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Mohamed AH, Abbassi MM, Sabry NA. Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt: "cross-sectional observational study". BMC MEDICAL EDUCATION 2024; 24:390. [PMID: 38594659 PMCID: PMC11005131 DOI: 10.1186/s12909-024-05367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Diabetes recently has been identified as a growing epidemic. Although insulin's vital role in both types of diabetes, it is considered one of the harmful medications if used incorrectly. In Egypt, effective usage of insulin remains a challenge due to insufficient knowledge of insulin and diabetes management, leading to errors in insulin therapy. As pharmacists are experts in pharmacological knowledge, they are uniquely situated to assess adherence to treatment regimens, the effect of drug therapy, or potential alterations in drug therapy to meet patient goals. To provide effective patient education and counseling, community pharmacists in Egypt should be efficiently knowledgeable about diabetes and insulin. OBJECTIVE To identify the knowledge, attitude, and practice of pharmacists and patients about insulin. To identify pharmacists' educational preparedness and confidence in counseling diabetic patients. METHODS A descriptive, cross-sectional study was conducted with two knowledge, attitude, and practice surveys. This study was carried out from September 2016 to February 2023. Face-to-face interviews were conducted with patients, and a paper-based questionnaire was administered to pharmacists. The two questionnaires were adapted from previous studies. RESULTS A total of 492 patients and 465 pharmacists participated in this study. The mean knowledge score of correct answers among patients and pharmacists was 10.67 ± 1.9 and 15 ± 3.6. Most of the patients and pharmacists had a positive attitude regarding insulin's role in improving health and to better control blood glucose. On the negative side, around half of the patients reported that they believe that regular use of insulin leads to addiction, while only 14.5% of the pharmacists believed that insulin could cause addiction. Self-confidence scores for pharmacists differed statistically with sex, years of experience, and pharmacist's direct exposure to diabetic patients. CONCLUSIONS This study uncovers considerable deficiencies in patients' and pharmacists' knowledge about insulin therapy. This study also strongly recommends higher education and a more structured pharmacist training schedule.
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Affiliation(s)
- Alaa H Mohamed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt.
| | - Maggie M Abbassi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt
| | - Nirmeen A Sabry
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt
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Ali HT, Barakat M, Abdelhalim AR, Al-Kurd IN, Muhammad MKE, Sharkawy MM, Elbahnasawy M, Amer SA. Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population. BMC Public Health 2024; 24:652. [PMID: 38429721 PMCID: PMC10905903 DOI: 10.1186/s12889-024-17913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM. METHODS We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). RESULTS 1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22-40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64-2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 - 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27-5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26-2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36-0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90-1.48; p-value = 0.268). CONCLUSIONS SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources.
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Affiliation(s)
| | - Mostafa Barakat
- Qena Faculty of Medicine, South Valley University, Qena, 83621, Egypt
| | | | | | | | | | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samar Ahmed Amer
- Department of Public Health and Community Medicine, Family Medicine, Membership at Royal College of General Practice [INT], Ministry Of Health (MOH) Saudi Arabia, Zagazig University, EgyptLondon, UK
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Youssef A, Amin MEK. Egyptian community pharmacies and self-care: Context, challenges and opportunities. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100384. [PMID: 38146318 PMCID: PMC10749267 DOI: 10.1016/j.rcsop.2023.100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
Community pharmacists are ideally positioned to play a key role in promoting self-care behaviors through judicious use of self-care interventions. As highlighted by the International Pharmaceutical Federation, supporting effective self-care is a key strategy for pharmacists to contribute to the sustainability of healthcare systems. Despite recent positive developments in national health policies, Egypt does not have a clear self-care strategy and policy. It also has no national programs focusing on community pharmacists and self-care, important components that future health policy initiatives should tackle. This commentary explores self-care policies, strategies, and developments in the Egyptian community pharmacy practice context. It describes national research, roles, and challenges within the current model of community pharmacy practice and education concerning self-care. It addresses opportunities that Egyptian community pharmacy has to support self-care in light of the anticipated changes in the Egyptian healthcare system. Noting that success in the delivery of self-care interventions within community pharmacies is associated with key factors, recommendations are suggested for community pharmacy stakeholders to address such factors guided by the World Health Organization's implementation considerations for individuals' health needs and self-care-related health system challenges (agency, availability, quality, cost, information, accessibility, utilization, social support, acceptability, and efficiency).
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Affiliation(s)
- Amr Youssef
- Alamein International University Faculty of Pharmacy, AlAlamein City Main Road, Matrouh, Egypt
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Hashmi FK, Khadka S, Yadav GK, Khan MM, Khan SU, Saeed H, Saleem M, Giri S, Rasool MF, Mansoor HUH, Riboua Z. Non-prescription antibiotics dispensing by community pharmacies: implications for antimicrobial resistance. Ann Med Surg (Lond) 2023; 85:5899-5907. [PMID: 38098592 PMCID: PMC10718340 DOI: 10.1097/ms9.0000000000001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction The non-prescription antibiotics dispensing (NPAD) from pharmacies is on the rise in low- and middle-income countries, which contributes to the emergence of antimicrobial resistance (AMR). This study was conducted with the objective to determine the community pharmacy personnel's perspectives on NPAD and its implications for AMR. Methods A questionnaire-based cross-sectional survey was conducted in Pakistan among 336 pharmacies. The data were analyzed using SPSS v21 and MedCalc for Windows v12.3.0. Modified Bloom's cut-off point was utilized to categorize the participants' overall knowledge, attitude, and practice. For univariable logistic regression analyses, odds ratio (OR) was calculated at 95% confidence interval (CI). For multivariable logistic regression analyses, adjusted OR was calculated at 95% CI. Spearman's rank correlation coefficient test was used to assess the relationships among knowledge, attitude, and/or practice scores. Results The majority of the respondents were staff pharmacists (45.5%). About four-fifths (78.9%) and half (50.9%) of the participants demonstrated moderate to good knowledge and practice, respectively. However, about only one-third (33.1%) had a moderate to good attitude. Staff pharmacists had higher odds of moderate to good knowledge (OR: 2.4, 95% CI: 1.2-4.7) and practice (OR: 2.3, 95% CI: 1.4-3.8). Total knowledge and practice (Spearman's ρ: 0.280; P <0.001) and total attitude and practice (Spearman's ρ: 0.299; P <0.001) scores were significantly correlated. Conclusion The qualified pharmacists had satisfactory knowledge, attitude, and practices toward antibiotics. However, non-pharmacist staff lacked knowledge and had probable NPAD practice, which has a negative impact on public health. Regular refresher training, seminars, and strict enforcement of rules and regulations are essential.
