Prevalence of proteinuria and its associated factors in hypertensive diabetic patients

OBJECTIVE

Hypertensive diabetic patients are at increased risk for chronic kidney disease. Proteinuria is an early sign of kidney damage. Limited research is available on proteinuria and on its associated factors in hypertensive patients with diabetes. This study aimed to assess the prevalence of proteinuria and its associated factors in hypertensive diabetic patients.

PATIENTS AND METHODS

The current retrospective study utilized medical records and hospital computers to collect sociodemographic and medical information about the study patients in two major hospitals in Jordan. Binary regression analysis was used to find the factors that are significantly and independently associated with the presence of proteinuria.

RESULTS

Data from 522 hypertensive diabetic patients were investigated. Factors including age (OR=0.691; 95% CI: 0.930-0.994; p<0.01), high-density lipoprotein level (OR=0.450; 95% CI: 0.211-0.960; p<0.05), and higher glomerular filtration rate (OR=0.964; 95% CI: 0.950-0.977; p<0.01) were associated with proteinuria among the study patients. In contrast to metformin (OR=0.237; 95% CI: 0.098-0.572; p<0.01), patients who received insulin (OR=1.992; 95% CI: 1.136-3.492; p<0.05), thiazide diuretics (OR=1.848; 95% CI: 1.108-3.083; p<0.05), calcium channel blockers (OR=1.833, 95% CI: 1.110-3.028, p<0.05), or beta-blockers (BBs) (OR=2.199, 95% CI: 1.257-3.848, p<0.01) had a higher likelihood of having proteinuria.

CONCLUSIONS

For preserving kidney function, it is deemed necessary to perform regular checkups for proteinuria among hypertensive diabetic patients, particularly in young patients, patients with low levels of high-density lipoprotein, and those with a lower glomerular filtration rate.

Public perceptions about home delivery of medications service in Lebanon: A cross-sectional survey

<b>Objectives: </b>To investigate the public’s perception of home delivery of medication service offered by community pharmacies in Lebanon and to assess factors affecting the use of this service.<br /> <b>Methods: </b>The present study represents a cross-sectional online survey study that took place in April-May 2022. The survey was uploaded on the google form platform and was distributed on popular social media platforms (Facebook and WhatsApp). Participants were asked to fill out the questionnaire to evaluate their awareness and perception of home delivery of medication service. Statistical analyses were performed using SPSS version 22.<br /> <b>Results: </b>During the study period, 517 participants agreed to fill out the study questionnaire. Only 18.4% of the study’s participants (n=95) had previously utilized home delivery of medications service. The majority of the participants believed that home delivery service made pharmacists less accessible to answer questions (n=332, 64.2%), and prevented pharmacists from explaining important points about prescriptions (n=322, 62.3%) compared to in-store refills. The main disadvantage of the service as perceived by the participants that home delivery of medications services is associated with the excessive cost of transporting medication (n=385, 74.5%), while the main advantage of this service is its ability to serve sick patients, elderly, disabled people (n=460, 88.9%). Finally, being female, being a university graduate or above, or having a monthly income of more than 500$/month are significantly associated with utilizing home delivery of medication service (p≤0.05).<br /> <b>Conclusion: </b>The majority of the Lebanese participants reported not utilizing the home delivery of medication service before, however, they have positively perceived medication home delivery service as an efficient pharmaceutical service. Serious efforts are needed by health policymakers to facilitate the implementation of this service in Lebanon.

Public satisfaction with community pharmacists roles as healthcare providers: a cross-sectional study from Jordan

Objectives

In recent years, the responsibilities of community pharmacists have changed significantly. This study aimed to assess Jordanian public satisfaction with community pharmacists’ role as healthcare providers and to evaluate factors affecting their satisfaction level.

Methods

This cross-sectional questionnaire study was conducted among the Jordanian public using a convenience sampling approach between May 2022 and June 2022. A link to the self-administered questionnaire was distributed via different social media platforms to be filled by participants willing to participate to evaluate their views and satisfaction of community pharmacists’ role as healthcare providers.

