western Health Partnership, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Melbourne, Victoria, Australia
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Odense M, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research – Western Health Partnership, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Melbourne, Victoria, Australia
| | - Kevin P Mc Namara
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
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Mc Namara KP, Alzubaidi H, Murray M, Samorinha C, Dunbar JA, Versace VL, Castle D. Should antidiabetic medicines be considered to reduce cardiometabolic risk in patients with serious mental illness? Med J Aust 2022; 217 Suppl 7:S29-S33. [PMID: 36183318 PMCID: PMC9828708 DOI: 10.5694/mja2.51701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/05/2022]
Abstract
Substantially reduced life expectancy for people with serious mental illness compared with the general population is primarily driven by physical health issues, of which cardiovascular disease is the leading cause. In this narrative review, we examine the evidence base for use of metformin and other antidiabetic agents as a means for reducing this excess cardiometabolic disease burden. Evidence from randomised controlled trials (RCTs) suggests substantial potential for metformin to prevent or manage weight gain and glycaemic impairment induced by atypical antipsychotic medications, whereas the impact of metformin on other cardiometabolic risk factors is less consistent. Evidence from RCTs also suggests potential benefits from glucagon-like peptide-1 receptor agonists (GLP-1RAs), particularly for addressing cardiometabolic risk factors in people using atypical antipsychotic medications, but this is based on a small number of trials and remains an emerging area of research. Trials of both metformin and GLP-1RAs suggest that these medications are associated with a high prevalence of mild-moderate gastrointestinal side effects. The heterogeneous nature of participant eligibility criteria and of antipsychotic and antidiabetic drug regimens, alongside short trial durations, small numbers of participants and paucity of clinical endpoints as trial outcomes, warrants investment in definitive trials to determine clinical benefits for both metformin and GLP-1RAs. Such trials would also help to confirm the safety profile of antidiabetic agents with respect to less common but serious adverse effects. The weight of RCT evidence suggests that an indication for metformin to address antipsychotic-induced weight gain is worth considering in Australia. This would bring us into line with other countries.
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Affiliation(s)
| | - Hamzah Alzubaidi
- Deakin UniversityWarrnamboolVIC,College of PharmacyUniversity of SharjahSharjahUnited Arab Emirates,Sharjah Institute for Medical ResearchUniversity of SharjahSharjahUnited Arab Emirates
| | | | - Catarina Samorinha
- Sharjah Institute for Medical ResearchUniversity of SharjahSharjahUnited Arab Emirates
| | | | | | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental HealthTorontoCanada
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Alzubaidi H, Namara KM, Samorinha C, Saidawi W, Versace VL, Speight J. Type 2 Diabetes Stigma Assessment Scale (DSAS-2): Cultural and linguistic adaptation and psychometric assessment of the Arabic version. Prim Care Diabetes 2022; 16:703-708. [PMID: 35965209 DOI: 10.1016/j.pcd.2022.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 06/21/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
AIMS To culturally and linguistically adapt the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) into Arabic and assess its psychometric properties. METHODS Following forward-backward translation of the DSAS-2, the Content Validity Index (CVI) was assessed. Cognitive debriefing and pilot testing were conducted with adults with T2DM. The Arabic DSAS-2 was included in a multi-center, cross-sectional study (N = 327) Arabic-speaking adults with type 2 diabetes. Psychometric analyses included exploratory and confirmatory factor analysis (EFA/CFA), internal consistency reliability, and convergent validity. RESULTS The Arabic DSAS-2 was considered appropriate, with an excellent CVI (0.98). Unforced EFA revealed a satisfactory three-factor structure, indicating the same subscales as the original instrument ('Treated differently', 'Blame and judgment', 'Self-stigma'). EFA for three factors showed good indicators (KMO=0.924; Bartlett's test of sphericity χ2 = 4063.709, df=171, p < 0.001). Internal consistency was satisfactory for both the three-factor structure (α = 0.91, α = 0.88, and α = 0.88, respectively) and the single factor (α = 0.94). CFA results were inconclusive. Although fit indices improved for the single-factor model, compared to the three-factor, they remained inadequate. The total scale demonstrated satisfactory convergent validity with self-esteem. CONCLUSIONS The Arabic DSAS-2 has excellent reliability and acceptable validity, supporting a three-factor structure as well as the use of a total score.
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Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, United Arab Emirates; Sharjah Institute for Medical Research, University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates.
| | - Kevin Mc Namara
- School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, Victoria 3216, Australia; Centre for Population Health Research, Deakin University, Burwood, Victoria 3125, Australia.
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates.
| | - Vincent L Versace
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, 75 Pigdons Rd, Waurn Ponds, Victoria 3216, Australia.
| | - Jane Speight
- Deakin University, School of Psychology, Geelong, Victoria, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.