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Affiliation(s)
- Furqan K. Hashmi
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Sitaram Khadka
- Shree Birendra Hospital, Nepalese Army Institute of Health Sciences, Kathmandu
| | | | | | - Saif Ullah Khan
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Hamid Saeed
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Mohammad Saleem
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | | | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Zineb Riboua
- McCourt School of Public Policy, Georgetown University, Washington, District of Columbia, USA
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Hamadouk RM, Alshareif EM, Ibrahim OM, Albashair ED, Yousef BA. The Extent of Antibiotic Dispensing in Self-Medication Encounters in Sudan: A Simulated Patient Study Focusing on Cefixime Sale. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2023; 12:227-237. [PMID: 38033381 PMCID: PMC10683652 DOI: 10.2147/iprp.s440010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
Background Antibiotics play an important role in decreasing morbidity and mortality worldwide. However, inappropriate use of them by patients or healthcare professionals contributes to their resistance rendering them less efficacious. Community pharmacists (CPs) have a significant part in reducing antibiotic resistance. Therefore, this study aimed to investigate the dispensing of antibiotics without prescription in community pharmacies with an emphasis on cefixime dispensing. Methods A cross-sectional, simulated patient (SP) study was conducted in the Khartoum locality. A total of 238 community pharmacies were randomly chosen using simple random sampling. One scenario of uncomplicated urinary tract infection was designed, and six female pharmacy students who were trained to act as SPs presented the scenario. Descriptive statistics were applied to report the study outcomes. Results In the 238 pharmacy visits, at least one antibiotic was dispensed without a prescription in 69.3% of the simulated visits. Among the dispensed antibiotics, ciprofloxacin was the most dispensed antibiotic followed by cefixime representing 51.5% and 41.8%, respectively, of total dispensed antibiotics. Cefixime was dispensed as a first choice by CPs in 29% of the visits, and in the rest of the visits, only 37.3% of CPs refused to dispense cefixime after SP demand. Conclusion The findings revealed a high rate of antibiotics dispensing without prescription by CPs in Khartoum state, and cefixime was obtained with ease before and after the patient's demand. Urgent corrective actions such as imposing strict regulations, monitoring pharmacists' practice, and endorsing educational programs for pharmacists are needed to prevent inappropriate antibiotic dispensing practices.
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Affiliation(s)
- Riham M Hamadouk
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Almughtaribeen University, Khartoum, Sudan
| | - Einass M Alshareif
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | | | - Esra D Albashair
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | - Bashir A Yousef
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
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Li J, Zhou P, Wang J, Li H, Xu H, Meng Y, Ye F, Tan Y, Gong Y, Yin X. Worldwide dispensing of non-prescription antibiotics in community pharmacies and associated factors: a mixed-methods systematic review. THE LANCET. INFECTIOUS DISEASES 2023; 23:e361-e370. [PMID: 37105212 DOI: 10.1016/s1473-3099(23)00130-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 04/29/2023]
Abstract
This mixed-method systemic review estimated the pooled prevalence of non-prescription antibiotic dispensing in community pharmacies worldwide and identified associated factors influencing the practice. 162 studies covering 52 countries were included. The pooled prevalence of community pharmacy non-prescription antibiotic dispensing was 63·4% (95% CI 59·6-67·1). The prevalence was significantly higher in low-income countries than in high-income countries. Additionally, the situation of dispensing antibiotics without prescriptions has not improved over time in the past two decades. Quantitative studies showed that pharmacies located in poorer economic areas, pharmacy staff who were also the pharmacy owners, and private pharmacies were more likely to dispense non-prescription antibiotics. Qualitative findings suggested four major factors driving antibiotics being dispensed without a prescription. First, strong customer demand for non-prescription antibiotics and a lack of relevant knowledge; second, pharmacy staff motivated by financial or personal viewpoints; third, alternative health-care services being expensive or inconvenient, or having irregular prescribing practices; and finally, weak social, industry, and legal regulation. The current antibiotic stewardship needs to be strengthened.
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Affiliation(s)
- Jinxi Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengfei Zhou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Hongbin Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Meng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Ye
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuqian Tan
- Department of Health Toxicology, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Nguyen PH, Nguyen PT, Vo TMH, Nguyen TTM. Evaluation of routine practices of dispensing pattern among community pharmacists in Can Tho city, Vietnam: A cross-sectional simulated patient approach. J Public Health Res 2023; 12:22799036231196681. [PMID: 37693737 PMCID: PMC10492490 DOI: 10.1177/22799036231196681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/30/2023] [Indexed: 09/12/2023] Open
Abstract
Background Drugstores are preferred patients' channels of contact when getting minor ailments. Given the hike in both the prevalence and severity of influenza and acute childhood diarrhea, the role, and performances of pharmacy staff should be examined. Design and methods A team of pharmacy students was voluntarily recruited and trained to play the role of simulated customer visiting 228 chosen community pharmacies in six districts in Can Tho city. This process is conducted from 2021 to 2022. Results The study reveals detailed information about symptoms is the most common inquiry (99.2% in scenario 1). The consulting quality is poor, 85% of instances recorded to have no medical guidelines for influenza circumstances. Meanwhile, nearly four-fifths of pharmacists provide instructions on dosage intake. It is also found that length of services is statistically different between influenza and watery diarrhea (p < 0.05, CI = 95%). Conclusions Clinical practices of community pharmacists, overall, are disappointing and far below expectations.
