Hospital pharmacists' knowledge, attitudes and practice of pharmaceutical care and the barriers for its implementation at the hospital setting

Objective

To assess hospital pharmacists' understanding of pharmaceutical care and their attitudes regarding the adoption of the patient-centered model, as well as investigate Jordan's current state of pharmaceutical care implementation and the associated barriers.

Methods

A validated survey was distributed to hospital pharmacists in different major tertiary hospitals in Jordan. The study questionnaire contained five sections to assess sociodemographic characteristics, pharmacists' understanding of pharmaceutical care, attitudes towards pharmaceutical care, potential barriers that may limit the delivery of pharmaceutical care, and the extent of pharmaceutical care implementation in the hospital setting.

Results

The survey was completed by 152 hospital pharmacists. Participants in this study demonstrated adequate levels of knowledge about pharmaceutical care (Mean = 9.36 out of 11, SD = 1.23) and expressed favorable perceptions of pharmaceutical care (mean = 3.77 out of 5; SD = 0.7). Although more than one-third of the pharmacists practiced pharmaceutical care, the study revealed a number of impediments to the delivery of pharmacological care services. Regression analysis revealed that age (P < 0.05) and years of experience (P < 0.05) were significant predictors of knowledge, while age (P < 0.05), gender (P < 0.05), the graduation university (governmental vs. private) (P < 0.05), and years of experience (P < 0.05) were significant predictors of attitude. Furthermore, Doctor of Pharmacy degree holders had fewer barriers to pharmaceutical care implementation but were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.01 and P < 0.05 respectively). Pharmacists with a Master's degree or higher in pharmacy were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.05). Pharmacists working in the Ministry of Health and the Royal Medical Services experienced more barriers than those working in teaching hospitals (P < 0.05).

Conclusions

Although the current study indicated high knowledge and perceptions regarding pharmaceutical care among hospital pharmacists, the provision of pharmaceutical care is not widely practiced in Jordan. Moreover, several barriers to the practice of pharmaceutical care were identified, highlighting the need for effective strategies to be put in place to overcome these obstacles. These strategies should include increasing the number of pharmacy staff, resolving timing issues, providing adequate financial initiatives, improving communication skills, changing the layout of pharmacies to include a private counseling room, developing specific policies that support the role of the pharmacist in patient care, and providing effective training and continuing professional education programs.

Prevalence of Medication Associated with QTc Prolongation Used Among Critically Ill Patients

Background

Acquired prolonged corrected QT (QTc) interval can lead to life-threatening Torsade de Pointes (TdP) arrhythmia. Multiple risk factors including medications, comorbidities, and electrolyte imbalances contribute significantly to acquired manifestations of the QTc prolongation. Critically ill patients are particularly more vulnerable to TdP due to complex medical conditions, aging, and polypharmacy.

Objective

This study aimed to assess the prevalence of TdP-associated medication prescribing, identify risk factors for QTc prolongation and TdP, and determine primary predictors of high TdP medication usage in critically ill patients in Jordan.

Methods

We conducted a retrospective cross-sectional analysis of electronic medical records for patients from King Abdullah University Hospital who were admitted to Intensive Care Unit (ICU) between (July 2012-July 2022). We collected data on patients' demographics, clinical characteristics, comorbidities, laboratory results, and prescribed medications. Medications were categorized into three TdP risk levels according to CredibleMeds® assessment tool. Data were analyzed using descriptive statistics and a binary logistic regression model.

Results

Of the 13,300 patients (58.2% male, median age 62 years). Prescribing prevalence for medications with known TdP risk was 19%, possible risk (24.7%), conditional risk (21.6%), and confirmed conditional risk (8.3%). Common comorbidities included hypertension (40.9%), diabetes (33.3%), and cancer (15.4%). Drugs with known TdP risk included citalopram, amiodarone, clarithromycin, and ciprofloxacin. A binary regression model revealed that as age increased, the odds of TdP associated medication prescribing decreased (OR = 0.989, p < 0.001), while patients on more than five medications had higher odds (OR = 4.281, p < 0.001).

Conclusion

The study identified a notable prevalence of prescribing for medications with QTc prolongation/TdP risk in critically ill patients. Healthcare providers in the ICU should exercise caution to minimize the inadvertent prescription of TdP associated medications especially among older patients and those with polypharmacy.

The era of E-learning from the perspectives of Jordanian medical students: A cross-sectional study

Introduction

Online learning is becoming a crucial part of the educational process worldwide, especially after the recent COVID-19 pandemic. This study was designed to assess medical students’ perception toward online learning and their perceived preparedness and barriers during the COVID-19 pandemic.