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Jirjees F, Barakat M, Shubbar Q, Othman B, Alzubaidi H, Al-Obaidi H. Perceptions of COVID-19 symptoms, prevention, and treatment strategies among people in seven Arab countries: A cross-sectional study. J Infect Public Health 2022; 15:1108-1117. [PMID: 36137360 PMCID: PMC9462932 DOI: 10.1016/j.jiph.2022.08.019] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUP the widespread COVID-19 infection worldwide has resulted in the inability of healthcare facilities to receive all infected patients; therefore, most are treated at home. In addition, factors such as high mortality, types and severity of symptoms, and the prevalence of unreliable information have prompted patients to resort to self-treatment. OBJECTIVES To assess prevention, treatment, degree of symptoms, and sources of information among patients with COVID-19 in Arab countries METHOD: A cross-sectional study was conducted in seven Arab countries: Algeria, Egypt, Iraq, Lebanon, Libya, Tunisia, and the United Arab of Emirates. People who have recovered from COVID-19 completed the study questionnaire. Score of symptoms during and after COVID-19 infection has been calculated by giving the participants a list of 13 symptoms. RESULTS A total of 3519 participants completed the survey. Mostly females (68.3%), and aged between 18 and 40 years old (59.4%). Prophylaxis treatments, including vaccines and antibiotics, have been used in around 40% of the participants. The total average score of symptoms during the infection period was found 7.31 ± 3.66 out of 13. However, the symptoms score upon recovery was low (0.48 ± 1.11 score). The significant associations with increased incidence of symptoms during infection were reported with older people, married, divorced or widowed, people with chronic diseases, and obese. Moreover, significant associations with decreased symptoms were reported with those who worked in the health sector, non- or ex-smokers, and vaccinated people. CONCLUSION The use of medication and other treatments to prevent infection with COVID-19 was common among the participants in the seven countries. Taking the vaccine was the only effect on the number of symptoms experienced by patients. Although nearly two years have passed since the onset of the disease, there is still a need to raise treatment awareness among patients at home.
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Affiliation(s)
| | - Muna Barakat
- School of Pharmacy, Applied Science Private University, Jordan
| | | | - Bayan Othman
- School of Pharmacy, Applied Science Private University, Jordan
| | | | - Hala Al-Obaidi
- College of Pharmacy and Health Sciences, Ajman University, UAE
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Alzubaidi H, Hafidh K, Saidawi W, Othman AM, Khakpour MM, Zoghbor MM, Abu-Gharbieh E, Alzoubi KH, Shaw JE. Behavioral, psychological, and clinical outcomes of Arabic-speaking people with type 2 diabetes during COVID-19 pandemic. Prim Care Diabetes 2022; 16:355-360. [PMID: 35410850 PMCID: PMC8993045 DOI: 10.1016/j.pcd.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023]
Abstract
AIMS Assess self-care activities, health behaviors, self-efficacy, diabetes distress, challenges, and changes in diabetes treatment and clinical parameters among Arabic-speaking people with T2DM during the COVID-19 pandemic. METHODS A cross-sectional study was conducted at a tertiary hospital in the United Arab Emirates. The study instrument collected self-reported data using validated tools about health behaviors, self-efficacy, and diabetes distress, and challenges in accessing and using healthcare services during the pandemic and documented clinical data and treatment before and during the pandemic from medical records. RESULTS 206 patients participated with a mean age of 58.7 years and 15.7 years since diabetes diagnosis. Non-adherence to healthful eating and exercise was reported by 38.3% and 73.7%, respectively. Exercise was the self-care activity that decreased the most (36.8%). Most participants had low diabetes distress (85.9%). There were no significant differences in clinical parameters before and during the pandemic, and diabetes treatment was unchanged for 72.8% of participants. Having two or more challenges with accessing and using diabetes healthcare services was significantly associated with decreased adherence to healthy eating (p = 0.025) and exercise (p = 0.003). CONCLUSIONS Arabic-speaking people with T2DM appeared to maintain relatively similar self-care levels, except exercise, with no deterioration in clinical parameters compared to pre-pandemic.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates; Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority UAE, Dubai Medical College, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Amna M Othman
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Mahta M Khakpour
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Malaka M Zoghbor
- Pharmacist, Fakeeh University Hospital, Dubai Silicon Oasis, Dubai, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Institute, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, PO Box 6492, Melbourne, VIC 3004, Australia.
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Abstract
OBJECTIVES To assess Arabic-speaking patients' preference for involvement in decision-making in the United Arab Emirates (UAE) and characterise people who preferred involvement in decision-making. DESIGN Cross-sectional quantitative study. The conduct and reporting of this research complied with Strengthening the Reporting of Observational Studies in Epidemiology guidelines for cross-sectional studies. SETTING Participants were recruited from outpatient clinics of 10 major hospitals in four cities in the UAE: Abu Dhabi, Dubai, Sharjah and Umm al Quwain. PARTICIPANTS Adult patients with at least one chronic disease completed a cross-sectional survey consisting of 37 items in six sections measuring variables that may influence preferred involvement in decision-making. These included health literacy, health status, unanswered questions about care and satisfaction with treatment decisions. Bivariate and multivariate analyses were performed to determine the predictors of patients' preferred involvement in decision-making. RESULTS A total of 516 participants completed the survey. One-in-four participants preferred shared decision-making. Preferred involvement in decision-making was more frequent among women, not married, unemployed, people who rarely/never had unanswered questions and participants with anxiety/depression symptoms. After adjustment, not being married (OR=1.634; 95% CI 1.049 to 2.544) remained as a predictor of preferred involvement in decision-making, while having unanswered questions (OR=0.612; 95% CI 0.393 to 0.954) and problems in self-care were predictors of a preference for paternalistic decision-making (OR=0.423; 95% CI 0.181 to 0.993). CONCLUSIONS Contrary to the results from Western countries, this study showed that a majority of Arabic-speaking patients with chronic diseases preferred a paternalistic decision-making model. At the same time, some subgroups of Arabic-speaking people (eg, women, unemployed patients) had a higher preference for participation in decision-making. Physicians' support and changes in healthcare systems are required to foster Arabic-speaking patients' involvement in treatment decision-making process.
