Ecopharmacology: Knowledge, Attitude, and Medication Disposal Practice Among Pharmacy Students

Background

Ecopharmacology, as a form of drug management for the environment, focuses on the impact of drugs on the environment. Pharmacists, and by extension pharmacy students, are expected to play an important role in ecopharmacology. Therefore, this study was conducted to determine the knowledge and attitude towards ecopharmacology and the practice of disposal of leftover or expired medicines among pharmacy students.

Methods

This was a descriptive cross-sectional study among pharmacy students in Northwestern Ethiopia. The study took place from May 1 to June 15, 2023. A self-administered questionnaire was used for data collection.

Results

Four hundred and forty-five students were included in the study. Only 91 (20%) of the students were aware of the term ecopharmacology, 27% knew that excretion from the human or animal body is the major route by which pharmaceutical agents enter the environment, and 42% were aware of the risk of increased antimicrobial resistance due to antibiotic residues in the environment. In addition, only 27% of respondents reported receiving information about the disposal of pharmaceuticals. The most common method of disposing of medications was throwing them away in household trash (61.8%).

Conclusion

Our results suggest that while most pharmacy students in Ethiopia have a positive attitude toward ecopharmacology, they do not know enough about ecopharmacology and dispose of their medicines poorly. More uniform education in ecopharmacology and pharmaceutical pollution might be warranted in the pharmacy curriculum.

In vivo antidiarrheal activity of the crude extract and solvent fractions of Rhamnus prinoides (Rhamnaceae) leaves

Background

Even though numerous conventional anti-diarrheal agents are available, the inherent toxicities of the drugs urge the search for alternative drugs that are safe and effective.

Objective

To evaluate the in-vivo anti-diarrheal activity of crude extract and solvent fractions of Rhamnus prinoides leaves.

Materials and methods

The Rhamnus prinoides leaves were macerated using absolute methanol and then fractionated using solvents of different polarity indexes. For in-vivo antidiarrheal activity evaluation of the crude extract and solvent fraction, castor oil-induced diarrhea, castor oil-induced anti-enteropolling, and intestinal transit models were used. One-way analysis of variance was used to analyze the data, followed by a Tukey post-test. The standard and negative control groups were treated with loperamide and 2% tween 80 respectively.

Results

A significant (p˂0.01) reduction in the frequency of wet stools and watery content of diarrhea, intestinal motility, intestinal fluid accumulation, and delaying the onset of diarrhea as compared with controls were observed in mice treated with 200 mg/kg and 400 mg/kg methanol crude extract. However the effect increased dose-dependently, and the 400 mg/kg methanol crude extract produced a comparable effect with the standard drug in all models. Amongst the solvent fractions, n-BF significantly delayed the time of diarrheal onset and reduced the frequency of defecation, and intestinal motility at doses of 200 mg/kg and 400 mg/kg. Furthermore, the maximum percentage inhibition of intestinal fluid accumulation was observed in mice treated with 400 mg/kg n-butanol extract (p˂0.01; 61.05%).

Conclusions

The results of this study showed that crude extract and solvent fractions of Rhamnus prinoides leaves showed a significant anti-diarrheal activity which supports its traditional use as a diarrhea treatment.

Vaccinated Healthcare Workers' Adherence to COVID-19 Prevention Measures and Associated Factors in Northwest Ethiopia: A Facility-Based Cross-Sectional Study

Background

The initial response to coronavirus disease 2019 (COVID-19) was non-pharmaceutical interventions (NPIs). Long-term protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection does not appear to be possible by either infection or vaccination. Thus, traditional herd immunity seems impossible. In addition to increasing vaccination rates, NPIs may be needed.

Methods

A facility-based cross-sectional study was conducted among vaccinated healthcare workers. The study took place from July 15 to August 15, 2022. A self-administered questionnaire was used for data collection. In a multivariable logistic regression model, a p-value of less than 0.05 was considered statistically significant.

Results

Four hundred eleven healthcare workers were included in the study. Sixty percent of participants were fully vaccinated. After vaccination, 10.2% of respondents reported infection with SARS-CoV-2. The study showed that 49.4% of participants had a good knowledge of the efficacy and safety of vaccines against SARS-CoV-2. In this study, 36% of individuals adhered well to the COVID-19 prevention strategies. Good knowledge of the efficacy and safety of SARS-CoV-2 vaccines (AOR = 1.69, 95% CI: 1.03-2.78) increased the odds of implementing preventive measures. Healthcare workers who perceived a low and medium risk of SARS-CoV-2 infection after vaccination and who were knowledgeable about SARS-CoV-2 breakthrough infections were less likely to follow preventive measures.

Conclusion

The knowledge of healthcare workers regarding the efficacy and safety of vaccines against SARS-CoV-2 was comparable. However, a large proportion of healthcare workers poorly adhered to prevention practices. Therefore, to reduce the risk of SARS-CoV-2 infection among healthcare professionals, prevention strategies must be continuously evaluated and awareness of the need for preventive measures must be raised even after vaccination.

Unintended medication discrepancies and associated factors upon patient admission to the internal medicine wards: identified through medication reconciliation

Background

Medication reconciliation (MedRec) is a widely accepted tool for the identification and resolution of unintended medication discrepancies (UMD).

Objective

This study aimed at assessing the magnitude and associated factors of UMD identified through medication reconciliation upon patient admission to the internal medicine wards.

Methods

Prospective cross-sectional study was conducted at the internal medicine wards of Felege Hiwot and Tibebe Ghion comprehensive specialized hospitals in Bahir Dar city, Northwest Ethiopia, from May 01 to July 30, 2021. Data were collected by using a data abstraction format prepared based on standard MedRec tools and previous studies on medication discrepancy. Pharmacists-led MedRec was made by following the WHO High5s “retroactive medication reconciliation model”. SPSS® (IBM Corporation) version 25.0 was used to analyze the data with descriptive and inferential statistics. A binary logistic regression analysis was used to identify factors associated with UMD. A statistical significance was declared at a p-value < 0.05.

Results

Among 635 adult patients, 248 (39.1%) of them had at least one UMD. The most frequent types of UMDs were omission (41.75%) and wrong dose (21.9%). The majority (75.3%) of pharmacists’ interventions were accepted. Polypharmacy at admission (p-value < 0.001), age ≥ 65 (p-value = 0.001), a unit increase on the number of comorbidities (p-value = 0.008) and information sources used for MedRec (p-value < 0.001), and medium (p-value = 0.019) and low adherence (p-value < 0.001) were significantly associated with UMD.

Conclusion

The magnitude of UMD upon patient admission to the internal medicine wards was considerably high. Omission and the wrong dose of medication were common. Older age, polypharmacy, low and medium adherence, and an increase in the number of comorbidities and information sources used for MedRec are significantly associated with UMDs. Pharmacists' interventions were mostly acceptable. Thus, the implementation of pharmacists-led MedRec in the two hospitals is indispensable for patient safety.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08628-5.