Methods

An electronic-based, cross-sectional survey was used to recruit eligible students in Pharmacy, Doctor of Pharmacy, Medicine, Nursing, Dentistry, and Veterinary Medicine programs at various Jordanian universities (public and private). Descriptive and linear regression analysis were conducted using S.P.S.S. software. The perception score was calculated based on a 5-point Likert scale.

Results

A total of 939 students agreed to participate in this study. The prominent category was females (n = 691, 73.6%), the median age of students was 22.0 years (IQR = 2.0), and around 56% of the students study in private universities (n = 520, 55.6%). More than half of the students reported that their experiences were unsatisfactory or very unsatisfactory (n = 510, 54.3%). The majority of students preferred face-to-face communication with their professors and colleagues and considered it more effective (n = 682, 72.6%). The median of the mean perception score was 2.4 (IQR = 1.1). Regarding challenges and barriers, more than 70% reported weak internet connection, E-learning boredom, and lack of motivation (n = 723, 77.0%).

Conclusion

This study reported inadequate satisfaction and perception towards the current experience in E-learning during the COVID-19 pandemic. It also discussed the barriers and challenges hindering this transition, such as weak internet connection and the lack of motivation, indicating a need for implementing new pedagogies to enhance students’ experiences regarding online education.

Community pharmacists’ attitudes toward practice-based research and their perceived utilization of scientific evidence

Background

Enhancing the contribution of practicing pharmacists into scientific evidence via practice-based research (PBR) is crucial in maintaining high-quality clinical practice and healthcare delivery. Involving community pharmacists in PBR can potentially can also help break barriers to the utilization of the current best evidence in everyday pharmacy practice. The impact of pharmacists’ attitude towards PBR on their utilization of current best evidence in pharmacy practice is understudied.

Objectives

The aim of the study was to investigate the impact of community pharmacists’ attitudes toward PBR on their utilization of current best evidence, barriers for conducting PBR in clinical practice were also investigated.

Methods

In this cross-sectional study, 169 community pharmacists working across Jordan filled a questionnaire to assess their attitudes towards PBR, barriers to PBR, and their utilization of the current best evidence in clinical practice.

Results

Pharmacists in this study showed a positive attitude toward PBR (attitude mean score >3.5). A positive attitude towards PBR was associated with high utilization of the best current scientific evidence. We also investigated several barriers to PBR and their association with utilization those included; the lack of perceived benefits, lack of institutional support, and lack of self-engagements of community pharmacists to PBR. The lack of perceived benefit was found to be negatively associated with pharmacists’ utilization of the current best scientific evidence.

Conclusion

In this study, pharmacists’ utilization of current best evidence was found to be significantly impacted by their attitude toward PBR. The current study findings highlight the importance of supporting, promoting, and facilitating PBR among community pharmacists which can potentially enhance their utilization of the current best evidence in their everyday pharmacy practice.

Pediatric palliative care from nursing and PharmD perspectives

BACKGROUND

This research aimed to survey a sample of nursing students and Doctor of Pharmacy (PharmD) students in Jordan about their knowledge of pediatric palliative care (PPC) in the context of treating terminally ill children.

METHOD

A descriptive, cross-sectional, correlational design was used to fulfill the goal of this research. A convenience sample of nursing and PharmD students currently studying in Jordan University of Science and Technology in Jordan was recruited to complete a survey that contained 20 statements about issues on and around the subject of PPC.

RESULTS

The results showed that there was a significant difference in PPC between nurses and PharmD students. The mother's education (t = 2.158, P = 0.032) and being a nursing or PharmD student (t = 1.969, P = 0.050) were associated with knowledge about PPC. Other listed factors such as gender, working ward, and age were not associated with knowledge of PPC.

CONCLUSION

This was the first study in Jordan to survey a sample of nursing students and PharmD students in Jordan about their knowledge of PPC. The current study found that knowledge of nursing and PharmD students regarding PPC was satisfactory, depending on the scale used.

Online learning for undergraduate health professional education during COVID-19: Jordanian medical students' attitudes and perceptions

Background

The popularity of online learning has increased tremendously in response to the needs of students amid outbreaks of emerging infectious diseases. Few studies have concentrated on the learner's perspectives involved with the transition from traditional to online learning. The aim of this study was to assess students' attitudes towards online learning as well as the perceived preparedness and barriers.

Methods

A descriptive, cross-sectional, correlational web-based survey design was used to recruit eligible participants from five Jordanian government universities. A Facebook-based campaign and snowball sampling approach were used to recruit potential survey participants.

