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Abdel-Qader DH, Abdel-Qader H, Silverthorne J, Kongkaew C, Meslamani AZA, Hayajneh W, Alwahadneh AM, Hamadi S, Abu-Qatouseh L, Awad R, Al Nsour M, Alhariri A, Shnewer K, Da'ssan M, Obeidat NM, Nusair KE, Jalamdeh MS, Hawari F, Asad M, AbuRuz S. Real-World Effectiveness of Four Types of COVID-19 Vaccines. Vaccines (Basel) 2023; 11:vaccines11050985. [PMID: 37243089 DOI: 10.3390/vaccines11050985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND There is a scarcity of evidence regarding the real-world effectiveness of coronavirus disease 2019 (COVID-19) vaccines. This was the first study to evaluate the effectiveness of four types of vaccines against asymptomatic and symptomatic infection, and COVID-19 outcomes among the general population. METHODS This was a matched comparison group quasi-experimental study conducted in Jordan between 1 January and 29 August 2021. In the first part of the study, 1200 fully vaccinated individuals were matched with 1200 unvaccinated control participants. In order to measure vaccine effectiveness, the infection rates of both vaccinated and unvaccinated groups were calculated. The second part of the study included measuring specific anti-SARS CoV-2 immune cells and antibodies. RESULTS BNT162b2 (Pfizer, New York, NY, USA) showed a significantly higher effectiveness against asymptomatic COVID-19 infection (91.7%) and hospitalization (99.5%) than BBIBP-CorV (Sinopharm, Beijing, China) (88.4% and 98.7%, respectively) and ChAdOx1 nCoV-19 (AstraZeneca, Cambridge, UK) (84.3%, and 98.9%, respectively). The effectiveness rates of the Sputnik V (Gamaleya Research Institute, Moscow, Russia) vaccine against asymptomatic, symptomatic, and hospitalization were 100%, 100%, and 66.7%, respectively. The highest median anti-spike (S) IgG values were seen in individuals who received BNT162b2 (2.9 AU/mL) and ChAdOx1 nCoV-19 (2.8 AU/mL) vaccines. The levels of anti-S IgG were significantly decreased after 7 months of vaccination with BNT162b2 and BBIBP-CorV. There were significant decreases in the median number of neutralizing antibodies one month and seven months after receiving BNT162b2 (from 88.5 to 75.2 4 Bioequivalent Allergen Unit per milliliter/mL), BBIBP-CorV (from 69.5 to 51.5 BAU/mL), and ChAdOx1 nCoV-19 (from 69.2 to 58.BAU/mL) vaccines. The highest percentage of T cells specific to COVID-19 vaccine was found in individuals who received BNT162b2 (88.5%). CONCLUSION All four vaccines evaluated in this study showed effectiveness against asymptomatic COVID-19 infection, symptomatic infection, hospitalization, and death. Furthermore, BNT162b2, BBIBP-CorV, and ChAdOx1 nCoV-19 induced high levels of immunology markers within one month of vaccination.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
- Al Rashid Hospital Center, Amman 11623, Jordan
| | | | - Jennifer Silverthorne
- Division of Pharmacy & Optometry, The University of Manchester, Manchester M13 9PL, UK
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Naresuan University, Phitsanulok 65000, Thailand
| | - Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
- College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
| | - Wail Hayajneh
- School of Medicine, St. Louis University, St. Louis, MO 63104, USA
- School of Medicine, Jordan University of Science & Technology, Irbid 3030, Jordan
| | | | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Luay Abu-Qatouseh
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Riad Awad
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Mohannad Al Nsour
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | | | | | | | - Nathir M Obeidat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | - Mohammad Asad