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Affiliation(s)
- Phuc Hung Nguyen
- Department of Pharmaceutical Management, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Phuong Thuy Nguyen
- Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Thi My Huong Vo
- Department of Medicinal Chemistry, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Thi Tuyet Minh Nguyen
- Faculty of Basic Sciences, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
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Wali HA, Alabdulwahed MA, Al-Hussain GY, Alabbad MA, Al-Khalaf LH, Alhumaidi SS, Alhussain K, Alomair SM, Almulhim AS. Assessment of knowledge, attitude, and practices of acute kidney injury incidence with co-administration of piperacillin/tazobactam and vancomycin among healthcare workers: A cross-sectional study. Saudi Pharm J 2023; 31:904-910. [PMID: 37234343 PMCID: PMC10205774 DOI: 10.1016/j.jsps.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Background No studies have identified a link between acute kidney injury (AKI) incidence due to the co-administration of vancomycin and piperacillin/tazobactam (VPT) and healthcare providers' knowledge, attitudes, and practices. We aimed to (1) assess the knowledge, attitudes, and practices towards AKI due to VPT co-administration among healthcare providers in Saudi Arabia, and (2) examine the relationship between healthcare providers' knowledge and attitudes about AKI due to VPT co-administration and their practices. Methods This cross-sectional study was conducted between February 2022 and April 2022. Healthcare providers, including physicians, pharmacists, and nurses, were included in the study population. The correlation coefficient assessed the relationship between knowledge, attitude, and practice. Spearman's rho was used as a test statistic. Results Of the invited healthcare providers, 192 responded to the survey. A significant difference in knowledge was found among healthcare providers for two variables: the definition of AKI (p < 0.001) and appropriate management of AKI due to VPT (p = 0.002). Physicians were found to rely less on the most common causative organisms of infection to guide empirical antibiotic therapy (p < 0.001). In addition, physicians were less likely to switch piperacillin/tazobactam to cefepime or meropenem in combination with vancomycin with AKI incidence (p = 0.001). A positive attitude towards the perceived AKI risk with VPT was positively correlated with avoiding using VPT unless no alternatives were available (Rho = 0.336) and taking protective measures when using VPT (Rho = 0.461). Conclusion Deviation has been observed in the knowledge, attitudes, and practices of AKI incidence with the co-administration of piperacillin/tazobactam and vancomycin among healthcare workers. Interventions at the organizational level are recommended to guide best practices.
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Affiliation(s)
- Haytham A. Wali
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mohammed A. Alabdulwahed
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Ghaida Y. Al-Hussain
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmacy Services, Al-Ahsa Hospital, Al-Ahsa, Saudi Arabia
| | - Meaid A. Alabbad
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Lojain H. Al-Khalaf
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Sarah S. Alhumaidi
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Khalid Alhussain
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Sufyan M. Alomair
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Abdulaziz S. Almulhim
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
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Maarouf L, Amin M, Evans BA, Abouelfetouh A. Knowledge, attitudes and behaviour of Egyptians towards antibiotic use in the community: can we do better? Antimicrob Resist Infect Control 2023; 12:50. [PMID: 37226221 DOI: 10.1186/s13756-023-01249-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 05/05/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Infectious diseases are among the leading causes of death worldwide. This is concerning because of the increasing capacity of the pathogens to develop antibiotic resistance. Antibiotic overuse and misuse remain the main drivers of resistance development. In the USA and Europe, annual campaigns raise awareness of antibiotic misuse hazards and promote their judicial use. Similar efforts are lacking in Egypt. This study assessed the knowledge of the public in Alexandria, Egypt of antibiotic misuse risks and their habits towards antibiotic use, in addition to conducting a campaign to increase awareness of the safe use of antibiotics. METHODS A questionnaire assessing knowledge, attitudes and behaviour towards antibiotics was used to collect responses from study participants at various sports clubs in Alexandria in 2019. An awareness campaign to correct misconceptions and a post awareness survey followed. RESULTS Most of the participants were well-educated (85%), in their middle age (51%) and took antibiotics last year (80%). 22% would take an antibiotic for common cold. This dropped to 7% following the awareness. There was a 1.6 time increase in participants who would start an antibiotic on a healthcare professional's advice following the campaign. A 1.3 time increase in participants who would finish an antibiotic regimen was also observed. The campaign made all participants recognize that unwise antibiotic use is harmful to them or others; and 1.5 more participants would spread the word about antibiotic resistance. Despite learning of the risks of antibiotic use, there was no change in how often participants thought they should take antibiotics. CONCLUSIONS Although awareness of antibiotic resistance is rising, some wrong perceptions hold fast. This highlights the need for patient and healthcare-tailored awareness sessions as part of a structured and national public health program directed to the Egyptian population.
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Affiliation(s)
- Lina Maarouf
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq, Azarita, Alexandria, 21521, Egypt
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Mohamed Amin
- Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Alamein International University, New Alamein City, 51718, Egypt
| | | | - Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq, Azarita, Alexandria, 21521, Egypt.
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alamein International University, New Alamein City, 51718, Egypt.
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Edessa D, Assefa N, Dessie Y, Asefa F, Dinsa G, Oljira L. Non-prescribed antibiotic use for children at community levels in low- and middle-income countries: a systematic review and meta-analysis. J Pharm Policy Pract 2022; 15:57. [PMID: 36180895 PMCID: PMC9524137 DOI: 10.1186/s40545-022-00454-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-prescribed antibiotic use is an emerging risky practice around the globe. An inappropriate use involving nonprescription access is one cause of the rapid increase in antibiotic resistance. Children commonly encounter many self-limiting illnesses for which they frequently use antibiotics without prescription. However, no specific and conclusive evidence exists to inform actions against this unsafe practice. We thus aimed to estimate the pooled proportion of non-prescribed antibiotic use for children at community levels in low- and middle-income countries. METHODS A systematic search of records was conducted from PubMed/Medline, Embase, Scopus, CINAHL, and Google scholar. Eligible English-language publications were original articles which reported on community-based non-prescribed antibiotic use for children and conducted in low- and middle-income countries. Study features and the number of antibiotics used without prescriptions were extracted and pooled for effect sizes employing a random-effects model. The pooled proportion of non-prescribed antibiotic use was estimated as a percentage. RESULTS In this analysis, we included a total of 39 articles consisting of 40,450 participants. Of these, 16,315 participants used non-prescribed antibiotics. The pooled percentage for this use of non-prescribed antibiotics was 45% (95% CI: 40-50%). The estimate was considerably higher in studies involving simulated patient methods (56%; 95% CI: 49-62%) than those studies with community surveys (40%; 95% CI: 34-46%) (P = 0.001). It was also varied by the recall period of antibiotics use-56% (95% CI: 50-62%) for instantly observed practice, 36% (95% CI: 22-50%) for within two week recall, 35% (95% CI: 26-45%) for 1-6 months recall, and 46% (95% CI: 37-54%) for more than six months recall (P = 0.001). Primary access points for the non-prescribed antibiotic uses were retail drug outlets. CONCLUSIONS We found that nearly half of the antibiotics used for children in community settings were without prescriptions. For these unsafe practices, caregivers accessed antibiotics mainly from drug outlets. Hence, context-specific educational and regulatory interventions at these outlets and the community levels are the first steps to improving antibiotic usage for children in low- and middle-income countries. TRIAL REGISTRATION NUMBER CRD42021288971 (PROSPERO). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288971 .