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Affiliation(s)
- Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Amal Hussein
- Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Basema Saddik
- Department of Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Samorinha C, Saidawi W, Saddik B, Abduelkarem AR, Alzoubi KH, Abu-Gharbieh E, Alzubaidi H. How is mental health care provided through community pharmacies? A quest for improvement. Pharm Pract (Granada) 2022; 20:2648. [PMID: 35919799 PMCID: PMC9296078 DOI: 10.18549/pharmpract.2022.2.2648] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Mental disease burden is increasing globally, and a substantial shortage of mental health professionals remains. Community pharmacists can improve population mental health outcomes to bridge the mental health care gap. However, there is a paucity of data on community pharmacists’ provision of mental health care. Objective: To assess community pharmacist-delivered care to people with mental illness in the United Arab Emirates (UAE), focusing on dispensing and counseling practices, pharmacists’ confidence and comfort in providing care, and attitudes and beliefs towards mental illness. Methods: This was a mixed-methods study with an exploratory, sequential design. Semi-structured interviews explored community pharmacists’ practices, challenges and strategies to improve care. Data were analyzed thematically, and the results guided questionnaire development. The questionnaire was also informed by the Framework of Core Mental Health Competencies for All Pharmacy Professionals and other relevant literature and administered to community pharmacists in four out of seven emirates. Logistic regression was used to identify the predictors of pharmacist practices. Results: In the interviews, community pharmacists described adopting a precautionary attitude and perceived their role as a dispensing one. They reported challenges such as emotional discomfort and lack of training but highlighted the need for a different approach to patients with mental illness. In total, 252 pharmacists completed the questionnaire, and 74% reported performing at least five counseling practices. Logistic regression showed that pharmacists who performed a higher number of practices (≥5) were younger, received continuing education on mental health care in the last two years, and had higher confidence levels. Conclusion: UAE community pharmacists performed basic dispensing practices and reported discomfort during encounters with patients with mental illness. Training on patient-centered communication skills and psychiatric therapeutics is needed to improve pharmacist-delivered services, alongside increased collaboration with other providers and services.
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Affiliation(s)
- Catarina Samorinha
- PhD. Post-doctoral Research Associate, Sharjah Institute for Medical Research, University of Sharjah, University City Road-University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Ward Saidawi
- Bpharm. Research Assistant, Sharjah Institute for Medical Research, University of Sharjah, University City Road-University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Basema Saddik
- PhD. Associate Professor, Department of Family and Community Medicine & Behavioral Sciences, College of Medicine,. Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Abduelmula R Abduelkarem
- PhD. Professor, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- PhD. Professor and Dean, College of Pharmacy, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Eman Abu-Gharbieh
- PhD. Professor, Department of Clinical Sciences, College of Medicine, Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Hamzah Alzubaidi
- PhD. Associate Professor, Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
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Basheti IA, Mhaidat NM, Al-Azzam S, Alqudah R, Nassar R, Alzubaidi H, Abu-Samak MS, Abu-Gharbieh E. Knowledge and perceptions of pharmacists' readiness during coronavirus pandemic: the case of United Arab Emirates. J Pharm Policy Pract 2021; 14:102. [PMID: 34857056 PMCID: PMC8637029 DOI: 10.1186/s40545-021-00382-z] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/23/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND With the outbreak of Coronavirus infection (COVID-19), pharmacists play an important role in supporting local health during this emergency. AIM To assess the knowledge and to identify information sources regarding COVID-19 used by pharmacists, to investigate the active and public perceived roles of pharmacists, to explore the role of the pharmacy facilities and health authorities, and to identify barriers that would hinder pharmacists from performing their duties optimally in the United Arab Emirates. METHODS This descriptive cross-sectional online study was conducted in the UAE during the COVID-19 outbreak, from 18 May to 20 June 2020. A validated online questionnaire addressing participants' current knowledge about pandemics and COVID-19, source of information, and their perspectives of their role was used. Participants were licensed pharmacists practising in community and hospital pharmacies in UAE, academics, and pharmacy students. RESULTS Almost two-thirds of the participants (71.2%) were aged 18-30 years, with 76.2% females. Only 57.5% of participants believed that they got enough education about pandemics, and 88.3% of them followed on the latest coronavirus updates regarding treatments, and that is mainly from the World Health Organization reports (53.9%), followed by health authorities (44.8%). Two-thirds of participants (69.7%) had good/very good current knowledge regarding COVID-19. Knowledge of pharmacy students compared to pharmacists was significantly higher (p < 0.001). CONCLUSION The majority of pharmacists and pharmacy students reported that they have a major role in managing pandemics executed through the community pharmacies and that it is their role to ensure the availability of key medications. Policymakers and health authorities are called upon to train pharmacists in advance of emerging situations, supporting and helping them to optimally fulfill their role.