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, The United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Arabyat M, Abdul-Sattar A, Al-Fararjah F, Al-Ghazawi A, Rabayah A, Al-Hasassnah R, Mohmmad W, Al-Adham I, Hamadi S, Idkaidek N. Therapeutic Drug Monitoring of Vancomycin in Jordanian Patients. Development of Physiologically-Based Pharmacokinetic (PBPK) Model and Validation of Class II Drugs of Salivary Excretion Classification System (SECS). Drug Res (Stuttg) 2022; 72:441-448. [PMID: 35760335 DOI: 10.1055/a-1852-5391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Vancomycin is a commonly used antibiotic for multi-drug resistant gram-positive infections treatment, especially methicillin-resistant Staphylococcus aureus (MRSA). Despite that, it has wide individual pharmacokinetic variability and nephrotoxic effect. Vancomycin trough concentrations for 57 Jordanian patients were measured in plasma and saliva through immunoassay and liquid chromatography-mass spectrometry (LC-MS/MS), respectively. Plasma levels were within accepted normal range, with exception of 6 patients who showed trough levels of more than 20 μg/ml and vancomycin was discontinued. Bayesian dose-optimizing software was used for patient-specific pharmacokinetics prediction and AUC/MIC calculation. Physiological-based pharmacokinetic (PBPK) vancomycin model was built and validated through GastroPlus™ 9.8 using in-house plasma data. A weak correlation coefficient of 0.2478 (P=0.1049) was found between plasma and saliva concentrations. The suggested normal saliva trough range of vancomycin is 0.01906 to 0.028589 (μg/ml). Analysis of variance showed significant statistical effects of creatinine clearance and albumin concentration on dose-normalized Cmin plasma and saliva levels respectively, which is in agreement with PBPKmodeling. It can be concluded that saliva is not a suitable matrix for TDM of vancomycin. Trough levels in plasma matrix should always be monitored for the safety of patients.
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Affiliation(s)
- Majd Arabyat
- College of Pharmacy, University of Petra, Amman, Jordan
| | | | | | | | | | | | | | | | - Salim Hamadi
- College of Pharmacy, University of Petra, Amman, Jordan
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Abdel-Qader DH, Saadi Ismael N, Al Meslamani AZ, Albassam A, El-Shara' AA, Lewis PJ, Hamadi S, Al Mazrouei N. The Role of Clinical Pharmacy in Preventing Prescribing Errors in the Emergency Department of a Governmental Hospital in Jordan: A Pre-Post Study. Hosp Pharm 2021; 56:681-689. [PMID: 34732922 DOI: 10.1177/0018578720942231] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Clinical pharmacists have a vital role in intercepting prescribing errors (PEs) but their impact within a Jordanian hospital emergency department (ED) has never been studied. Objective: To evaluate the impact of clinical pharmacy services on PEs and assess predictors of physicians' acceptance of clinical pharmacists' interventions. Setting: This study was conducted in the ED of the largest governmental hospital in Jordan. Method: This was a pre-post study conducted in October and November 2019 using a disguised observational method. There were 2 phases: control phase (P0) with no clinical interventions, and active phase (P1) where clinical pharmacists prospectively intervened upon errors. The clinical significance of errors was determined by a multidisciplinary committee. The SPSS software version 24 was used for data analysis. Main Outcome Measure: PEs incidence, type, severity, and predictors for physicians' acceptance. Results: Of 18003 patients, 8732 were included in P0 and 9271 in P1. PEs incidence decreased from 24.6% to 5.4%. Contraindication, drug selection, and dosage form error types were significantly reduced from 32.6%, 9.1%, and 3.7% (P0) to 12.6%, 0.0%, and 0.0% (P1), respectively. Albeit not statistically significant, drug-drug interaction, drug frequency, and allergy error types were reduced from 4.9%, 3.1%, and 0.1% to 4.5%, 2.5%, and 0.0%, respectively. Significant and serious errors were significantly reduced from 68.7% and 3.0% (P0) to 8.9% and 1.8% (P1), respectively. During P1, most errors were minor (89.3%, 1574/1763), and lethal errors ceased. Predictors for physicians' acceptance were: significant errors (OR 3.1; 95% CI 2.6-4.3; P = 0.03) and non-busy physicians (OR 2.1; 95% CI 1.6-2.7; P = 0.04). Conclusion: Clinical pharmacists significantly reduced PEs in the ED by 76%; most of interventions were significant. Policymakers are advised to implement active clinical pharmacy in the ED.