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Affiliation(s)
- Dumessa Edessa
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. .,School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center-Oak Ridge National Laboratory (UTHSC-ORNL, Memphis, TN, USA
| | - Girmaye Dinsa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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de Souza EV, Vieira LJSC, dos Santos SNP, Cerqueira-Santos S, Rocha KSS, de Lyra DP. Antimicrobial dispensing process in community pharmacies: a scoping review. Antimicrob Resist Infect Control 2022; 11:116. [PMID: 36116000 PMCID: PMC9482305 DOI: 10.1186/s13756-022-01157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background Antimicrobial resistance remains a major global public health concern, and antimicrobial dispensing in community pharmacies is an important factor in preventing this damage. However, the current literature focuses on the technical and attitudinal aspects related to antimicrobial dispensing, with little emphasis on the interventions provided in this service. Thus, this study aimed to determine the antimicrobial dispensing process in community pharmacies. Methods A scoping review was performed in September 2020 using the PubMed, EMBASE, LILACS, Web of Science, and Cochrane databases. The search terms included words related to dispensing, antibacterial agents, and pharmacies in various combinations. Two reviewers screened the titles, abstracts, and full-text articles according to the eligibility criteria, and extracted the data. The findings were presented in a descriptive form. Results Of the 7713 studies screened, 35 were included, of which 22 (63%) were published in Asia. Most studies followed a cross-sectional design (n = 27), and the simulated patient was the most often used method to assess the antimicrobial dispensing process (n = 22). Moreover, 31 (89%) studies investigated antimicrobial dispensing without prescription, and only four (11%) studies evaluated antimicrobial dispensing with prescription. In the 35 studies, the most frequently asked questions were about drug allergies (n = 19) and patient symptoms (n = 18), and counseling mainly focused on the side effects (n = 14), precautions (n = 14), how to take the medication (n = 12), and duration of medication use (n = 11). Another common intervention was referral (n = 15). Among clinical cases, counseling on medication use occurred often in cases of urinary tract infection (51%) and otitis media (50%). Conclusions Antimicrobial dispensing processes have been primarily investigated in low- and middle-income countries, with a focus on dispensing antimicrobials without prescriptions. During the dispensing process, pharmacists mostly posed minimal questions and counseling, highlighting the deficiencies that persist in this practice. Our results indicate the need for multifaceted strategies, such as implementing educational, regulatory or administrative strategies and changes in cultural background, especially in low- and middle-income countries, that aim to reduce indiscriminate use of antimicrobials. Therefore, qualifying the antimicrobial dispensing process is a fundamental factor for improving the rational use of antimicrobials and reducing microbial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01157-0.
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Boura F, Al-Tabakha M, Hassan N, Darwich M. Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review. Pharm Pract (Granada) 2022; 20:2701. [PMID: 36733522 PMCID: PMC9851829 DOI: 10.18549/pharmpract.2022.3.2701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
Background The use of simulated patient (SP) methodology in pharmacy practice settings has increased recently. However, its applications can vary significantly within a region, hence affecting the quality of the SP methodology. Objective The purpose of this systematic review is to critically assess the use of the SP methodology for assessing the practice of community pharmacists (CP) in the Middle East and North Africa (MENA) region. Methods A comprehensive literature search was conducted using EMBASE, MEDLINE, ProQuest, and SCOPUS to identify articles published from 2011 to 2022. The selection of relevant studies for inclusion in the systematic review was based on the pre-determined inclusion criteria. The Mixed Method Appraisal Tool (MMAT) was used to assess the methodological quality of the included studies. Results Electronic search yielded 478 publications. A total of 45 studies were reviewed. The studies were conducted in 12 countries of the MENA region. The sample size between the reviewed articles ranged from 20 to 1000 (median= 129). A greater number of the included studies measured the adequacy of skill (pre-dispensing and/or post-dispensing) 38 (84.4%). The vast majority of the studies reported unsatisfactory results regarding the competencies of CP. The number of the SP ranged from 1 to 37 (median= 2). Most of the studies recruited only one SP per pharmacy 35 (77.8%). The most common data collection method was written data collection form 42 (93.3%). Few studies only had a detection system for SP visits 11 (24.4%), and only six studies incorporated performance feedback (13.3%). More than two-thirds of the studies provided a training session for SP 37 (82.2%). There was variation in the symptoms and drugs used in the SP scenarios in the studies. Conclusion Although the results demonstrate the growth in the use of the SP method in MENA region countries, studies showed high variability in the level of reporting the study methodology. Consequently, we argue the need for standardized reporting of these studies.
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Affiliation(s)
- Fatima Boura
- BSc, MSc. Department of Clinical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Moawia Al-Tabakha
- BPharm, PhD. Department of Pharmaceutical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Nageeb Hassan
- MBBS., MSc, PhD. Department of Clinical Sciences, College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates.
| | - Mohamad Darwich
- MD, MRCPH. Department of pediatrics. Medcare Hospital, Sharjah, United Arab Emirates.