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Affiliation(s)
- Iman A. Basheti
- Clinical Pharmacy, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Nizar M. Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Rajaa Alqudah
- Clinical Pharmacy, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Razan Nassar
- Clinical Pharmacy, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Mahmoud S. Abu-Samak
- Clinical Pharmacy, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Eman Abu-Gharbieh
- Department of Clinical Sciences, College of Medicine, University of Sharjah, 27272 Sharjah, United Arab Emirates
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Alzubaidi H, Jirjees FJ, Franson KL, Saidawi W, Othman AM, Rabeeah ZH, Al-Obaidi HJ, Hatahet T, Caliph S. A global assessment of distance pharmacy education amid COVID-19: teaching, assessment and experiential training. Int J Pharm Pract 2021; 29:633-641. [PMID: 34609503 DOI: 10.1093/ijpp/riab064] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 09/16/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To explore pharmacy colleges' experiences and challenges worldwide with the transition to online teaching during the coronavirus disease 2019 (COVID-19) pandemic. METHODS From the six World Health Organization regions, 28 countries with the highest number of COVID-19 cases were identified, and 111 pharmacy colleges were randomly selected from these countries. Two online surveys were sent to faculty members and senior administrators. They assessed changes in teaching and learning, experiential training, assessment, readiness for and challenges with distance e-learning and work-related stress. KEY FINDINGS Data were collected from 46 colleges. The majority (80.4%) of colleges transitioned to distance e-learning. On-site experiential training was discontinued in 55.5% of colleges and 25.0% redesigned on-site training into remote learning experiences. Assessments were modified in 75.9% of colleges. Assuring the integrity of assessments and delivering practical classes were the most prominent faculty challenges. The majority of faculty (75.0%) and administrators (61.9%) reported moderate work-related stress. Nevertheless, most academics felt that they received adequate support from their institutions and had positive perceptions of the transition to distance e-learning during the pandemic. CONCLUSIONS The COVID-19 pandemic required drastic changes for most programs' teaching methods. Our results showed that educational institutions were somewhat able to support faculty and the needs of educational programs were largely met. However, academic rigour and provision of experiential training can be improved. Faculty emotional support and training needs were not fully addressed in these difficult times. These results shed light on how the global pharmacy academy has addressed the COVID-19 pandemic and help rethink crisis response models.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Kari L Franson
- School of Pharmacy, University of Southern California, Los Angeles, California, United States of America
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Amna M Othman
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Zainab H Rabeeah
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Hala Jehad Al-Obaidi
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Taher Hatahet
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Suzanne Caliph
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
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17
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Alzubaidi H, Sulieman H, Mc Namara K, Samorinha C, Browning C. The relationship between diabetes distress, medication taking, glycaemic control and self-management. Int J Clin Pharm 2021; 44:127-137. [PMID: 34586556 DOI: 10.1007/s11096-021-01322-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/07/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Aim To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting Various healthcare settings in Australia. Method A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.
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Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates. .,Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.
| | - Hana Sulieman
- Department of Mathematics and Statistics, American University of Sharjah, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin University, Victoria, Australia.,Centre for Population Health Research, Deakin University, Burwood, VIC, Australia
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Colette Browning
- School of Nursing and Healthcare Professions, Federation University, Ballarat, VIC, Australia.,Australian National University, Australian Capital Territory, Canberra, Australia
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Alzubaidi H, Samorinha C, Saddik B, Saidawi W, Abduelkarem AR, Abu-Gharbieh E, Sherman SM. A mixed-methods study to assess COVID-19 vaccination acceptability among university students in the United Arab Emirates. Hum Vaccin Immunother 2021; 17:4074-4082. [PMID: 34534052 DOI: 10.1080/21645515.2021.1969854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/17/2022] Open
Abstract
To effectively achieve herd immunity against COVID-19, a substantial proportion of a population would need to be vaccinated. However, vaccine hesitancy and refusal are significant issues globally. This mixed-methods study aimed to investigate university students' attitudes in the United Arab Emirates (UAE) toward the COVID-19 vaccination, determine the factors associated with vaccine hesitancy, and understand the underlying reasons. We conducted an online survey between 16th-24th February 2021 in 669 students from the University of Sharjah (UAE) and semi-structured qualitative interviews with a subsample of 11 participants. Data on COVID-19 vaccine intention and uptake, risk perception, beliefs and attitudes toward the disease and the vaccine were collected. Multinomial logistic regression was applied and thematic content analysis was conducted with qualitative data. Overall, 31.8% of students demonstrated vaccine hesitancy; 24.4% of students reported a high intention to get the vaccine, and 43.8% were already vaccinated. Vaccine hesitancy was associated with less positive beliefs and attitudes toward the COVID-19 vaccine (AdjOR = 0.557;95%CI 0.468-0.662), high perceived adverse effects (AdjOR = 1.736;95%CI 1.501-2.007), and not perceiving easy access to a vaccination center (AdjOR = 0.820;95%CI 0.739-0.909). The main reasons underlying vaccine hesitancy were related to uncertainty about the effectiveness of the vaccine, knowledge about negative experiences from vaccination among family and/or community, overvaluing the risks of the vaccine in relation to the potential benefits, and not perceiving immunization as a social norm. To increase COVID-19 vaccination uptake, interventions to reduce hesitancy could focus on reducing fears about adverse effects and highlighting individual and societal benefits of the vaccination.