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Affiliation(s)
- Derar H Abdel-Qader
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | | | - Ahmad Z Al Meslamani
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | | | - Asma' A El-Shara'
- Department of Clinical Sciences, Philadelphia University, Amman, Jordan
| | - Penny J Lewis
- Division of Pharmacy & Optometry, The University of Manchester, UK
| | - Salim Hamadi
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, UAE
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Abdel-Qader DH, Ismael NS, Albassam A, El-Shara’ AA, Aljamal MS, Ismail R, Abdel-Qader HA, Hamadi S, Al Mazrouei N, Ibrahim OM. Antibiotics use and appropriateness in two Jordanian children hospitals: a point prevalence study. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Although inappropriate antibiotics prescribing in hospitals is a key factor in accelerating antibiotic resistance, inadequate data are available about antibiotics prescribing rate and appropriateness. Our study aimed to measure antibiotics prescribing rate, indications, appropriateness and predictors.
Methods
The study was conducted in two public children hospitals (five wards) in Jordan using one-week point prevalence survey to prospectively collect the data. Appropriateness of antibiotics therapy was assessed by a multidisciplinary committee and predictors of inappropriate prescribing were studied through multivariate logistic regression.
Key findings
The overall antibiotics prescribing rate was 75.6% (n = 501/663), where the highest rate of antibiotics prescribing was in the Pediatrics ward (82.2%, n = 222/270). However, the lowest rate was in the Pediatric Intensive Care Unit (30.0%, 9/30). The most common antibiotics classes prescribed were: Beta-lactams (57.5%, n = 492/855). The most common underlying condition for antibiotics prescribing was upper respiratory tract infections (25.5%, n = 128/501) followed by pneumonia (20.6%, n = 103/501). Around half of antibiotics were prescribed upon appropriate decision (49.5%, n = 423/855). However, 22.0% (n = 188/855) of antibiotics were wrongly chosen, and 9.5% (n = 81/855) were wrongly applied. Initially inappropriate decision for prescription occurred in 15.3% (n = 131/855) of antibiotics. Ceftriaxone (OR 3.1; 95% CI 2.6–4.1; P = 0.03) and patients with ≥3 medication orders (OR 2.6; 95% CI 1.7–3.5; P = 0.001) significantly predicted inappropriate antibiotics prescribing.
Conclusions
The incidence of antibiotics prescribing in Jordanian children hospitals was high compared to other countries. Further multi-centric studies are required to enhance the generalisability of results and better develop effective and efficient antibiotic stewardship programmes.
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Affiliation(s)
| | | | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | | | | | - Rami Ismail
- Faculty of Pharmacy, Philadelphia University, Amman, Jordan
| | - Hasan A Abdel-Qader
- Consultant Pediatrician and Neonatologist, Ministry of Health, Amman, Jordan
| | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah., Sharjah, UAE
| | - Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah., Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Al Jomaa EE, Abdel-Qader DH, Silverthorne J, Hamadi S, Al Meslamani AZ. Pharmacy students' attitude towards providing pharmaceutical care to patients with anxiety and their knowledge of psychotropic medicines in Jordan. Int J Pharm Pract 2021; 29:196-199. [PMID: 33729530 DOI: 10.1093/ijpp/riaa015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/04/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To describe pharmacy students' attitude towards providing pharmaceutical care (PC) to patients with anxiety and their knowledge of psychotropic medicines (PM). METHODS A cross-sectional emailed survey was sent to all 200 pharmacy students (fourth and fifth year) in one Jordanian university. Statistical analysis included descriptive statistics and chi-square test. KEY FINDINGS A total of 134 responses were received (response rate 67%). About two-thirds of students (87, 64.9%) would like to give enough time to patients with anxiety to discuss their medications. Only half of students knew correctly that alprazolam (53.7%) and diazepam (50.0%) are categorized as anxiolytics. Undertaking a course in psychiatry was significantly associated with better students' knowledge in PM (P < 0.05). CONCLUSION Despite positive attitudes towards providing PC to patients with anxiety, policy makers should include courses on psychiatric pharmacotherapy in pharmacy curricula to improve pharmacy students' knowledge of PM.
