A Pilot Study Assessing the Barriers to Pharmacy Practice in Dubai, United Arab Emirates

Purpose: To explore the barriers to the practice of pharmacy in Dubai, United Arab Emirates (UAE).Methods: In a questionnaire-based cross-sectional study, 50  questionnaires were distributed torandomly selected pharmacies in Dubai. The questionnaire contained information for collecting data on demographic data, technical-related information, and barriers to optimized pharmaceutical services.Results: A total of 31 of the 50 questionnaires were returned, giving a response rate of 62 percent. Of these, 20 (65 %) were male, 25 (81 %) holding bachelor degree, and almost three quarters 23 (74 %) were Indian and had their bachelor degree in India. More than half (n = 18, 59 %) reported that they functioned as pharmacists-in-charge and dispense more than 100 prescriptions in 1 business week during the study period. Enhanced pharmacy services offered by pharmacists under investigation were minimal for drug outcomes monitoring (9.68 %), counseling in hyperlipidaemia (6.45 %), and hypertension (9.68 %). A high proportion of pharmacists studied agreed that pharmacists lack customers' recognition in Dubai (54.8 %) and receive inadequate salary (67.8 %), and that pharmacy practice in Dubai is business-oriented (74.2 %). Nearly all the pharmacists (93.5 %) agreed that lack of sales bonus and high running costs are major barriers to optimized pharmacy services in Dubai.Conclusion: This pilot study gives some insight into the impediments community pharmacists in Dubai face while delivering pharmacy services to patients. These findings can be used to promote discussion in the profession and with stakeholders about the future role of the community pharmacist in patient care in UAE.Keywords: Barriers; Community pharmacy; Pharmacy practice; United Arab Emirates, Drug outcomes monitoring, Counselin

Changes of some Health Indicators in Patients with Type 2 Diabetes: A Prospective Study in three Community Pharmacies in Sharjah, United Arab Emirates

Aim: The study aimed to examine changes in some health indicators in people with type 2 diabetes mellitus, namely: reported self-care activity, health related quality of life, and patient opinion of the services provided by three community pharmacies in Sharjah, UAE. Method: A group of patients was followed over 24 months. Patients under investigation received reminders packages during the first three months of the study. No reminders were sent after 3 months after the study was underway. Repeated measures ANOVA were used to test differences between means over different periods. Results: All patients included in this study were found to have poor diet and exercise behavior at baseline. Three months into the study, more than 27% of the patients had acceptable diet, exercise, foot care and self-testing behavior. However, evaluation at six months and 24-months show that mean scores had almost returned to baseline levels. There were significant differences between the mean values of initial (baseline data) and final (at the end of the study) scores for general health (5.86, p = 0.001), vitality (5.25, p < 0.001), and role physical scales (3.81, p = 0.02). There was a significant (p < 0.001) 25% increase in the patients' perception of the ability of the pharmacist to assist in decreasing blood glucose level. Conclusion: Ongoing reminder packages are needed for continued progress in self-care activities and for achieving lasting changes in the behavior. Implementation of such a strategy through community pharmacies could help to improve patients' views of the quality of services received from these pharmacies and patient's quality of life, which should improve patient's drug therapy and reduce complications of diabetes

Erratum to: What drives using antibiotic without prescriptions? A qualitative interview study of university students in United Arab Emirates

The authors acknowledge that Liz Ellis did not co-author this article and was erroneously listed as co-author. Editor’s note: COPE flowchart Changes in authorship d) (“Request for removal of author after publication”) was followed

Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach

Background: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. Objective: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. Methods: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists’ current professional role, and barriers to enhanced pharmacy services. Results: About half of the respondents (45.4%, n=90) agreed that pharmacy clients under-estimate them and 52.5% (n=104) felt the same by physicians. About 47.5% (n=94) of the respondents felt that they are legally unprotected against profession’s malpractice. Moreover, 64.7% (n=128) stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252) found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124) disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134) gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not. Conclusions: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost

A qualitative study exploring public perceptions on the role of community pharmacists in Dubai