Key findings

In this study, 710 participants agreed to participate in this study. The participants had a median age of 36.0 years and 62.3% of them were female. The most frequent reason for visiting any community pharmacy was purchasing prescription medications (83.1%). The location of the pharmacy was the most selected factor influencing the choice of a particular community pharmacy by the study participants (89.3%). Results showed that respondents had an acceptable satisfaction score about pharmacists’ behaviours and roles (median score of 32.0 out of 40.0). More than 80% of the participants were satisfied with the language used by the pharmacist in discussing drug-related matters (84.9%), with the privacy maintained by the pharmacist while dealing with them (83.1%), with pharmacists’ professionalism in dealing with patients (82.3%), and with the positive relationship between pharmacists and patients (81.0%). Respondents with a higher level of education showed more satisfaction towards pharmacists’ services compared to those with lower levels of education (Beta = 0.088, P = 0.031).

Conclusions

This study demonstrated an acceptable general satisfaction of community pharmacists while conducting their job, yet their role still mainly involves dispensing prescriptions.

Home delivery of medications: Community pharmacists' perspectives on the pros and cons of the service

Objectives

The main goal of the current study was to investigate pharmacists' perception of home delivery of medications service in Jordan and their willingness to use the service.

Method

This cross-sectional observational study was conducted between March and April 2022. The study targeted community pharmacists working at different community pharmacies across Jordan. The study questionnaire was distributed through Facebook to target Jordanian community pharmacists' groups.

Results

Three hundred and twenty-four community pharmacists participated in the study, 75% (n = 244) of pharmacists reported being willing to use the home delivery and 274 (84.6%) thought it increases the efficiency of their community pharmacies' services. Only 129 (39.8%) pharmacists agreed or strongly agreed that unlike in-store service, home delivery of medications is suitable only for OTC but not for prescriptions medications Nearly half the number of participating pharmacists (n = 153, 47.2%) believe that the service is suitable for refill prescriptions but not for new prescriptions. Pharmacists believe that the foremost pros of the service were to continue life-saving medical treatment (n = 249, 76.9%), serve sick, elderly, and disabled patients (n = 241, 74.4%), and decrease congestion at health facilities (n = 228, 70.4%). On the other hand, the cons of this service, as perceived by pharmacists included failing to build a professional relationship with patients (n = 203, 62.7%), and the contribution to communication errors (n = 147, 45.4%). Logistic regression showed that pharmacists who serve 50 patients or more per day were more willing to use the service than those serving less than 50 patients per day (OR = 2.058, P = 0.032).

Conclusion

The majority of participating pharmacists in this study were willing to use the service at their community pharmacies, especially those serving a large number of patients per day which may indicate the potential of this service in relieving the pressure on community pharmacies and allowing them to serve more patients efficiently.

Personal attributes and attitudes to substance use disorder: A study among Jordanian undergraduate medical majors students

Background

Emerging health professionals in undergraduate programs should be equipped to provide care to people with substance use disorder (SUD). The students’ personal attributes may impact their attitude toward those with SUD. This study aims to evaluate the impact of personal attributes of Jordanian undergraduate health students on their attitudes toward SUD and examine the relationship between the personal attributes and their devaluation and discriminatory (stigmatory) behaviour toward those with SUD.

Method

A cross-sectional descriptive design was used to examine the attitudes and stigmatory behaviours. The data were collected between May to October 2017 with a structured questionnaire that consisted of three parts: 1) a data sheet to collect the socio-demographic characteristics of the participants, 2) the Acute Mental Health Scale (ATAMHS), and 3) the Devaluation-Discrimination Scale (DDS).

Findings

Younger and females demonstrated a positive attitude toward those with SUD compared to older or male students. Age, gender, and previous experience with SUD are significant factors that affect their attitude.

Conclusion

Identifying the attitude to people with SUD and personal attributes of emerging health professionals in Jordan will help identify the need to educate them prior to their entry into practice.