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Affiliation(s)
- Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.,Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Abduelmula R Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Eman Abu-Gharbieh
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Alzubaidi H, Hasan S, Saidawi W, Mc Namara K, Chandir S, Krass I. Outcomes of a novel pharmacy screening intervention to address the burden of type 2 diabetes and cardiovascular disease in an Arabic-speaking country. Diabet Med 2021; 38:e14598. [PMID: 33969536 DOI: 10.1111/dme.14598] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022]
Abstract
AIMS Aim of this study is to evaluate the capacity of a pharmacist-delivered screening model for type 2 diabetes and cardiovascular disease (CVD) in identifying and referring individuals at risk. METHOD A screening programme was implemented in 12 community pharmacies in three cities in the United Arab Emirates. Trained pharmacists screened adults (≥40 years) without a previous diagnosis of diabetes or CVD. Most participants were recruited during their visits to the pharmacies; pharmacy-based advertising and social media were also used. The screening included medical history, anthropometric measurements, point-of-care glycated haemoglobin (HbA1c ) levels, and a lipid panel. High-risk individuals (HbA1c ≥ 5.7% [39 mmol/mol], a high diabetes risk score, or a 10-year CVD risk ≥7.5%) were given a referral letter and advised to visit their physician. Risk factors for elevated HbA1c were identified by logistic regression. RESULTS Of the 568 screened participants, 332/568 (58%) were identified to be at risk: HbA1c levels were consistent with diabetes 67/560 (12%) or prediabetes 148/560 (26%), high diabetes risk score 243/566 (43%), CVD risk score > 7.5% 79/541 (15%). Obese people were more likely to have prediabetes or diabetes OR (95% CI): 3.2 (1.3, 7.5), as were those who spent more than 11 h/day sitting: 5.7 (1.8, 17.6). Of the 332 at-risk participants, 206 (62%) responded to a telephone follow-up at six weeks; one-third had discussed screening results with their physician. CONCLUSIONS Community pharmacists detected and referred individuals at risk for diabetes or CVD, although participant follow-up with their physician could be improved. Pharmacy screening is feasible and will potentially improve outcomes.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin University, Geelong, Vic., Australia
- Centre for Population Health Research, Deakin University, Burwood, Vic., Australia
| | - Subhash Chandir
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- IRD Global, Singapore, Singapore
| | - Ines Krass
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Abstract
BACKGROUND The global prevalence of Alzheimer's disease (AD) and its treatment costs are projected to increase significantly, placing increasing pressure on health systems to create new models of care. Community pharmacists are well-positioned to provide medication management for people with AD. In Arabic-speaking countries, little is known about pharmacists' knowledge and practices in caring for people with AD. OBJECTIVE To evaluate community pharmacists' knowledge of AD and its management, counseling skills, and dispensing patterns when caring for people with AD and their caregivers in the United Arab Emirates (UAE). METHODS A large-scale cross-sectional survey of community pharmacists was conducted in three cities in the UAE using stratified random sampling. The questionnaire comprised of validated tools to measure knowledge and open-ended questions. A logistic regression model was conducted to predict counseling comprehensiveness. RESULTS A total of 325 community pharmacists completed the questionnaire. The mean knowledge scores about AD and its pharmacotherapy were 57.0% and 67.6%, respectively. Major shortcomings in pharmacists' practices were identified; history-taking, adherence assessment, and counseling were provided by 2.2%, 9.3%, and 17.3%, respectively. A minority provided comprehensive counselling; the multivariate analysis yielded new insights into pharmacist characteristics associated with such counseling. CONCLUSION Pharmacists did not provide structured patient-centered care for people with AD. Community pharmacists did not provide adequate counseling, did not assess adherence-related issues appropriately, and had deficient knowledge. To develop patient-centered pharmacy-based services for Arabic-speaking communities, a multifaceted approach is required that goes beyond improving pharmacy workforce knowledge and communication skills to address broader sociocultural, legislative, and financial factors.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.,Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Amal Hussein
- Family and Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Sulaiman N, Rishmawy Y, Hussein A, Saber-Ayad M, Alzubaidi H, Al Kawas S, Hasan H, Guraya SY. A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students. BMC Med Educ 2021; 21:203. [PMID: 33836727 PMCID: PMC8035734 DOI: 10.1186/s12909-021-02645-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/24/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students' readiness and positive attitudes towards IPE have been reported from the Arabian context. METHODS A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. RESULTS This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. CONCLUSION This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.
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Affiliation(s)
- Nabil Sulaiman
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Family & Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Baker Heart and Diabetes Institute, Melbourne, Victoria Australia
| | - Youssef Rishmawy
- Department of Family & Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amal Hussein
- Department of Family & Community Medicine & Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Maha Saber-Ayad
- Department of Clinical Sciences, College of Medicine & Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, Cairo University, Giza, Egypt
| | - Hamzah Alzubaidi
- Pharmacy Practice & Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Salman Y. Guraya
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Alzubaidi H, Namara KM, Saidawi W, Hasan S, Krass I. Pharmacists' experiences and views on providing screening services: An international comparison. Res Social Adm Pharm 2020; 16:1558-1568. [DOI: 10.1016/j.sapharm.2020.07.019] [Citation(s) in RCA: 3] [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: 02/27/2020] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 01/16/2023]
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Mc Namara KP, Krass I, Peterson GM, Alzubaidi H, Grenfell R, Freedman B, Dunbar JA. Implementing screening interventions in community pharmacy to promote interprofessional coordination of primary care - A mixed methods evaluation. Res Social Adm Pharm 2019; 16:160-167. [PMID: 31088777 DOI: 10.1016/j.sapharm.2019.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/14/2018] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Screening is a critical component of efforts to reduce the population burden of cardiovascular disease (CVD), by facilitating early use of cost-effective prevention and treatment strategies. While international evidence suggests that screening in community pharmacies improves screening access and identifies at-risk individuals, concerns from medical organisations about the absence of interdisciplinary coordination and related lack of continuity of care with general practice have significantly contributed to reluctance from some stakeholders to endorse, and engage with, pharmacy-based screening initiatives. The Cardiovascular Absolute Risk Screening (CARS) study was designed to address these challenges and promote an interprofessional approach to screening for cardiovascular disease risk by pharmacists. This study describes the impact of the CARS implementation model on interdisciplinary coordination and continuity of care. METHODS In addition to clinical training, pharmacists at eleven participating pharmacies were provided with implementation training, resources and support to promote interprofessional coordination. Completion of training and pharmacy implementation plans, both of which highlighted GP engagement strategies, were pre-requisites for screening commencement. Using mixed methods approaches, data were analyzed from screening records (n = 388), researcher interviews with patients at 6-10 weeks post-screening (n = 248, 64%), and pharmacist interviews (n = 10). RESULTS Screening records suggested that 94% of screened individuals were advised to seek formal GP assessment, and 98% consented to sharing of results. Among interviewed participants, 81% recalled direct pharmacist action to facilitate GP engagement. Among interviewees who had seen their GP already (n = 70), 79% reported that their GP was aware of the results (another 16% were uncertain). Pharmacists reported positive GP feedback stemming from efforts at early engagement, but an absence of ongoing collaboration. CONCLUSIONS Use of implementation planning by pharmacists, alongside clinical training, can effectively promote an interdisciplinary coordination focus by pharmacists.