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Sweileh WM. Global research publications on irrational use of antimicrobials: call for more research to contain antimicrobial resistance. Global Health 2021; 17:94. [PMID: 34429128 PMCID: PMC8383246 DOI: 10.1186/s12992-021-00754-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 08/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Irrational use of antimicrobials is highly prevalent. It is a major driving factor for antimicrobial resistance (AMR). Research on irrational antimicrobial use is important for developing policies and regulations to combat and contain AMR. The present study aims to provide an overview of research publications on the irrational use of antimicrobials at the national and global levels. METHODS Publications on irrational use of antimicrobials were extracted from Scopus using a wide range of relevant keywords for the study period from 1980 to 2020. RESULTS In total, 656 publications on irrational use of antimicrobials were found. The bulk of publications in this field were about irrational use in humans. A limited number of publications were found on the irrational use of antimicrobials in the context of veterinary and environment. The number of publications, contributing countries, and the mean number of authors per article increased with time, most notably in the last decade. Authors from 105 different countries participated in publishing the retrieved articles with 22 (21.0%) participated in 10 or more publications. The United States led with 140 (21.6%) articles followed distantly by China (n = 49, 7.5%), India (n = 45, 6.9%), and the United Kingdom (n = 45, 6.9%). Countries in the South-East Asian region (n = 69, 10.5%) and the African region (n = 42, 6.4%) made the least contribution. The list of most frequent author keywords included "antimicrobial stewardship" and "community pharmacies". The research themes focused on the hospital-based rational use of antimicrobials and the self-medication practices with antimicrobials in the community. In total, 420 different journals participated in publishing the retrieved documents. The Plos One journal (17, 2.6%) ranked first. The retrieved articles received an average of 15.6 citations per article and an h-index of 52. The most frequent antimicrobials encountered in the retrieved literature were penicillin, cephalosporin, and fluoroquinolones while the most frequently encountered pathogens were S. aureus and P. aeruginosa. CONCLUSION Research on the irrational use of antimicrobials is needed from all countries and regions to implement appropriate policies to contain the AMR. Research on irrational use of antimicrobials in the context of veterinary is needed.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Akpan RM, Udoh EI, Akpan SE, Ozuluoha CC. Community pharmacists' management of self-limiting infections: a simulation study in Akwa Ibom State, South-South Nigeria. Afr Health Sci 2021; 21:576-584. [PMID: 34795710 PMCID: PMC8568250 DOI: 10.4314/ahs.v21i2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are dispensed only when necessary. OBJECTIVE To assess community pharmacists' management of self-limiting infections. METHODS A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit. Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research Ethics Committee. RESULTS For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was ofered in 73% and 87% of the interactions, respectively. CONCLUSION This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists. Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed.
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Affiliation(s)
- Richard Mary Akpan
- Faculty of Pharmacy, University of Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigeria
| | - Emmanuel Imo Udoh
- Faculty of Pharmacy, University of Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigeria
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Wondimsigegn D, Woldegerima B, Taddese AA. History taking and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia: a simulated-client survey. J Pharm Policy Pract 2021; 14:26. [PMID: 33641665 PMCID: PMC7919074 DOI: 10.1186/s40545-021-00310-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background Self-care is one of the growing tasks of community pharmacy professionals. They are highly engaged in consultations in response to specific drug request (product-based presentation) or symptoms clients describe (symptom-based presentation). Purpose This study was aimed at assessing the appropriateness of patient assessment and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia. Methods A descriptive cross-sectional study design based on simulated-client method of visit was conducted from 03 August to 21 September, 2020. An adult female diarrheal case scenario was developed and used to guide data collectors to interact with professionals in a standardized and consistent way. All 60 dispensaries in the town during the data collection were included in the study. A pretested data collection tool was used to record the conversation between simulated clients and providers. The data were analyzed using SPSS version 20. Results With regard to patient history, age of the patient, whether diarrhea is watery or bloody and onset and duration of diarrhea were the three most commonly requested questions with 59 (98.3%), 55 (91.7%) and 46 (76.7%), respectively. Past-medical and medication history are enquired in none of the visits. Medication was dispensed in 57 (95%) of the visits and no referral to a health facility was recommended in majority (90%) of cases. The most commonly recommended medications were ciprofloxacin 30 (52.6%) and metronidazole 20 (35.1%). ORS was considered in only 6 (10.5%) dispensaries. Conclusion Patient assessment, final decisions and treatment recommendations for an adult diarrheal case are inadequate, irrational and illegal. Educational interventions coupled with incentive mechanisms for cognitive pharmaceutical service and strict regulatory enforcement are needed to reduce the problem.
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Affiliation(s)
- Dawit Wondimsigegn
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Berhanemeskel Woldegerima
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study. Antibiotics (Basel) 2021; 10:antibiotics10020154. [PMID: 33546476 PMCID: PMC7913721 DOI: 10.3390/antibiotics10020154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/17/2022] Open
Abstract
In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.
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Palaian S, Buabeid M, Ashames A. Patient Safety Culture in Handling Prescriptions and Interprofessional Collaboration Practices Amongst Community Pharmacists: An Investigative Simulated Patient Study from the United Arab Emirates. Risk Manag Healthc Policy 2021; 13:3201-3209. [PMID: 33408542 PMCID: PMC7781103 DOI: 10.2147/rmhp.s282571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/22/2020] [Indexed: 11/29/2022] Open
Abstract
Background Community pharmacists are in a unique position to identify drug therapy-related problems (DTRPs) in prescriptions and mitigate them by communicating with prescriber. This study assessed the ability of community pharmacists (CPs) to identify DTRPs in prescriptions, the level of interprofessional collaboration among physician and CPs in mitigating the identified DTRPs, and the existing safety culture practices among CPs. Methods Trained simulated patients (SPs), five final-year BSc Pharm female students, visited conveniently selected community pharmacies (n = 50) in Ajman emirate of the United Arab Emirates, with dummy prescriptions containing DTRPs (total 50 prescriptions with five different types of DTRPs categorized per the Pharmaceutical Care Network Europe Version 8) and assessed the DTRP-identifying ability of the CPs. SPs also observed the steps taken by the CPs to mitigate identified DTRPs and existing (if any) collaborative practices between CPs and physician. SPs documented their observations in a checklist immediately after leaving the pharmacy premises, which served as the data source. Statistical analyses were performed with chi-square at alpha = 0.05. Results Of the 50 respondents, 44% (n = 22) were able to identify the DTRPs. DTRP identification by pharmacists was associated with labeling [chi-square = 7.879, p value = 0.019], reconciliation [chi-square = 10.359, p value = 0.001], counseling standard [chi-square = 19.09, p = 0.000] and physician visit suggestion [chi-square = 31.15, p = 0.000]. The labeling standards for prescriptions with DTRPs were “low” in five (50%), “average“ in three (30%) and “good” in two (20%) of the cases with wrong dose. Average counseling time of the CPs was 80.38 ± 71.61 seconds. The counseling standard had no significant association with counseling time [chi-square = 34.79, p = 0.250] and use of drug information sources [chi-square = 2.86, p = 0.243]. Average time spent in dispensing is 74.4 ± 73.05 seconds. None (n = 0) of the CPs communicated with the physician, and only five out of 50 (10%) of CPs checked any DI sources. However, in 19 (38%) cases, the CPs recommended the SPs to consult their physician prior to taking the medications. Conclusion CPs were generally able to identify DTRPs and mitigate DTRPs by recommending physician consultation. Nevertheless, there were no professional collaborations between the SPs and physicians. The dispensing and counseling standards were not appreciable.