Public Perceptions About Home Delivery of Medication Service and Factors Associated with the Utilization of This Service

INTRODUCTION

Home medication delivery service is a major service for the public. It reduces overcrowding and unnecessary visits to health centers. This study aims to investigate the public perception of home delivery of medication service in Jordan and evaluate factors affecting the use of this service.

METHODS

The study was conducted in March 2022 using an online survey. Participants were asked to fill out a validated questionnaire to evaluate their perception of home delivery of medication service.

RESULTS

Among the 1032 adult participated in this study, the majority reported that they had heard of home delivery of medication service (n = 832, 80.6%). However, only 30.9% of them have used this service before. Results showed that 71.4% of the participants (n = 737) believe that home delivery of medication service is more convenient and accessible than in-store drug refill. In addition, 65.6% of the participants (n = 677) believed that home delivery of medication service is suitable only for refill-prescription drugs (65.0%). The main pros of the service as perceived by the study participants were to serve sick patients, elderly, and disabled people (n = 822, 79.7%). In contrast, the inability of patients to build a professional relationship with pharmacists using home delivery of medications service was the most perceived con of this service (n = 627, 60.8%). Finally, regression analysis revealed that older participants, those with chronic diseases, and those who visit community pharmacies two times or more per month revealed higher use of the service (P = <0.05).

CONCLUSION

This study has shown that most participants showed positive perceptions toward the home delivery of medication services. However, participants believed that this service may decrease pharmacist's patient contact time, thus affecting the quality of medication counseling. More comprehensive future studies are necessary to examine the financial aspects of such a service and its associated drawbacks.

Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors

Background

Medication errors remained among the top 10 leading causes of death worldwide. Furthermore, a high percentage of medication errors are classified as medication discrepancies. This study aimed to identify and quantify the different types of unintentional medication discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional medication discrepancies among this cohort of patients.

Methods

This was a prospective observational study undertaken in a large teaching hospital. A convenience sample of adult patients, taking ≥4 regular medications, with a prior history of treated hypertension admitted to a medical or surgical ward were recruited. The best possible medication histories were obtained by hospital pharmacists using at least two information sources. These histories were compared to the admission medication orders to identify any possible unintentional discrepancies. These discrepancies were classified based on their severity. Finally, the different predictors affecting unintentional discrepancies occurrence were recognized.

Results

A high rate of unintentional medication discrepancies has been found, with approximately 46.7% of the patients had at least one unintentional discrepancy. Regression analysis showed that for every one year of increased age, the number of unintentional discrepancies per patient increased by 0.172 (P = 0.007), and for every additional medication taken prior to hospital admission, the number of discrepancies increased by 0.258 (P= 0.003). While for every additional medication at hospital admission, the number of discrepancies decreased by 0.288 (P < 0.001). Cardiovascular medications, such as diuretics and beta-blockers, were associated with the highest rates of unintentional discrepancies in our study. Medication omission was the most common type of the identified discrepancies, with approximately 46.1% of the identified discrepancies were related to omission. Regarding the clinical significance of the identified discrepancies, around two-third of them were of moderate to high significance (n= 124, 64.2%), which had the potential to cause moderate or severe worsening of the patient´s medical condition.

Conclusions

Unintentional medication discrepancies are highly prevalent among hypertensive patients. Medication omission was the most commonly encountered discrepancy type. Health institutions should implement appropriate and effective tools and strategies to reduce these medication discrepancies and enhance patient safety at different care transitions. Further studies are needed to assess whether such discrepancies might affect blood pressure control in hypertensive patients.

Attitudes, barriers, motivators and utilization of clinical research: a cross-sectional survey of hospital pharmacists

Objectives

Research is crucial for improving patients’ healthcare. Although pharmacists’ important role in implementing research has been emphasized by different health organizations, pharmacist’s participation in research is still suboptimal. This study aims to evaluate hospital pharmacists and assistant pharmacists’ attitudes, barriers and motivators towards clinical research practice and research utilization in practice settings.

Methods

This cross-sectional study used an online-validated questionnaire which evaluated socio-demographics, attitudes, barriers and motivators which Jordanian hospital pharmacists and assistant pharmacists have to implement clinical research and extent of its utilization in practice settings. Analysis of Covariance was modelled to evaluate the differences in the factors’ scores between different groups. Multiple linear regressions were conducted to assess the effect of the attitudes and motivators scores on the research utility practice score.