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Affiliation(s)
- Kevin P Mc Namara
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia; Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia.
| | - Ines Krass
- School of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Gregory M Peterson
- School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Hamzah Alzubaidi
- University of Sharjah, Sharjah Institute for Medical Research and College of Pharmacy, Sharjah, United Arab Emirates
| | - Rob Grenfell
- CSIRO Health and Biosecurity, Parkville, Victoria, Australia
| | - Ben Freedman
- Heart Research Institute/Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - James A Dunbar
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
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Alzubaidi H, Hussein A, Mc Namara K, Scholl I. Psychometric properties of the Arabic version of the 9-item Shared Decision-Making Questionnaire: the entire process from translation to validation. BMJ Open 2019; 9:e026672. [PMID: 30948608 PMCID: PMC6500381 DOI: 10.1136/bmjopen-2018-026672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To translate the German 9-item Shared Decision-Making Questionnaire (SDM-Q-9) to Arabic and assess its psychometric properties for measuring Arabic-speaking patients' perceptions of the shared decision-making (SDM) process. DESIGN Multicentre cross-sectional study. SETTING Secondary healthcare settings; outpatient clinics of 10 major hospitals were selected in four emirates in the United Arab Emirates (Abu Dhabi, Dubai, Sharjah and Umm Al Quwain). PARTICIPANTS Patients with chronic diseases who attended outpatient clinics of participating hospitals. MEASUREMENTS The original German SDM-Q-9 was translated to Arabic. International multiphase translation guidelines and the process of cross-cultural adaptation of self-reported measures were used. Various psychometric properties were assessed, including reliability (internal consistency), and construct validity (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). RESULTS The final Arabic version of the SDM-Q-9 was tested among 516 secondary care patients. Internal consistency yielded a Cronbach's alpha of 0.929 for the whole scale. EFA showed a one-factorial solution, Kaiser-Meyer-Olkin measure of sampling adequacy was 0.907 and Bartlett's test of sphericity was significant (χ2=3413.69, df=36, p<0.0005). For the CFA, two different models were tested; Model 1 included the nine items and Model 2 was monofactorial that included items 2-9 and thus excluded item 1. Both models were adequate as they produced similar indices. CONCLUSIONS The Arabic version of SDM-Q-9 showed excellent reliability and acceptable validity parameters among secondary care patients. The newly translated Arabic questionnaire is the first psychometrically tested tool that can be used in the 22 member states of the Arab league to assess patients' perspectives on the SDM process.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Amal Hussein
- Family and Community Medicine & Behavioral Sciences, University of Sharjah, College of Medicine, Sharjah, United Arab Emirates
| | | | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract
Cardiovascular diseases (CVDs) are a leading cause of death globally. This article explores the evidence surrounding community pharmacist interventions to reduce cardiovascular events and related mortality and to improve the management of CVD risk factors. We summarize a range of systematic reviews and leading randomized controlled trials and provide critical appraisal. Major observations are that very few trials directly measure clinical outcomes, potentially owing to a range of challenges in this regard. By contrast, there is an extensive, high-quality evidence to suggest that improvements can be achieved for key CVD risk factors such as hypertension, dyslipidemia, tobacco use, and elevated hemoglobin A1c. The heterogeneity of interventions tested and considerable variation of the context under which implementation occurred suggest that caution is warranted in the interpretation of meta-analyses. It is highly important to generate evidence for pharmacist interventions in developing countries where a majority of the global CVD burden will be experienced in the near future. A growing capacity for clinical registry trials and data linkage might allow future research to collect clinical outcomes data more often.
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Affiliation(s)
- Kevin Mc Namara
- School of Medicine, Deakin University, Geelong, VIC, Australia,
- Deakin Health Economics, Centre for Population Health, Deakin University, Geelong, VIC, Australia,
- Centre for Medicine Use & Safety, Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia,
| | - Hamzah Alzubaidi
- Institute for Medical Research and College of Pharmacy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
| | - John Keith Jackson
- Centre for Medicine Use & Safety, Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia,
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26
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Alzubaidi H, Saidawi W, Mc Namara K. Pharmacist views and pharmacy capacity to deliver professional services in the United Arab Emirates. Int J Clin Pharm 2018; 40:1106-1115. [PMID: 29926256 DOI: 10.1007/s11096-018-0662-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/14/2017] [Accepted: 05/17/2018] [Indexed: 01/19/2023]
Abstract
Background The benefits of professional pharmacy services in improving patient outcomes and reducing health expenditure are well documented. To a large extent, these services are not implemented in many developing countries. Objective To explore pharmacists' perceptions of and willingness to provide professional services in the United Arab Emirates (UAE) and the perceived barriers and facilitators. The current provision of pharmacy-based services and capacity for service delivery were also explored. Setting Community pharmacies in Sharjah and Dubai in the UAE. Methods A 34-item cross-sectional survey was conducted. It assessed community pharmacists' perceptions of and willingness to provide professional services in the future, current service provision and capacity to deliver professional services. A descriptive analysis of responses was undertaken. Main outcome measure Community pharmacists' perceptions of and willingness to provide pharmacy-based professional services in the United Arab Emirates (UAE) and associated barriers and facilitators. Results Overall, 200 community pharmacists completed the survey. Ninety-two percent of participants thought that it is time for community pharmacists to engage in extended services (screening, medication use reviews, and chronic disease management) provided that adequate training and regulatory approvals are given. The current restrictive legislations and negative public perception were perceived as major barriers to providing extended services, but lack of time and support staff were also considered barriers. Conclusions Community pharmacists held strong positive views regarding future engagement in professional services. Given the compelling public health case for expansion of affordable care, it is timely to expand health services in the UAE by using the untapped clinical skills of pharmacists. Transition towards professional pharmacy services requires support from key stakeholders including medical and regulatory organizations, and public acceptance.
