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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, 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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Hasan S, Al Zubaidi H, Saidawi W, Zitouni H, Hussein SA. Pharmacist insights into antimicrobial stewardship: A social marketing approach. Res Social Adm Pharm 2024; 20:190-202. [PMID: 37993380 DOI: 10.1016/j.sapharm.2023.11.003] [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: 09/08/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Antimicrobial resistance is a worldwide public health problem. Antimicrobial stewardship programs (ASPs) optimize antimicrobial use within hospitals. The social marketing framework has been used in analyzing systems and devising best practices. OBJECTIVE (s): To use the social marketing framework to explore pharmacist experiences and perceptions of structural, behavioral and interventional strategies that support ASPs. METHODS A qualitative approach utilizing semi-structured individual interviews was utilized. A purposive sample of hospital pharmacists was invited to participate. An interview guide was constructed to describe participant experience and perceptions regarding ASPs in their institutions based on elements of social marketing: Behavioral goals; Customer Insight; Segmentation and Targeting; Competition; Exchange; and Marketing and Interventional mix. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was conducted using deductive methods. A combination of case-based and code-based approaches allowed individual and holistic analyses respectively. Codes were collated into themes and subthemes. RESULTS Saturation of themes occurred with 25 interviews from 17 hospitals. ASP metrics included: consumption of antibiotics using days of therapy and defined daily dose, rates of C. difficile and multidrug resistant organisms, resistance patterns, and provider adherence to the ASP. Active stewardship tools such as preauthorization, and prospective feedback/audit were preferred over passive tools such as order sets and automatic stop orders. A physician champion and a clinical pharmacist with infectious disease training were core elements in the multidisciplinary team. Despite certain areas being considered key for stewardship, participants emphasized a hospital-wide approach including outpatient departments; discharge stewardship emerged as a primary theme. Leadership supported ASPs with finances, rapid and novel diagnostics, Clinical Decision Support Systems, mobile technology, and continuous staff training. CONCLUSIONS The social marketing framework has been used to explore pharmacist perceptions that inform successful qualities including metrics, restriction methods, personnel, benefits, barriers, training needs/modes, and promotional avenues that support ASPs in hospitals.
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Affiliation(s)
- Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates; Center of Medical and Bio-allied Health Sciences, Ajman University, Ajman, United Arab Emirates.
| | - Hamzah Al Zubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates.
| | - Ward Saidawi
- Research Institute for Medical and Health Sciences, University of Sharjah, United Arab Emirates.
| | - Hibaterrahmane Zitouni
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates.
| | - Saeed Abdullah Hussein
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, 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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Hasan S, Zubaidi HA, Saidawi W. Assessing Pharmacy Student Performance and Perceptions on Counseling Skills Through a Simulated Telehealth Encounter. Am J Pharm Educ 2022; 86:8619. [PMID: 34507953 PMCID: PMC10159465 DOI: 10.5688/ajpe8619] [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: 02/25/2021] [Accepted: 09/03/2021] [Indexed: 05/06/2023]
Abstract
Objective. To describe the implementation of a teleconferencing-based patient counseling role play assessment in a newly developed pharmacy communications course, assess student performance on the role play and compare it with other assessments, and measure student perceptions of and satisfaction with the experience.Methods. Eighteen cases were developed, each belonging to one of three interactions in community pharmacy: filling a new prescription, completing a refill, or handling a request for a nonprescription (ie, over-the-counter [OTC]) medication. A rubric was designed to evaluate each type of interaction. Student scores in various course assessments were tested and scores on the three cases were compared. Students also evaluated their experience and satisfaction of the assessment and effectiveness of the course.Results. Seventy-nine students completed the assessment, achieving a mean score of 17.4/20 (87%). Student scores in the counseling role play were similar among case types and positively correlated with other traditional assessments in the course. Despite internet connectivity issues and heightened student anxiety, 71% of students agreed that the assessment did not affect the quality of their counseling, and 74% agreed that the experience was comparable to traditional assessments. The telehealth activity led to enhanced perceived student knowledge and confidence in interviewing and counseling patients.Conclusion. Students attained high scores that were consistent with other assessments in the course. Students reported that the assessment did not affect the quality of their counseling and felt the setting and context were still authentic. The experience required dedicated preparation and organization but was successful in demonstrating overall student satisfaction and positive perceptions.
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Affiliation(s)
- Sanah Hasan
- Ajman University, Center of Medical and Bio-allied Health Sciences, College of Pharmacy and Health Sciences, Ajman, United Arab Emirates
| | - Hamzah Al Zubaidi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
| | - Ward Saidawi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
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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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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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11
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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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12
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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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15
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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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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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