Key findings

A total of 316 responses were collected. The means for attitudes, motivators, and research utilization scores were 3.84, 3.84 and 3.80, respectively. The most agreed motivator was the role of research in the enhancement of the service to patients (mean = 4.19). The most reported research barriers were lack of time and support (57.6% and 44.3%, respectively). Linear regression analysis showed that attitudes (regression coefficient (b) = 0.34, P &lt; 0.01) and motivators (b = 0.18, P &lt; 0.01) were significant predictors of the extent of research utilization.

Conclusion

Jordanian hospital pharmacists and assistant pharmacists had a positive attitude towards research and they are willing to participate in research but they are confronting several obstacles.

Willingness of Middle Eastern public to receive COVID-19 vaccines

Background

COVID-19 is a pacing pandemic that affected health systems, economy, and social life in the whole world. Currently, there is no treatment for it, but the world is in a race that yielded, in a relatively short time than usual, several approved, promising vaccines in the middle of a storm of debates because of the speed of their production and approval.

Objective

This study assessed the willingness of Middle Eastern Arab publics to receive COVID-19 vaccines and investigated the factors behind any reluctance to receive them.

Methods

A self-administered questionnaire was distributed through social media applications in four Arab countries (Jordan, Saudi Arabia, Lebanon, and Iraq). Participants’ demographics, medical history, their experience with COVID-19, and their willingness to receive the available vaccines were obtained and analyzed.

Results

A total of 2,925 completed forms were included. Only 25% of the participants were willing to receive a vaccine while 33% were hesitant. Iraqis were the most willing to receive it while Jordanians were the least (35% and 17% of each country, respectively). Interestingly, 60% of the acceptors were ready to pay for the vaccine if not covered by governments. It was also found that American vaccines were preffered by 50% of the acceptors. However, 30% of acceptors were unsure of which vaccine is the best and 11% stated that any vaccine is good. Social media were the major source of information about COVID-19 and its vaccines. Finally, predictors of acceptance of the vaccines included living in Saudi Arabia and Iraq, being unmarried, having monthly income > $1,000, holding a medical degree, having high fear from COVID-19, feeling of being at risk of getting infected with COVID-19, and previous reception of influenza vaccine, whereas predictors of refusal included female sex and previous infection with COVID-19.

Conclusion

Middle Eastern Arabs are less likely to accept receiving the COVID-19 vaccines compared with non-Arabs. Health authorities in these countries are advised to intensify their awareness-raising activities about the vaccines while ensuring fair distribution of them.

The perception of nurses towards their roles during the COVID-19 pandemic

PURPOSE

The study aims to evaluate the available content on local Jordanian Facebook nursing groups regarding perception of their roles during coronavirus pandemic.

METHOD

Researchers used the Facebook search engine to select local Facebook groups.

RESULTS

Nurses were perceived to perform a constructive role when acting as the first-line health provider, having a public awareness role and providing care for patients. Advocating and supporting the sick and their families, ignoring and underestimating their role, nurses have a positive perception of their roles during the coronavirus pandemic. Besides being responsible for their daily activities during the epidemic, they had additional roles of ensuring the safety and contentment of their patients.

CONCLUSION

In general, nurses in Jordan perceived their roles during the COVID-19 outbreak to be constructive. They performed the task of supporting and advocating for the sick and their families. Despite these efforts during the outbreak.

IMPLICATION FOR NURSING

Nurses in general, nursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID-19 crisis. There must be an explicit adoption of strategy in all clinical environments and other clinical institutions to enhance the nurse image among themselves and community members.

Perception of pharmacy students towards their community pharmacy training experience: a cross-sectional study from Jordan

BACKGROUND

The fact that pharmacists are in the front line of patients' care gives a great responsibility to focus on education and training of pharmacy students to build a 'patient-centered' clinicians. Unfortunately, pharmacy education in the developing countries, have been lagging behind actual practice delivered by pharmacists. This highlighted the need to evaluate the perceptions of undergraduate pharmacy students regarding their current pharmacy training practices and experiences.