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Affiliation(s)
- Esraa E Al Jomaa
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
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Abdel-Qader DH, Al Jomaa EE, Silverthorne J, Shnaigat W, Hamadi S, Al Meslamani AZ. Evaluating psychiatrists’ attitudes and expectations about pharmacists’ role in psychiatry in Jordan. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmab007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective.
Methods
An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression.
Key findings
A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role.
Conclusion
Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Esraa E Al Jomaa
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Jennifer Silverthorne
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Ahmad Z Al Meslamani
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
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Idkaidek N, Hamadi S, Bani-Domi R, Al-Adham I, Alsmadi M, Awaysheh F, Aqrabawi H, Al-Ghazawi A, Rabayah A. Saliva versus Plasma Therapeutic Drug Monitoring of Gentamicin in Jordanian Preterm Infants. Development of a Physiologically-Based Pharmacokinetic (PBPK) Model and Validation of Class II Drugs of Salivary Excretion Classification System. Drug Res (Stuttg) 2020; 70:455-462. [PMID: 32877949 DOI: 10.1055/a-1233-3582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gentamicin has proven to be a very successful treatment for bacterial infection, but it also can cause adverse effects, especially ototoxicity, which is irreversible. Therapeutic drug monitoring (TDM) in saliva is a more convenient non-invasive alternative compared to plasma. A physiologically-based pharmacokinetic (PBPK) model of gentamicin was built and validated using previously-published plasma and saliva data. The validated model was then used to predict experimentally-observed plasma and saliva gentamicin TDM data in Jordanian pediatric preterm infant patients measured using sensitive LCMS/MS method. A correlation was established between plasma and saliva exposures. The developed PBPK model predicted previously reported gentamicin levels in plasma, saliva and those observed in the current study. A good correlation was found between plasma and saliva exposures. The PBPK model predicted that gentamicin in saliva is 5-7 times that in plasma, which is in agreement with observed results. Saliva can be used as an alternative for TDM of gentamicin in preterm infant patients. Exposure to gentamicin in plasma and saliva can reliably be predicted using the developed PBPK model in patients.
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Affiliation(s)
| | - Salim Hamadi
- College of Pharmacy, University of Petra, Amman, Jordan
| | | | | | - Motasem Alsmadi
- College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Faten Awaysheh
- Royal Medical Services, Queen Rania Children Hospital, Amman, Jordan
| | - Hisham Aqrabawi
- Royal Medical Services, Queen Rania Children Hospital, Amman, Jordan
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Abdel-Qader DH, Al Meslamani AZ, Lewis PJ, Hamadi S. Incidence, nature, severity, and causes of dispensing errors in community pharmacies in Jordan. Int J Clin Pharm 2020; 43:165-173. [PMID: 32803560 DOI: 10.1007/s11096-020-01126-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Background Medication dispensing is a core function of community pharmacies, and errors that occur during the dispensing process are a major concern for pharmacy profession. However, to date there has been no national study of medication dispensing errors in Jordan. Objective The study aimed to investigate the incidence, nature, severity, causes and predictors of medication dispensing errors. Setting The study was conducted in randomly selected community pharmacies across Jordan. Method A mixed method approach was taken, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee evaluated the severity of errors. Proportionate random sampling was used to include 350 pharmacies from across all regions of Jordan. SPSS (Version 24) was used for data analysis. Main outcome measure Incidence, nature, severity, causes and predictors of medication dispensing errors. Results The overall rate of medication dispensing errors was 24.6% (n = 37,009/150,442), of which 11.5% (n = 17,352/150,442) were prescription related errors and 13.1% (n = 19,657/150,442) pharmacist counselling errors. The most common type of prescription-related errors were wrong quantity (37.9%, n = 6584/17,352), whereas the most common pharmacist counselling error was wrong drug (41.9%, n = 8241/19,657). The majority of errors were caused by poor handwriting (30.7%, n = 75,651/37,009), followed by high workload (17.3%, n = 22,964/37,009). More than half of errors (52.6%) were moderate in severity, followed by minor errors (38.8%), and 8.6% of errors were rated as serious. Predictors of medication dispensing errors were: Sundays (OR 2.7; 95% CI 2.15-3.94; p = 0.02), grade A pharmacies (dispensing ≥ 60 prescriptions a day (OR 3.6; 95% CI 2.89-4.78; p = 0.04)), and prescriptions containing ≥ 4 medication orders (OR 4.1; 95% CI 2.9-6.4; p = 0.001). Conclusion Medication dispensing errors are common in Jordan and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing and independent prescribing for pharmacists.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.