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Affiliation(s)
- Subish Palaian
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Manal Buabeid
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Akram Ashames
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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AlRukban M, AlRuthia Y, Almasaoud M, Al-Owairdhi M, Alsouan A, Alrabiah A, Alshaikh A, Alsuhaibani A, Aleidan A. Community Pharmacists' Views of the Enforced Antibiotics Dispensing Law and Its Impact on Oral Antibiotics Sales in Saudi Arabia. Risk Manag Healthc Policy 2020; 13:2899-2907. [PMID: 33335435 PMCID: PMC7737627 DOI: 10.2147/rmhp.s278404] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
Objective(s) The aim of this study was to explore community pharmacists’ views toward the antibiotics dispensing law that was enforced in May 2018 and bans the sale of antibiotics without a prescription in community pharmacy settings in Saudi Arabia. Moreover, the potential impact of the law enforcement on the sales of oral antibiotics in Saudi Arabia was also explored. Methods A questionnaire-based cross-sectional study was conducted between September 2019 and March 2020 in Riyadh, Saudi Arabia. A multistage sampling technique was used to recruit community pharmacists from different districts. Pharmacists who consented to participate and reported practicing prior to the law enforcement were interviewed about their views of the law using a 14-item newly developed questionnaire. The annual sales of oral antibiotics for the years of 2017, 2018, and 2019 were retrieved from the Saudi Food and Drug Authority (SFDA) database. Results Two hundred and eighty six pharmacists consented to participate and met the inclusion criteria. After the law enforcement, approximately 51% of the participants reported that the percentage of patients seeking antibiotics without a prescription is less than 25%. Moreover, the majority (87.41%) reported a drop in the sales of antibiotics. Additionally, about 90% of the participants believed that the rate of inappropriate use of antibiotics will decrease as a result of the law enforcement. About 41% of the participants reported that the law has negatively impacted their pharmacies’ profits. The sales of oral antibiotics have seen a 16.6% drop in the year of 2019 as compared to 2017. Conclusion The antibiotics dispensing law is favorably perceived among community pharmacists in Saudi Arabia despite some concerns about its impact on their sales. Exploring different business models that delink the profits from the volume of antibiotics sales is necessary for this vital industry to thrive.
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Affiliation(s)
- Mohammed AlRukban
- Department of Family Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Majed Almasaoud
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Al-Owairdhi
- Department of Pharmacoeconomics and Drug Pricing, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Anwar Alsouan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Alan Aleidan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Tawfik AG, Abdelaziz AI, Omran M, Rabie KA, Ahmed ASF, Abou-Ali A. Assessment of community pharmacy management towards self-medication requests of tetracyclines for pregnant women: a simulated client study in Upper Egypt. Int J Clin Pharm 2020; 43:969-979. [PMID: 33231814 DOI: 10.1007/s11096-020-01203-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
Background Self-medication is a worldwide phenomenon of using medications without medical supervision. It is even more prevalent in low-income countries, where individuals seek community pharmacies because of accessibility and affordability. Although self-medication is associated with an increased risk of medication errors, few studies have been conducted to examine the quality of community pharmacy management towards self-medicating individuals of at-risk populations such as pregnant women. Objective We sought to investigate the quality of community pharmacies management of self-medication requests of tetracyclines for pregnant women. Setting The study was conducted in community pharmacies in Minya, Egypt. Methods A random sample of 150 community pharmacies was chosen from the urban areas of five districts of Minya, Egypt. To evaluate the actual practice, a simulated client was trained to visit pharmacies and purchase doxycycline for a pregnant woman. In a random subset of the sampled pharmacies (n = 100), interviews were conducted to evaluate pharmacy staff knowledge and attitudes regarding information gathering and dispensing practice. Main outcome measure Dispensing rate of doxycycline for pregnant women. Results From simulated client visits, almost all pharmacy staff (99.1%) dispensed doxycycline without requesting a prescription or collecting any information. About 25% of staff members did not abstain from dispensing even after knowing about pregnancy. On the other hand, most interviewed pharmacy staff (91.5%) reported that they ask about pregnancy before dispensing. Conclusion Our findings show that the current community pharmacy practice puts pregnant women at high risk of experiencing harmful self-medication outcomes. Therefore, strict legislative measures and pharmacy education programs should be considered in Egypt to lessen inappropriate dispensing rates in community pharmacies.
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Affiliation(s)
- Abdelrahman G Tawfik
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Deraya University, Minia, Egypt
| | - Abdullah I Abdelaziz
- Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia, Egypt.,Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | | | | | - Al-Shaimaa F Ahmed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Minia, Egypt.
| | - Adel Abou-Ali
- Risk Management and Benefit Risk, Astellas Pharma, Northbrook, IL, USA
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Batista AD, A. Rodrigues D, Figueiras A, Zapata-Cachafeiro M, Roque F, Herdeiro MT. Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review. Antibiotics (Basel) 2020; 9:E786. [PMID: 33171743 PMCID: PMC7694985 DOI: 10.3390/antibiotics9110786] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/31/2020] [Accepted: 11/06/2020] [Indexed: 01/10/2023] Open
Abstract
Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practice.
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Affiliation(s)
- Ana Daniela Batista
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Daniela A. Rodrigues
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), 6300-559 Guarda, Portugal; (D.A.R.); (F.R.)
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702 Santiago de Compostela, Spain; (A.F.); (M.Z.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15702 Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702 Santiago de Compostela, Spain; (A.F.); (M.Z.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001 Madrid, Spain
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), 6300-559 Guarda, Portugal; (D.A.R.); (F.R.)