METHODS

This is a cross-sectional study that was conducted in Jordan during the period from August 2018 to October 2018. During the study period, a questionnaire was distributed to pharmacy students to collect information regarding 1) pharmaceutical care services provided by them during their experiential training, 2) their perceptions towards training sites, 3) their perceptions of the outcomes of their training experience, 4) information about their training site and 5) their demographics characteristics.

RESULTS

A total of 202 pharmacy students responded to the questionnaire. The majority of them reported having the opportunity to dispense refill or new prescriptions (73.8%, n = 149), and conduct patient interviews (69.8%, n = 141, but they were not provided good opportunities to create electronic patient profiles using the information obtained (53.0%, n = 107), perform required dose calculations based on patient information (37.6%, n = 76), and interact with other healthcare professionals (34.6%, n = 70). In addition, students showed positive attitudes toward training sites, positive feedback about the outcomes of their training experience (median scores range between 4 and 5 for all statements (IQR = 1 for all)).

CONCLUSION

Students showed positive feedback about the outcomes of their training experience, but they felt that the selected training sites do not have adequate resources to meet their training competencies. Memorandums of understanding development is needed to specify the purpose of training and define the responsibility for both parties of the training process.

Medication errors: a focus on nursing practice

Objectives

Health departments endeavor to give care to individuals to remain in healthy conditions. Medications errors (MEs), one of the most types of medical errors, could be venomous in clinical settings. Patients will be harmed physically and psychologically, in addition to adverse economic consequences. Reviewing and understanding the topic of medication error especially by nurses can help in advancing the medical services to patients.

Methods

A search using search engines such as PubMed and Google scholar were used in finding articles related to the review topic.

Key findings

This review highlighted the classifications of MEs, their types, outcomes, reporting process, and the strategies of error avoidance. This summary can bridge and open gates of awareness on how to deal with and prevent error occurrences. It highlights the importance of reporting strategies as mainstay prevention methods for medication errors.

Conclusions

Medication errors are classified based on multifaceted criteria and there is a need to standardize the recommendations and make them a central goal all over the globe for the best practice. Nurses are the frontlines of clinical settings, encouraged to be one integrated body to prevent the occurrence of medication errors. Thus, systemizing the guidelines are required such as education and training, independent double checks, standardized procedures, follow the five rights, documentation, keep lines of communication open, inform patients of drug they receive, follow strict guidelines, improve labeling and package format, focus on the work environment, reduce workload, ways to avoid distraction, fix the faulty system, enhancing job security for nurses, create a cultural blame-free workspace, as well as hospital administration, should support and revise processes of error reporting, and spread the awareness of the importance of reporting.

Jordanian National Study of Nurses' Barriers and Predictors for Research Utilization in Clinical Settings

Background

The nurses are the healthcare providers and researchers in the health institutions. Investment in the research potential of nurses will ultimately benefit society. The purpose of this study was to survey nurses regarding barriers to participating in research studies.

Methods

This was a cross-sectional descriptive study using electronic surveys sent by email, and social media groups (WhatsApp). A total of 447 nurses agreed to participate in this study. Barriers were measured using the Barriers of Research Utilization (BRU) Scale.

Results

More than half (53.3%) of the participants perceived the barriers to be high, whereas a small fraction (8.9%) perceived them as low. Barriers related to the organization scored the highest (P<0.01) compared to the other domains (nurse, innovation, and communication). The regression analysis model showed that age, working experience, and nationality were associated with barriers to participate in research (P<0.05).

Conclusion

More than half of the nurses in Jordan perceived barriers to participating in research studies to be high. The barriers associated with the organization had more influence. A comprehensive approach should be developed to boost research utilization among nurses by overcoming the barriers identified in the current study.

Perceptions Towards Medical Research Participation: A Study from Jordan

PURPOSE

Progress and development in medical researches require the participation of volunteers in such research, but unfortunately, the participation rate is low. This study aimed to assess Jordanian public perceptions towards participation in medical research and to understand motivators and barriers that may affect their participation.