Background: The role of community pharmacists is very important due to their access to primary care patients and expertise. For this reason, the interaction level between pharmacists and patients should be optimized to ensure enhanced delivery of pharmacy services. Objective: To gauge perceptions and expectations of the public on the role of community pharmacists in Dubai, United Arab Emirates (UAE). Methods: Twenty five individuals were invited to participate in 4 separate focus group discussions. Individuals came from different racial groups and socio-economic backgrounds. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers coded all transcripts to identify emerging themes. Appropriate measures were taken to ensure study rigor and validity. Results: All facilitators and barriers that were identified were grouped into 5 distinct themes. The pharmacist as a healthcare professional in the public mind was the most prominent theme that was discussed in all 4 focus groups. Other themes identified were, in decreasing order of prevalence, psychological perceptions towards pharmacists, important determinants of a pharmacist, the pharmacy as a unique healthcare provider, and control over pharmacies by health authorities. Conclusions: This study provided insight into the way that the public looks at the role of community pharmacists in Dubai. Determinants that influence their perception are the media, health authorities, pharmacist’s knowledge level, attire, nationality, age, and pharmacy location

Evaluation of Adherence to Diabetic Treatment in Northern Region of United Arab Emirates

Purpose: To determine medication adherence and predictors of suboptimal adherence in patients with diabetes type 2, and to address the factors that are associated with treatment non-adherence in Northern Region of United Arab Emirates (UAE).Methods: This cross-sectional study involved 200 type 2 diabetes mellitus (T2DM) patients randomly selected from outpatient clinics in Northern Region, UAE. Special questionnaire form have been prepared to assess the level of adherence then filled in through direct interviewing with the patients. The adherence level score was calculated based on total summation of items related to good adherence and accordingly participants’ scores of 90 % or more were considered adherent and who achieved less than 90 % were non-adherent.Results: Only 120 (60 %) of the patients were adherent. Factors that are associated with nonadherence were :age ≥ 50 (OR = 1.8, 95 % CI= 1.02 - 3.19), lower education level (OR = 0.17, 95 % CI = 0.09 - 0.31), lack of health insurance (OR = 21, 95 % CI = 9.62 - 45.85), forgetfulness (OR=  0.29, CI = 0.13 - 0.61), co-morbidities (OR = 0.24, 95 % CI = 0.11 - 0.51), &gt; 6.5 % HbA1C (OR = 7.22,95 % CI = 3.69 - 14.14); longer time since last visit to clinic (OR = 14, 95 % CI = 6.52 - 30.04); increased medication cost (OR = 30, 95 % CI = 11.2 - 80.1); and unawareness (lack of awareness) of physician instructions (OR = 7.22, 95 % CI = 3.7 - 14.1).Conclusion: Adherence to diabetes treatment was quite poor among participants. Glycemic control could be improved through early identification and incentives for adherence behaviors which can be supported using a counseling approach of communication with the patients by healthcare professionals before applying any individual patient management plan.Keywords: Medication adherence, Type 2 diabetes, Antidiabetic, Predictors, United Arab Emirate

Denosumab Use in Chronic Kidney Disease Associated Osteoporosis: A Narrative Review

Abduelmula R Abduelkarem,1,2 Adnane Guella,3 Amar M Hamrouni,4 Mohammed M Hassanein,1 Ahmed Nasr,5 Owais Rana6 1Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates; 2Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 3Department of Nephrology, University Hospital Sharjah, Sharjah, United Arab Emirates; 4Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates; 5Pharmacy Department, University Hospital Sharjah, Sharjah, United Arab Emirates; 6Department of Internal Medicine, University Hospital Sharjah, Sharjah, United Arab EmiratesCorrespondence: Abduelmula R Abduelkarem, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates, Tel +97165057443, Email [email protected]: Chronic kidney disease (CKD) and hemodialysis (HD) patients have a high incidence of bone disease and increased fracture risk, making effective management of their bone health a clinical challenge. Denosumab, a human monoclonal antibody, has been investigated as a therapeutic option in this patient population. In this review, we summarize the current evidence on the efficacy and safety of denosumab in CKD and HD patients. A comprehensive search of the relevant literature was conducted, including randomized controlled trials, observational studies, and meta-analyses. The findings suggest that denosumab reduces the risk of fractures and improves bone mineral density in all stages of CKD. The results of this review support the use of denosumab as a promising option for managing bone disease in CKD and HD patients.Keywords: denosumab, chronic kidney disease, hemodialysis, bone disease, fracture risk reductio