| | | | - Penny J Lewis
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
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Abdel-Qader DH, Al Meslamani AZ, El-Shara' AA, Ismael NS, Albassam A, Lewis PJ, Hamadi S, Abbas HS, Al Mazrouei N, Mohamed Ibrahim O. Investigating prescribing errors in the emergency department of a large governmental hospital in Jordan. Journal of Pharmaceutical Health Services Research 2020. [DOI: 10.1111/jphs.12376] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Although prescribing errors (PEs) are the most common type of medication errors and cause morbidity and mortality, they have been rarely studied.
Objective
The study aimed to investigate PEs incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.
Setting
This study was conducted in the emergency department of the largest governmental hospital in Jordan.
Method
This was a retrospective observational 4-week study. A validated definition of PEs was adopted, and errors were identified by direct observation of all prescriptions. Structured interviews with doctors to assess the causes of errors were conducted within three days of the prescription date; the severity of PEs was rated by a committee.
Main outcome measure
Prescribing errors incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.
Results
For 1330 patients, 3470 medication orders were recorded. Almost one in five patients had PEs (n = 288, 21.65%), and the total number of medication orders for patients who had errors was 610. The PEs incidence was 12.5% (95% CI 11.4%–3.5% (n = 450/3597)). Analgesics were the most common medications associated with PEs (232/610, 38.03%). The top two types of PEs detected were wrong drug (165/450, 36.6%) and wrong dose (142/450, 31.5%) respectively. Most PEs were clinically significant errors (342/450, 76%). Doctors refused pharmacists' interventions on their orders in 132 (45.8%) prescriptions. The most common cause of errors was poor skills of doctors in electronic prescribing system (266/450, 59%). Predictors of PEs were the following: drug with multiple dosage forms (OR 2.998; 95% CI 1.41–6.34; P = 0.004) and a prescription with polypharmacy (OR 1.685; 95% CI 1.25%–2.26%; P = 0.001).
Conclusion
A national approach for observing, intervening on and correcting PEs is necessary to improve patient safety.
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Affiliation(s)
| | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, United Arab Emirates
| | | | | | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Penny J Lewis
- Division of Pharmacy & Optometry, The University of Manchester, Manchester, UK
| | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Hazim Saleem Abbas
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Osama Mohamed Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Idkaidek N, Qawasmi H, Hanahen A, Abuqatouseh L, Hamadi S, Bustami M. Applicability of Saliva for Evaluation of Some Biochemical Parameters of Kidney and Liver Function in Healthy Individuals. mljgoums 2020. [DOI: 10.29252/mlj.14.4.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Alsmadi MM, Alfarah MQ, Albderat J, Alsalaita G, AlMardini R, Hamadi S, Al‐Ghazawi A, Abu‐Duhair O, Idkaidek N. The development of a population physiologically based pharmacokinetic model for mycophenolic mofetil and mycophenolic acid in humans using data from plasma, saliva, and kidney tissue. Biopharm Drug Dispos 2019; 40:325-340. [DOI: 10.1002/bdd.2206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 09/22/2019] [Accepted: 10/09/2019] [Indexed: 02/06/2023]
Affiliation(s)
| | | | - Jawaher Albderat
- Queen Rania Abdullah Children Hospital, Royal Medical Services Amman Jordan
| | - Ghazi Alsalaita
- Queen Rania Abdullah Children Hospital, Royal Medical Services Amman Jordan
| | - Reham AlMardini
- Queen Rania Abdullah Children Hospital, Royal Medical Services Amman Jordan
| | - Salim Hamadi
- Deparment of Pharmaceutical Technology, Faculty of PharmacyUniversity of Petra Amman Jordan
| | | | - Omar Abu‐Duhair
- Deparment of Pharmaceutical Technology, Faculty of PharmacyUniversity of Petra Amman Jordan
| | - Nasir Idkaidek
- Deparment of Pharmaceutical Technology, Faculty of PharmacyUniversity of Petra Amman Jordan