PATIENTS AND METHODS

This is a cross-sectional study that was conducted from December 2019 to February 2020. Adults from the public were invited to participate in this paper-based survey. The survey assessed public perception (values, trust and ethics), motivators, and barriers towards participation in medical research.

RESULTS

During the study period, 2000 subjects were recruited. Around 82.3% (n = 1643) strongly agreed/agreed that medical research is important for the advancement of science. Helping the society was found to be the main motivators to participate in medical research (n = 1708, 85.4%), while time constrains (n = 1400, 70.0%), lack of opportunity (n = 1278, 63.9%), and the lack of knowledge and awareness about these researches (n = 1152, 57.6%) were among the top barriers towards the participation in medical research. Finally, results showed that previous participation in medical research was correlated with lower overall perception of values and ethics of research, and higher trust in research (p-value <0.001).

CONCLUSION

Jordanians have positive perception toward participation in medical research, which could be improved by increasing awareness, trust, and training of researchers on responsible conduct of research(RCR) in the country.

Medication histories documentation at the community pharmacy setting: A study from Jordan

Objectives

The main objective of this study was to evaluate community pharmacists’ awareness and perception about medication reconciliation service and to assess the completeness of collecting patients’ medication histories in the community pharmacy setting.

Methods

A cross-sectional study was conducted between February to March 2018 in Amman-Jordan. During the study period, 150 community pharmacists were invited to participate in the study. Each pharmacist completed a validated structured questionnaire evaluating their awareness, current practice, perceived attitude and perceived barriers towards the implementation of medication reconciliation and the collection of medication histories at the community pharmacy setting.

Results

A total of 121 pharmacists agreed to participate and filled the questionnaire. Our results showed that only 13.2% of the pharmacists were able to define “medication reconciliation” correctly, and around 31% have a misconception that the medication reconciliation process should be performed only at the inpatient setting.

Only 19.8% (n = 24) of the participating pharmacists stated that they ask all patients for a complete current medication list of medications when they arrive at the pharmacy site. Medication histories for most patients were lacking information about the dosage, route, frequency, and time of the last refill for each medication listed. “Patients lack of awareness about all the medications they are receiving” was the main barrier discouraging community pharmacists from collecting medication histories and participating in reconciliation service.

Conclusion

Community pharmacists in Jordan showed a low awareness about the medication reconciliation concept and demonstrated a modest role in obtaining medication histories in community pharmacies. But still, they showed a positive attitude towards their role in implementing the different steps of medication reconciliation. This suggests that educational workshops to increase pharmacists’ awareness about their role and responsibilities in collecting a complete and accurate medication history are warrented.

Pharmacy drive-thru service in Jordan: assessing customers' awareness, perceptions and factors affecting the use of this service

Objectives

In Jordan, drive-thru pharmacy service has recently been introduced representing a new trend in community pharmacy services. This study aimed to evaluate pharmacy customers' awareness and perceptions towards the drive-thru service to unveil important information regarding such service.

Methods

A Self-administered questionnaire was used in this cross-sectional study which was conducted in Amman-Jordan between April and August 2017. A Self-administered questionnaire was used to evaluate pharmacy customers' awareness and perceptions towards pharmacy drive-thru services. Factors affecting customers' use of this service was also investigated.

Key findings

A total of 789 pharmacy customers participated in the current study. Mean age of study participants was 27.7 years (SD = 10.6) and half of them were men (n = 397, 50.4%). Although 26.8% (n = 212) of the customers knew that the drive-thru pharmacy service was newly implemented in Jordanian pharmacies, only 10.9% (n = 86) reported to have used this service. Customers (59.1%) expressed their support for the introduction of this service to pharmacy practice in the country. Certain factors affected customers' use of the drive-thru pharmacy service positively, including male gender, Jordanian nationality, non-single marital status and having children (P-value &lt;0.05).