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Dhingra S, Rahman NAA, Peile E, Rahman M, Sartelli M, Hassali MA, Islam T, Islam S, Haque M. Microbial Resistance Movements: An Overview of Global Public Health Threats Posed by Antimicrobial Resistance, and How Best to Counter. Front Public Health 2020; 8:535668. [PMID: 33251170 PMCID: PMC7672122 DOI: 10.3389/fpubh.2020.535668] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022] Open
Abstract
Antibiotics changed medical practice by significantly decreasing the morbidity and mortality associated with bacterial infection. However, infectious diseases remain the leading cause of death in the world. There is global concern about the rise in antimicrobial resistance (AMR), which affects both developed and developing countries. AMR is a public health challenge with extensive health, economic, and societal implications. This paper sets AMR in context, starting with the history of antibiotics, including the discovery of penicillin and the golden era of antibiotics, before exploring the problems and challenges we now face due to AMR. Among the factors discussed is the low level of development of new antimicrobials and the irrational prescribing of antibiotics in developed and developing countries. A fundamental problem is the knowledge, attitude, and practice (KAP) regarding antibiotics among medical practitioners, and we explore this aspect in some depth, including a discussion on the KAP among medical students. We conclude with suggestions on how to address this public health threat, including recommendations on training medical students about antibiotics, and strategies to overcome the problems of irrational antibiotic prescribing and AMR.
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Affiliation(s)
- Sameer Dhingra
- School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Nor Azlina A. Rahman
- Department of Physical Rehabilitation Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan, Malaysia
| | - Ed Peile
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Massimo Sartelli
- Department of General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Mohamed Azmi Hassali
- The Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Malaysia
| | | | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
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Goswami N, Dahal P, Shrestha S, KC B, Mallik SK. <p>Community Pharmacy Personnel Understanding of Antibiotic Dispensing in Eastern Nepal</p>. Healthc Policy 2020; 13:1513-1522. [PMID: 32982509 PMCID: PMC7490080 DOI: 10.2147/rmhp.s264192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
Background Objective Methods Results Conclusion
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Affiliation(s)
- Nikita Goswami
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
| | - Prasanna Dahal
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
- Correspondence: Prasanna Dahal Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang56611, NepalTel +9779852049828 Email
| | - Shakti Shrestha
- School of Pharmacy, Pharmacy Australia Center of Excellence, The University of Queensland, Brisbane, QLD4102, Australia
| | - Bhuvan KC
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan47500, Bandar Sunway Selangor Darul Ehsan, Malaysia
| | - Shyam Kumar Mallik
- Purbanchal University College of Medical and Allied Sciences, Purbanchal University, Sundar Haraicha, Gothgaun, Morang, Nepal
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Araby E, Nada HG, Abou El-Nour SA, Hammad A. Detection of tetracycline and streptomycin in beef tissues using Charm II, isolation of relevant resistant bacteria and control their resistance by gamma radiation. BMC Microbiol 2020; 20:186. [PMID: 32600267 PMCID: PMC7325294 DOI: 10.1186/s12866-020-01868-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 06/22/2020] [Indexed: 01/10/2023] Open
Abstract
Background Misuse of antibiotics in veterinary medicine has the potential to generate residues in animal derived products, which could contributing to the development of an important health risk either through the exposure to antibiotic residues or the transfer of antibiotic resistance among foodborne pathogens as well. Tetracycline (TE) and eptomycin (ST) are commonly used as antibiotics in the Egyptian animal husbandry. The objective of this study, quick detection of TE and ST in fresh local beef tissue samples using radioimmunoassay Charm II technique, isolation and identification of relevant highly resistant bacterial strains. In addition to investigating the effect of gamma radiation on the susceptibility of such resistant strains to TE and ST. Results Tetracycline (TE) was detected in all collected samples, while ST was detected in 38.46% (5/13) and 87.5% (7/8) of meat and liver samples, respectively. Fifty-one bacterial isolates were isolated from the tested samples, among them, the highest resistant isolates to TE or ST were identified as Streptococcus thoraltensis, Proteus mirabilis (2 isolates) and E. coli (3 isolates). Among them, the highest D10-values in phosphate buffer; 0.807 and 0.480; kGy were recorded with S. thoraltensis and E. coli no.3, respectively. Such values increased to record 0.840 and 0.549 kGy, respectively after artificial inoculation into meat, indicating increased resistance to gamma radiation. Gamma radiation at dose 3 kGy increased the susceptibility of S. thoraltensis up to 50% to TE and ST, while the sensitivity of E. coli no.3 reached up 56% to both antibiotics at the same dose. Conclusions High prevalence of TE in all fresh collected tissue samples suggests an extensively use of TE as antimicrobial in conventional beef production as compared to ST in the Egyptian cows’ husbandry. Moreover, irradiation of food from animal origin by gamma radiation could potentially provide protection against resistant strains. In spite of limited samples used in this study, our data could raise the concerns of public health professionals about a withdrawal period before animals slaughtering, and address the importance of gamma radiation to minimize the hazards of foodborne resistant bacteria.
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Affiliation(s)
- Eman Araby
- Radiation Microbiology Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), 3 Ahmed El-Zomor St., P.O. Box 29, Nasr City, Cairo, Egypt
| | - Hanady G Nada
- Drug Radiation Research Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), 3 Ahmed El-Zomor St., P.O. Box 29, Nasr City, Cairo, Egypt.