Results

The results show that 1,210 medical college students decided to take part in this online survey. Students' attitudes and perceived preparedness for online learning were moderate, while perceived barriers were high. This study revealed a connection between students' attitudes toward online learning and their gender, major, living area, college level, and prior experience. The main obstacles to online learning were an unstable Internet connection, a lack of motivation, and a lack of instructions.

Conclusion

The majority of students had mixed feelings about online learning and were largely supportive of conventional classroom learning. Students were pessimistic about their chances of learning professional skills and core competencies online. More research is required to determine whether students are ready and able to make greater use of online education in order to access high-quality learning opportunities.

Physicians' Knowledge and Attitudes Regarding Point-of-Care Pharmacogenetic Testing: A Hospital-Based Cross-Sectional Study

Introduction

Pharmacogenetic testing (PGx) is a diagnostic technique used by physicians to determine the possible reactions of patients to drug treatment on the basis of their genetic makeup. The aim of this study was to determine the impact of physicians’ awareness, attitudes, and sociodemographics on the adoption of point-of-care (POC) PGx testing as a diagnostic method, as well as the impact of their knowledge, attitudes, and sociodemographics on its adoption.

Methods

A cross-sectional survey of 200 physicians and medical trainees working at the Clinics of King Abdullah University Hospital in Jordan was performed. Data on sociodemographics, knowledge and attitudes concerning PGx testing, genetic information sources, and barriers to POC-PGx testing adoption were gathered.

Results

Participants’ perceived knowledge of the role of PGx testing in therapeutic decision-making was rated as “Excellent” (1.9%), “Very Good” (19.4%), “Good” (34.4%), “Fair” (32.5%), and “Poor” (11.9%). Physicians’ actual knowledge of PGx testing was adequate (mean=3.56 out of 7, SD=1.2), but their attitudes were generally favorable (mean=3.64 out of 5.00, SD=0.52). According to Rogers’ theory, many variables (eg, perceived need, relative advantage, compatibility) had a significant impact on physicians’ willingness to endorse POC-PGx testing.

Discussion

The majority of physicians stated that they were unaware of PGx testing. Physicians’ perceived knowledge of POC-PGx testing, however, was higher than those who participated in other studies. Participants were optimistic about the future benefits of PGx testing in prescribing effective medications and reducing potential side effects, which were consistent with previous studies. Physicians’ willingness to accept and implement POC-PGx testing was hampered by a lack of PGx expertise, as well as concerns about patient confidentiality, employability, and insurability. More training and genetic courses are needed, according to the majority of participants.

Knowledge of pediatric palliative care among medical students in Jordan: A cross-sectional study

Purpose

The aim of this study was to examine the medical student knowledge regarding pediatric palliative care (PPC) and determine the predictors of knowledge among them toward PPC.

Methods

A cross-sectional engaging study was directed with 326 medical students studying in Jordanian universities. A campaign utilizing online social media and Web-based software were executed to promote, enlist, overview undergraduate medical students, and gather information for this study. The authors employed four techniques to select undergraduate medical students on paid-promoted Facebook, personal messages, and postings in clinical forums.

Results

The results of this study showed that medical students have inadequate knowledge about pediatric palliative care in Jordan. The only factors that predict the knowledge toward PPC is gender.

Conclusion

it should build the medical students' information on pediatric palliative care. The pointer was not significant in the multivariate studies, and that vicariate studies indicated no distinction in the overall scores on either test among the nonmedical students, Training projects ought to be established and delivered to pediatric medical students to improve their knowledge about pediatric palliative/palliative consideration.

Nursing and PharmD Undergraduate Students' Attitude Toward the "Do Not Resuscitate" Order for Children with Terminally Ill Diseases

BACKGROUND

Nurses and Doctor of Pharmacy (pharmD) must communicate and properly documented the do not resuscitate orders for terminally ill children and their relatives. They also have to offer excellent care including more family support, assisting the child with terminally ill disease in passing on peacefully, and preventing unnecessary cardiopulmonary resuscitation. This research was aimed to survey attitudes of nursing and pharmD undergraduate students about the "do not resuscitate" order for children with terminally ill diseases.

METHODS

A cross-sectional correlational design was used to study the correlation between attitude toward DNR and demographic variables. More than 400 nursing and pharmD students from Jordan University of Science and Technology were recruited in this study. All the participating students were e-mailed information regarding the study, including the web survey link.