Conclusions

This study demonstrated positive customer awareness and perceptions towards the drive-thru pharmacy service. Busy customers seem to use this service more (men being married and having children). Hence, this service seems to be most beneficial to a certain type of customers. However, concerns about poor communication between the pharmacist and the patient represented the main disadvantage of the drive-thru service.

Patients' perspective of the impact of COPD on quality of life: a focus group study for patients with COPD

Background The quality of life has been shown to be poor in patients with chronic obstructive pulmonary disease (COPD). Furthermore, patients' perspective and attitudes toward COPD and its impact on their quality of life have been remarkably ignored. Objective To explore patients' views and perceptions regarding COPD and its impact on their quality of life. Setting COPD clinic at the Royal Medical Services Hospital, Amman, Jordan. Method Focus groups discussions to explore patients' views and perceptions about COPD were conducted using purposive sampling technique till data saturation achieved. A predesigned topic guides including knowledge about COPD and its management and the impact of COPD on the quality of life in patients with COPD was used to facilitate discussion during the interviews. All interviews were transcribed and analyzed using a thematic analysis approach. Main outcome measure Impact of COPD on patients' quality of life. Results The main themes emerged included information needs about COPD and its management, physical and psychological impact of COPD and reliance on others. The most commonly expressed problem was breathlessness which restricted physical activity and led to panic and anxiety attacks. Constant breathlessness coupled with anxiety can force COPD patient to avoid all physical activity and becoming reliant on others. Conclusion In addition to the lack of knowledge about COPD and its management, it was evident that COPD had a negative physical and psychological impact on COPD patients. Future disease management and clinical pharmacy services programs should address the current study findings in order to improve the health outcomes for patients with COPD.

An audit on the knowledge, beliefs and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan

This study aimedto assess general knowledge, beliefs and attitudes of people towards the use of antibiotics. Individuals referring to the outpatient pharmacies of 2 major teaching hospitals in the north of Jordan completed a self-administered, validated questionnaire. A total of 1091 individuals (56.8% males) participated in the study. Of these, 20.1% of the participants stated that antibiotics were used for bacterial infections, while 18.3% thought they were used for viral infections and 43.6% for mixed bacterial/viral infections. The average knowledge score of the participants about antibiotic uses and side-effects was low. Middle-aged participants and those with an education beyond high school had significantly higher knowledge scores about antibiotics use. Almost 75% of the participants disagreed that antibiotics could be given without a prescription.

Healthcare professional experiences and attitudes on unlicensed/off-label paediatric prescribing and paediatric clinical trials

OBJECTIVES

To investigate the knowledge and views of a range of healthcare professionals (consultant paediatricians, general practitioners (GPs), community pharmacists and paediatric nurses) regarding the use of unlicensed/off-label medicines in children and the participation of children in clinical trials.

METHODS

A regional study in which a survey instrument with 39 items was issued to 500 randomly selected GPs, all community pharmacists (n = 512), 50 hospital consultants and 150 paediatric nurses in Northern Ireland.

RESULTS

Approximately half (46.5%) of the 1,212 healthcare professionals approached responded to the questionnaire. The majority of respondents indicated their familiarity with the term unlicensed (82.9%) or off-label (58.6%) prescribing with the most frequently quoted reason for such prescribing being younger age (33.6%). Apart from community pharmacists, most respondents reported having gained their knowledge through personal experience. Even though a large percentage of respondents expressed concerns about the safety (77.8%) or efficacy (87.9%) of unlicensed/off-label prescribing in children, only 30.7% reported informing parents/guardians of these concerns on the use of such medicines in children. In addition, only 56% of respondents believed that unlicensed/off-label medicines should undergo clinical trials in children. Overall, 28.4% of respondents (20.1% of GPs, 41.4% of community pharmacists, 27.7% of paediatric nurses and 94% of consultant paediatricians) indicated their willingness to be actively involved in, and recruit their patients for paediatric clinical research.

CONCLUSION

The use of unlicensed and off-label medicines remains a major issue in paediatric medicine. Until such times as more licensed medicines are available for children, clear guidance should be developed to allow consistency in practice across the spectrum of healthcare professionals who are involved with such medicines in their routine practice.