| | - Salwa A Abou El-Nour
- Radiation Microbiology Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), 3 Ahmed El-Zomor St., P.O. Box 29, Nasr City, Cairo, Egypt
| | - Ali Hammad
- Radiation Microbiology Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), 3 Ahmed El-Zomor St., P.O. Box 29, Nasr City, Cairo, Egypt
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Soltani D, Ebrahimpour S, Hajimiri SH, Jafarzadeh Kohneloo A, Jahangard-Rafsanjani Z. Assessment of Antibiotic Dispensing Practice in Community Pharmacies of Tehran, for 2 Common Infectious Symptoms, Using Simulated Patient Method. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2020; 19:35-43. [PMID: 33841518 PMCID: PMC8019864 DOI: 10.22037/ijpr.2020.112096.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Resistance to antibiotics is a worldwide concern and community pharmacies can play a strategic role in controlling this issue through rationalizing antibiotic consumption. Considering that dispensing any type of antibiotics without a prescription is prohibited according to Iran's regulations, this study was conducted to quantify the rate of antibiotic dispensing without a prescription by pharmacists in Tehran, Iran. A descriptive cross-sectional study was conducted from September 2016 through May 2017. Two scenarios of common infectious symptoms including sore throat and dysuria were simulated by pharmacy student in three different regions of Tehran. Each scenario was performed in three levels of demand including requesting for any medicine, asking for a stronger medicine, and direct request for an antibiotic. A total of 388 pharmacy visits were acceptable including 195 and 193 pharmacies for dysuria and sore throat, respectively. Antibiotics were provided in 39.9% of dysuria (67.5% in the first level of demand) and in 52.3% of sore throat (49% in the first level of demand) simulations. The time devoted by the pharmacists to each case was less than 60 second in more than 90% of the cases. The completion of the course of antibiotic therapy was emphasized by pharmacists in only 18% of cases in both scenarios. Our findings revealed that antibiotic dispensing without a prescription is a routine practice in community pharmacies in Tehran, Iran. Unfortunately, patient assessment and evaluation of the symptoms are not performed properly by pharmacists as well.
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Affiliation(s)
- Delaram Soltani
- Department of Clinical Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran.
| | - Sholeh Ebrahimpour
- Department of Clinical Pharmacy, Virtual University of Medical Sciences, Tehran, Iran.
| | - Seyed Hossein Hajimiri
- Department of Pharmacoeconomics and Pharmaceutical administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Aarefeh Jafarzadeh Kohneloo
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Jahangard-Rafsanjani
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
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Alrasheedy AA, Alsalloum MA, Almuqbil FA, Almuzaini MA, Aba Alkhayl BS, Albishri AS, Alharbi FF, Alharbi SR, Alodhayb AK, Alfadl AA, Godman B, Hill R, Anaam MS. The impact of law enforcement on dispensing antibiotics without prescription: a multi-methods study from Saudi Arabia. Expert Rev Anti Infect Ther 2019; 18:87-97. [PMID: 31834825 DOI: 10.1080/14787210.2020.1705156] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes.Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios.Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively.Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.
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Affiliation(s)
| | - Muath A Alsalloum
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Feras A Almuqbil
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | | | | | - Ahmed S Albishri
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Faisal F Alharbi
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Saleh R Alharbi
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | | | - Abubakr A Alfadl
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.,School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ruaraidh Hill
- Evidence synthesis, Health Services Research, University of Liverpool, Liverpool, UK
| | - Mohammed S Anaam
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
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Kurdi S, Faran A, Eareeni E, Alhalal N, Joseph R, Wali H, Alshayban D. Assessment of knowledge and attitude toward the new antibiotic dispensing law and its effect on antibiotic use in Saudi Arabia. Saudi Pharm J 2019; 28:58-67. [PMID: 31920432 PMCID: PMC6950961 DOI: 10.1016/j.jsps.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 11/02/2019] [Indexed: 12/24/2022] Open
Abstract
Background Antibiotics resistance is a serious problem around the world, which has been increasing in the last century due to misuse of antibiotics. Recently, Saudi Arabia enforced the Executive Regulations of Health Practice Law that prohibits dispensing antibiotics without prescription. Aim (1) To assess the association between the knowledge and attitude toward the recent enforcement of the antibiotic restriction Law and the antibiotic use among Saudi population. (2) To assess the pattern of antibiotic use before and after the enforcement of the Law. Method An online cross-sectional study was conducted among residents of Saudi Arabia. Results The study was carried out among 570 Saudi participants; the result shows no considerable difference before and after law enforcement in purchasing and use of antibiotics. During the six months before the law implementation, antibiotics were obtained by 42 (7%) through purchase from the pharmacy without a prescription, 23 (4%) through remains of previously used containers, and 7 (1%) through a relative or a friend; while during the six months after the law implementation it was 31 (5%), 22 (4%) and 7 (1%), respectively. Only 48% agreed that they always received advice from a doctor, nurse or pharmacist on how to use your antibiotics. 32% have no knowledge about antibiotic resistance or drug resistance or antibiotic-resistant bacteria. More than two third (75%) were aware of the recent enforcement of the law that prohibits dispensing antibiotics without prescription. Among the participants, 91 (16%), 285 (50%) and 194 (34%) were expressed negative, neutral and positive attitude towards the law, respectively. Conclusion In spite of the recent enforcement of the Law, there is still misuse of antibiotics, which indicate need for educational programs and campaigns to improve the knowledge of the population.
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Affiliation(s)
- Sawsan Kurdi
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Abrar Faran
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Eman Eareeni
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Noor Alhalal
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Royes Joseph
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Haytham Wali
- King Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Al-Ahsa 36362, Saudi Arabia
| | - Dhafer Alshayban
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
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AlQahtani HA, Ghiasi FS, Zahiri AN, Rahmani NI, Abdullah N, Al Kawas S. Self-medication for oral health problems among adults attending the University Dental Hospital, Sharjah. J Taibah Univ Med Sci 2019; 14:370-375. [PMID: 31488970 PMCID: PMC6717111 DOI: 10.1016/j.jtumed.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/16/2019] [Accepted: 06/21/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the self-medication practices for oral health problems among adults attending the University Dental Hospital Sharjah (UDHS). The reasons for visits and types, durations, and sources of self-medication were recorded. Methods This cross-sectional study was conducted among adult patients attending UDHS. A total of 566 participants were recruited using pre-determined inclusion and exclusion criteria. Data collection was performed using a self-administered closed-ended questionnaire, and information was analysed using SPSS software version 22. Results Four hundred of 566 (70.7%) respondents indicated that they practice self-medication. Among those who practiced self-medication for oral health problems, the mean age was 26 ± 9.4 years (52% men and 48% women), and the majority (46%) had obtained higher education, although their profession was not related to the medical field (69.97%). The most common factor that triggered self-medication practices was toothache (56.5%), while the main reasons for self-medication were both lack of time to visit a dental clinic (37.6%) and the perception that dental ailments were not serious health issues (36.8%). Analgesics were the main medicines used for self-medication. Conclusion Self-medication for oral health problems is a common practice in UAE. Lack of time to visit dental clinics and the perceived low importance of oral health problems were the main reasons for self-medication. Analgesics for toothache were the most frequent medications purchased from the local pharmacy.
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