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Affiliation(s)
- Hamzah Alzubaidi
- Sharjah Institute for Medical Research and College of Pharmacy, University of Sharjah, PO Box 2727, Sharjah, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research and College of Pharmacy, University of Sharjah, PO Box 2727, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia.,Centre for Population Health Research, Deakin University, Burwood, VIC, 3125, Australia.,Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, VIC, 3052, Australia
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Alzubaidi H, Mc Namara K, Versace VL. Predictors of effective therapeutic relationships between pharmacists and patients with type 2 diabetes: Comparison between Arabic-speaking and Caucasian English-speaking patients. Res Social Adm Pharm 2017; 14:1064-1071. [PMID: 29217315 DOI: 10.1016/j.sapharm.2017.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/03/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND The benefits of pharmacist-led interventions in achieving desired patient outcomes have been well established. Effective patient-pharmacist relationships are required to provide high-quality pharmacy care. Limited information is available about how Arabic-speaking migrants with diabetes, in Australia, perceive patient-pharmacist relationship and how these perspectives differ from the mainstream society (represented by Caucasian English-speaking people). OBJECTIVE To examine and compare the patient-pharmacist relationship, medication underuse and adherence levels among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes. METHODS A 98-item survey incorporating several previously-validated measurements was completed by Arabic-speaking migrants (ASMs) and Caucasian English-speaking patients (ESPs) with type 2 diabetes. Participants were recruited from various healthcare settings in the Melbourne metropolitan area and rural Victoria, Australia. This survey-based, cross-sectional study was designed to explore patients' perceptions of the patient-pharmacist relationship. A descriptive analysis of responses was undertaken, and binary logistic regression was used to explore patient-pharmacist relationships. RESULTS A total of 701 participants were recruited; 392 ASMs and 309 ESPs. Of ASMs, 88.3% were non-adherent to their prescribed medication, compared with 45.1% of ESPs. The degree of relationship with community pharmacists differed significantly between ASMs and ESPs. Compared with ASMs, significantly more ESPs reported that they have thought about consulting a pharmacist when they had health problems (P = 0.002). Compared with ESPs, significantly fewer ASMs reported always following pharmacist recommendations (32% versus 61.9% respectively). CONCLUSIONS Arabic-speaking migrants had less-effective relationships with community pharmacists when having their prescriptions filled. Community pharmacists' expertise appeared to be underused. These minimal relationships represent missed opportunities to improve health outcomes.
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Affiliation(s)
- H Alzubaidi
- University of Sharjah, Sharjah Institute for Medical Research and College of Pharmacy, PO Box 2727, Sharjah, United Arab Emirates; Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
| | - K Mc Namara
- Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia; Centre for Population Health Research, Deakin University, Burwood, Victoria 3125, Australia
| | - V L Versace
- Deakin Rural Health, School of Medicine, Deakin University, PO Box 423, Warrnambool, Victoria 3280, Australia
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Alzubaidi H, Mc Namara K, Browning C. Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care. Diabet Med 2017; 34:348-355. [PMID: 27864988 DOI: 10.1111/dme.13286] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 11/29/2022]
Abstract
AIM The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. METHODS Two qualitative methods were used: face-to-face semi-structured individual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a diverse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. RESULTS No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. CONCLUSIONS A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change.
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Affiliation(s)
- H Alzubaidi
- Sharjah Institute for Medical Research and College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Department of Pharmacy Practice, Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - K Mc Namara
- Department of Pharmacy Practice, Centre for Medicine Use and Safety, Monash University, Parkville, Australia
- School of Medicine, Deakin University, Waurn Ponds, Australia
- Centre for Population Health Research, Deakin University, Burwood, Australia
| | - C Browning
- RDNS Research Institute, St Kilda, Victoria, Australia
- International Institute for Primary Health Care Research, Shenzhen, China
- School of Primary Health Care, Monash University, Melbourne, Australia
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Alzubaidi H, Mc Mamara K, Chapman C, Stevenson V, Marriott J. Medicine-taking experiences and associated factors: comparison between Arabic-speaking and Caucasian English-speaking patients with Type 2 diabetes. Diabet Med 2015; 32:1625-33. [PMID: 25761373 DOI: 10.1111/dme.12751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 01/01/2023]
Abstract
AIM The aim of this study was to explore and compare medication-taking experiences and associated issues in Arabic-speaking and Caucasian English-speaking patients with Type 2 diabetes in Australia. METHODS Various healthcare settings in metropolitan Melbourne, Australia, were purposefully selected to obtain a diverse group of participants with Type 2 diabetes. Recruitment occurred at diabetes outpatient clinics in two tertiary referral hospitals, six primary care practices and ten community centres. Face-to-face semi-structured individual interviews and group interviews were employed. All interviews were audiotaped, transcribed and coded thematically. Data collection continued until saturation was reached. RESULTS In total, 100 participants were recruited into two groups: 60 were Arabic-speaking and 40 were Caucasian English-speaking. Both groups had similar demographic and clinical characteristics. Only 5% of the Arabic-speaking participants had well-controlled diabetes compared with 17.5% of the participants in the English-speaking group. Arabic-speaking participants actively changed medication regimens on their own without informing their healthcare professionals. Arabic-speaking patients had more knowledge gaps about their prescribed treatments, compared with the English-speaking group. Their use of diabetes medicines was heavily influenced by peers with diabetes and family members; conversely, they feared revealing their diagnosis within the wider Arabic community due to stigma and collective negative social labelling of diabetes. Confidence in non-Arabic-speaking healthcare providers was lacking. CONCLUSIONS Findings yielded new insights into medication-taking practices and associated factors in Arabic-speaking patients with diabetes. It is vital that healthcare professionals working with Arabic-speaking patients adapt their treatment approaches to accommodate different beliefs and views about medicines.