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Idkaidek N, Hamadi S, El-Assi M, Al-Shalalfeh A, Al-Ghazawi A. Saliva versus Plasma Therapeutic Drug Monitoring of Pregabalin in Jordanian Patients. Drug Res (Stuttg) 2018; 68:596-600. [PMID: 29684922 DOI: 10.1055/a-0600-2113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The objective is using saliva instead of plasma for pregabalin therapeutic drug monitoring (TDM) since saliva reflects the free non-protein bound drug concentration, simple and noninvasive sampling, cheaper and does not require the expertise of drawing blood. Forty four patients participated in this study, two samples of saliva and another two of blood were taken from each patient; first sample of both saliva and blood is the trough sample and was taken just before the first dose of the day and second sample is the peak sample and was taken 1 h after taking the first dose of the day. Descriptive statistics and t-testing after log transformation were done using Excel, p-value=0.05 was adopted for significant difference. Optimized effective intestinal permeability of pregabalin was estimated by PK-Sim program version 7. This study for the first time revealed that pregabalin is excreted in saliva and classified as class 1 based on Salivary Excretion Classification System (SECS). A good correlation of 0.71-0.83 between Cmin and Cmax of plasma and saliva pregabalin was observed respectively which indicate that saliva sampling is a good alternative matrix for pregabalin TDM. C/D-ratios were calculated to demonstrate pharmacokinetic variability of Pregabalin; the results showed that C/D-ratio was higher in women, elderly and in those patients who had Scr.≥0.9 mg/dl. Proposed pregabalin therapeutic ranges are 0.7 to 1.84 µg/ml in plasma and 0.055 to 0.145 µg/ml in saliva, for neuropathic pain, diabetic neuropathy and disc prolapse patients.
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Affiliation(s)
| | - Salim Hamadi
- University of Petra, College of Pharmacy, Amman, Jordan
| | - Manal El-Assi
- University of Petra, College of Pharmacy, Amman, Jordan
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Idkaidek N, Arafat T, Hamadi H, Hamadi S, Al-Adham I. Saliva Versus Plasma Bioequivalence of Azithromycin in Humans: Validation of Class I Drugs of the Salivary Excretion Classification System. Drugs R D 2017; 17:219-224. [PMID: 28074334 PMCID: PMC5318338 DOI: 10.1007/s40268-016-0170-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aim The aim of this study was to compare human pharmacokinetics and bioequivalence metrics in saliva versus plasma for azithromycin as a model class I drug of the Salivary Excretion Classification System (SECS). Methods A pilot, open-label, two-way crossover bioequivalence study was done, and involved a single 500-mg oral dose of azithromycin given to eight healthy subjects under fasting conditions, followed by a 3-week washout period. Blood and unstimulated saliva samples were collected over 72 h and deep frozen until analysis by a validated liquid chromatography with mass spectroscopy method. The pharmacokinetic parameters and bioequivalence metrics of azithromycin were calculated by non-compartment analysis using WinNonlin V5.2. Descriptive statistics and dimensional analysis of the pharmacokinetic parameters of azithromycin were performed using Microsoft Excel. PK-Sim V5.6 was used to estimate the effective intestinal permeability of azithromycin. Results and Discussion No statistical differences were shown in area under the concentration curves to 72 h (AUC0–72), maximum measured concentration (Cmax) and time to maximum concentration (Tmax) between test and reference azithromycin products (P > 0.05) in the saliva matrix and in the plasma matrix. Due to the high intra-subject variability and low sample size of this pilot study, the 90% confidence intervals of AUC0–72 and Cmax did not fall within the acceptance range (80–125%). However, saliva levels were higher than that of plasma, with a longer salivary Tmax. The mean saliva/plasma concentration of test and reference were 2.29 and 2.33, respectively. The mean ± standard deviation ratios of saliva/plasma of AUC0–72, Cmax and Tmax for test were 2.65 ± 1.59, 1.51 ± 0.49 and 1.85 ± 1.4, while for the reference product they were 3.37 ± 2.20, 1.57 ± 0.77 and 2.6 ± 1.27, respectively. A good correlation of R = 0.87 between plasma and saliva concentrations for both test and reference products was also observed. Azithromycin is considered a class I drug based on the SECS, since it has a high permeability and high fraction unbound, and saliva sampling could be used as an alternative to plasma sampling to characterize its pharmacokinetics and bioequivalence in humans when adequate sample size is used.