RESULTS

The results showed that there was a significant difference in perception toward do not resuscitate order between nursing and pharmD students (p ≤ 0.05). The pharmD students had more positive attitude toward do not resuscitate than the nursing students. Approximately, 60% of the nursing and pharmD students would disclose the need for the do not resuscitate order for children with terminally ill diseases Demographic variables were not associated with the perception toward do not resuscitate orders (p ≥ 0.05).

CONCLUSION

This study showed that Jordanian nursing and pharmD students are willing to learn more about different aspects of do not resuscitate orders for terminally ill children. Analyzing their responses to many items showed their misconception about do not resuscitate orders for terminally ill children.

Online Education for Undergraduate Health Professional Education during the COVID-19 Pandemic: Attitudes, Barriers, and Ethical Issues

Background

The online teaching demand has increased tremendously to promote the implementation of online teaching-leaning system to meet the need of students during the outbreaks of emerging infectious disease. This study aims to explore whether the pandemic of COVID-19, which requires universities to rapidly offer online learning, will affect attitudes about online education for undergraduate health sciences students. Also, it investigates the barriers for using online tools.

Method

A cross-sectional survey using online social media was used to recruit eligible participants. The data for this study were focused on students' experiences utilizing an online education method offered by the Jordanian government universities. This study is utilizing newly developed measuring tools that are expected to enable students to evaluate online teaching in terms of their own learning progress.

Results

A total of 1,210 participants agreed to complete the online survey questionnaire. The mean score preparedness and attitude toward online education was average. The majority of students agreed that online courses helped assign reading and homework time better than on-campus approach (75.0%) and felt comfortable to actively communicate with my classmates and instructors online. Zoom and eLearning were the most common online platforms utilized by students. The geographic locations, lack of past experience on using online tools, and lack of past experience on using online tools were identified by students as the main barrier to online educations.

Conclusions

Although the pandemic of COVID-19 appeared as uncommon catalyst for promoting eLearning, further research is needed to assess whether learners are ready and willing to make greater use of online education to obtain high quality teaching and learning opportunities, which could totally change educators' and students' attitudes and impression, and subsequently the general themes of online education.

Media's effect on shaping knowledge, awareness risk perceptions and communication practices of pandemic COVID-19 among pharmacists

Coronavirus disease (COVID-19), an infection of the zoonotic coronavirus, is presenting a healthcare challenge around the globe. This study aims to assess the levels of disease knowledge and risk perception among pharmacists. We also recognize predictors of risk perception and perceived media roles. Methods This is a questionnaire-base cross-sectional study. The questionnaire was developed on a web-based platform and invitations were sent to pharmacists nationwide to participate in the study using social media applications. Results A total of 486 pharmacists participated in this study, where females were dominant (78.6%, n = 382). Most (40.4%, n = 198) pharmacists scored 4 out of 5 in basic disease knowledge, and more than half were able to recognize common methods of spread. Risk was highly perceived among participants, and was predicted by gender, living area, and having children (p < 0,05). Frequency of watching the media and sources of information also influenced both risk perception and perceived media roles. Conclusion Disease awareness among pharmacists, as well as risk perception must be considered for effective risk communication planning. The role of media in shaping perceptions should also be carefully studied to encourage compliance with government containment measures and engagement in preventive behaviors.

Physicians' Attitudes and Ethical Obligations to Pharmacogenetic Testing

INTRODUCTION

Despite the increased utilization of pharmacogenetic (PGt) testing to guide drug therapy, little is known about the ethical challenges posed by the use of these genetic tools.

METHODS

This cross-sectional study aimed to address ethical issues related to ancillary genetic information, consent forms, and potential confidentiality breaches from physicians' perspectives. A questionnaire was administered to all practicing physicians working in KAUH.

RESULTS

Almost 49% and 65% of physicians were willing to recommend PGt testing for adult and pediatric patients, respectively. The findings showed that physicians attitudes towards the clinical utility of PGt testing became more preceptive. The majority (73.7%) indicated that PGt testing should not be treated as other routine laboratory tests. The finding also focused on potential conflicts regarding ancillary genetic information, in which 78.8% indicated that they would like to preserve the confidentiality and privacy of the patients and only 14.4% of physicians did not feel obligated to let patients know about any future risk that might be uncovered using PGt testing. The findings showed that collecting both verbal and written consents was imperative prior to testing. Seriousness and predictability of the diseases were reported to be legitimate circumstances that allow disclosure of genetic information.

DISCUSSION

Unless the field of PGt testing addresses the ethical challenges that might be encountered during PGt treatment, these issues might influence its acceptance in routine clinical settings. Establishing a minimal set of ethical standards may help emphasize the role of physicians and thus facilitate the implementation of PGt tests.