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Affiliation(s)
- H Alzubaidi
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - K Mc Mamara
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
- Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Australia
| | - C Chapman
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - V Stevenson
- Diabetes Education Services Heidelberg Repatriation Hospital, Heidelberg, Australia
| | - J Marriott
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
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Alzubaidi H, Mc Namara K, Browning C, Marriott J. Barriers and enablers to healthcare access and use among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes mellitus: a qualitative comparative study. BMJ Open 2015; 5:e008687. [PMID: 26576809 PMCID: PMC4654379 DOI: 10.1136/bmjopen-2015-008687] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The objective of this study was to explore the decision-making processes and associated barriers and enablers that determine access and use of healthcare services in Arabic-speaking and English-speaking Caucasian patients with diabetes in Australia. STUDY SETTING AND DESIGN Face-to-face semistructured individual interviews and group interviews were conducted at various healthcare settings-diabetes outpatient clinics in 2 tertiary referral hospitals, 6 primary care practices and 10 community centres in Melbourne, Australia. PARTICIPANTS A total of 100 participants with type 2 diabetes mellitus were recruited into 2 groups: 60 Arabic-speaking and 40 English-speaking Caucasian. DATA COLLECTION Interviews were audio-taped, translated into English when necessary, transcribed and coded thematically. Sociodemographic and clinical information was gathered using a self-completed questionnaire and medical records. PRINCIPAL FINDINGS Only Arabic-speaking migrants intentionally delayed access to healthcare services when obvious signs of diabetes were experienced, missing opportunities to detect diabetes at an early stage. Four major barriers and enablers to healthcare access and use were identified: influence of significant other(s), unique sociocultural and religious beliefs, experiences with healthcare providers and lack of knowledge about healthcare services. Compared with Arabic-speaking migrants, English-speaking participants had no reluctance to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviours were straightforward. CONCLUSIONS Arabic-speaking migrants appear to intentionally delay access to medical services even when symptomatic. Four barriers to health services access have been identified. Tailored interventions must be developed for Arabic-speaking migrants to improve access to available health services, facilitate timely diagnosis of diabetes and ultimately to improve glycaemic control.
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Affiliation(s)
- H Alzubaidi
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
| | - K Mc Namara
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
- Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Victoria, Australia
| | - Colette Browning
- Institute at Royal District Nursing Service, Melbourne, Australia
| | - J Marriott
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
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Alzubaidi H, Mc Narmara K, Kilmartin GM, Kilmartin JF, Marriott J. The relationships between illness and treatment perceptions with adherence to diabetes self-care: A comparison between Arabic-speaking migrants and Caucasian English-speaking patients. Diabetes Res Clin Pract 2015; 110:208-17. [PMID: 26415673 DOI: 10.1016/j.diabres.2015.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 08/03/2015] [Accepted: 08/18/2015] [Indexed: 01/22/2023]
Abstract
AIMS To compare illness and treatment perceptions between Arabic-speaking immigrants and Caucasian English-speaking people with type 2 diabetes, and explore the relationships between these beliefs and adherence to self-care activities. METHODS A cross-sectional study was conducted in healthcare settings with large Arabic populations in metropolitan and rural Victoria, Australia. Adherence to self-care activities, illness and treatment perceptions, and clinical data were recorded. Bivariate associations for continuous normally distributed variables were tested with Pearson's correlation. Non-parametric data were tested using Spearman's rank correlation coefficient. RESULTS 701 participants were recruited; 392 Arabic-speaking participants (ASPs) and 309 English-speaking participants (ESPs). There were significant relationships between participants' illness and treatment perceptions and adherence to diabetes self-care activities. ASPs' negative beliefs about diabetes were strongly and significantly correlated with poorer adherence to diet recommendations, exercise, blood glucose testing and foot care. ASPs were significantly less adherent to all aspects of diabetes self-care compared with ESPs: dietary behaviours (P=<0.01; 95% confidence interval (CI)=-1.17, -0.84), exercise and physical activity (P=<0.001, 95% CI -1.14, -0.61), blood glucose testing (P=<0.001) and foot-care (P=<0.001). 52.8% of ASPs were sceptical about prescribed diabetes treatment compared with only 11.2% of the ESPs. 88.3% of ASPs were non-adherent to prescribed medication, compared with 45.1% of ESPs. CONCLUSIONS Arabic-speaking migrants' illness and treatment perceptions were significantly different from the English-speaking group. There is a pressing need to develop new innovative interventions that deliver much-needed improvements in adherence to self-care activities and key health outcomes.
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Affiliation(s)
- Hamzah Alzubaidi
- Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
| | - Kevin Mc Narmara
- Greater Green Triangle University, Department of Rural Health, Flinders University and Deakin University, PO Box 423, Warrnambool, Victoria 3280, Australia; Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Gloria M Kilmartin
- Goulburn Valley Diabetes Centre, Goulburn Valley Health, Graham St., Shepparton, Victoria 3630, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Science, Shepparton, Victoria 3630, Australia
| | - John F Kilmartin
- Goulburn Valley Diabetes Centre, Goulburn Valley Health, Graham St., Shepparton, Victoria 3630, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Science, Shepparton, Victoria 3630, Australia
| | - Jennifer Marriott
- Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
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