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Affiliation(s)
| | - Tawfiq Arafat
- Faculty of Pharmacy, Petra University, Amman, Jordan
| | - Hazim Hamadi
- Faculty of Pharmacy, Petra University, Amman, Jordan
| | - Salim Hamadi
- Faculty of Pharmacy, Petra University, Amman, Jordan
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Ktari K, Mohamed M, Wadiaa H, Saoussen M, Wadiaa H, Radhia S, Hamadi S. Quels sont les facteurs prédictifs de la douleur lors du traitement des calculs rénaux par lithotritie extracorporelle ? Prog Urol 2015; 25:753-4. [DOI: 10.1016/j.purol.2015.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Darwish DA, Abdelmalek S, Abu Dayyih W, Hamadi S. Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan. J Infect Dev Ctries 2014; 8:616-23. [PMID: 24820466 DOI: 10.3855/jidc.4086] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 01/05/2014] [Accepted: 01/02/2014] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Antimicrobial resistance is a serious global health concern. It has considerable implications on societies' health and resources. In Jordan, there is a large Iraqi community due to the ongoing turmoil in Iraq. Unfortunately, health awareness and practices of this community are under-investigated due to scarcity of research. This paper assesses the awareness of antibiotic use and antimicrobial resistance in the Iraqi community residing in Amman, Jordan. Their level of interaction with health care professionals regarding antibiotics and differences in their antibiotic use between Iraq and Jordan are also discussed. METHODOLOGY A cross-sectional questionnaire-based survey involving randomly selected Iraqis residing in Amman, Jordan was conducted. RESULTS The study involved 508 participants. Sixty-two percent of participants agreed with buying antibiotics without a prescription, 29% agreed with obtaining antibiotics from friends or relatives, and 46% agreed with keeping leftover antibiotics for future use. Furthermore, 60% disagreed with not completing an antibiotic course and almost 90% of the sample listed viral diseases as an indication for antibiotics. Forty-four percent of participants abided by physicians' instructions on antibiotic use. Half of the participants believed that pharmacists provided instructions on antibiotics all the time, whereas physicians were perceived to do so by 29% of participants. CONCLUSIONS Gaps exist in knowledge of antibiotic use and reasons for antimicrobial resistance among Iraqis residing in Jordan. These gaps should serve in planning educational campaigns to raise the community's awareness of responsible antibiotic use. Law enforcement to restrict access to antibiotics is also pivotal to tackle their misuse.
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Affiliation(s)
- Dana A Darwish
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.
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Radhia S, Samira F, Mounir T, Hamadi S. [Seminal vesicle cyst associated with renal agenesis and ipsilateral ectopic ureter. Report of a case]. Ann Urol (Paris) 2002; 36:381-3. [PMID: 12611140 DOI: 10.1016/s0003-4401(02)00135-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The authors report one case of a seminal vesicle cyst. They discuss this pathology and its relation to ureteral ectopy, as well as the therapeutic options for these entities. They present their experience in the resolution of this case.
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Affiliation(s)
- S Radhia
- Service d'urologie, hôpital F. Bourguiba, 5000 Monastir, Tunisie.
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Hussain A, Hamadi S, Kagashima M, Iseki K, Dittert L. Does increasing the lipophilicity of peptides enhance their nasal absorption? J Pharm Sci 1991; 80:1180-1. [PMID: 1815079 DOI: 10.1002/jps.2600801217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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