Perception of community pharmacy personnel towards patient counseling and continuing pharmacy education programs in Aden, Yemen

© 2018, Journal of Clinical and Diagnostic Research. All rights reserved. Introduction: Patient counseling is a major component of pharmaceutical care, especially in community pharmacy settings. However, most community pharmacists still do not offer patient-oriented services. Despite the beneficial role of community pharmacists, research examining their roles and responsibilities in developing countries like Yemen is lacking. Aim: To assess the community pharmacy personnel’s perceptions towards patient counseling and to recognise the major barriers to successful counseling; and to assess their perception towards continuing pharmacy education programs in Aden. Materials and Methods: A descriptive, cross-sectional study was conducted among 200 community pharmacy personnel in Aden using a self-administered, structured questionnaire. Data were collected regarding community pharmacy personnel’s knowledge, attitude, and their perception about patients’ attitude concerning patient counseling and respondents’ attitude toward the continuing pharmacy education. Results: The majority of the respondents had a positive attitude towards patient counseling (85%) and continuing pharmacy education (94.0%); dose and frequency (43.0%), duration (34.0%) and indication (11.5%) were the major information mentioned while counseling their patients. Lack of patient interest (47.0%), lack of knowledge (20.0%) and lack of time (15.5%) were the major barriers towards counseling. Conclusion: The present study showed that most community pharmacy personnel in Aden, Yemen had a positive perception towords patient counseling and continuing pharmacy education program

Prostate-Specific Antigen Levels Among Diabetic Men: Exploring Patients Attending Outpatient Clinic in Yemen

Introduction: It has been reported that patients with diabetes have a decreased risk for developing prostate cancer. The study aimed to measure Prostate-specific antigen (PSA) levels among diabetic men who had not previously been diagnosed with prostate cancer. Materials and Methods: A cross-sectional study was carried out in public hospitals among diabetic men in Aden, Yemen. A predesigned structured questionnaire, including the personal data as well as physical and clinical characteristics of the study population, such as height, weight, smoking status, the duration of diabetes, and the type of treatment, was included. Blood samples were collected from the respondents, and the levels of fasting blood glucose (FBG) and PSA were measured. The data were analyzed using descriptive and inferential statistics. Results: A total of 145 diabetic male patients were included in this study. The mean PSA level of the respondents was 2.56 ng/ml. There were significant differences in PSA levels according to patient age (p=0.000). The elderly patients exhibited significantly higher PSA levels than the younger groups. The PSA levels of smokers (2.60±0.48 ng/ml) were significantly higher (p=0.035) than those of nonsmokers (2.45±0.65 ng/ml). However, no significant difference was found in PSA levels according to body mass index (BMI) category, the type of treatment, or the duration of diabetes. Additionally, our results showed that PSA levels were not significantly correlated with FBG levels. Conclusion: PSA levels were associated with age and smoking status, but not with BMI, the type of diabetic treatment, the duration of diabetes, or with FBG levels

Attitudes and practices of community pharmacists and barriers to their participation in public health activities in Yemen: Mind the gap

Background: Patients in Yemen commonly visit community pharmacies to obtain consultation or treatment for common ailments. Community pharmacists have an opportunity to optimize medication use and improve patient outcomes. This study aimed to evaluate the attitudes and practices of community pharmacists regarding their participation in public health activities and barriers to their participation in these activities. Methods: This cross-sectional study was carried out among community pharmacists working in pharmacies located in urban areas of the Aden governorate of Yemen from March to June 2017 using a self-administered questionnaire. We selected pharmacies from a line list using proportional sampling according to the number of pharmacies in the urban areas of each district. The questionnaire contained four sections: demographic characteristics, attitudes, practices, and barriers encountered. Data were analyzed descriptively, and the Chi-square test was used for analyzing the association of variables (alpha = 0.05). Results: The questionnaire was distributed to 200 community pharmacists working in community pharmacies. Of the 200 respondents, 62% (n = 124) were male. Overall, the mean age (sd) was 30.0 years (8.6) with the number of years of work experience between 2 and 9.9 years (n = 158, 79%). On average, 62.3% of the pharmacists had a positive attitude toward participation in public health activities. Providing education to stop tobacco chewing, smoking, alcohol drinking and improve oral hygiene was an important activity of the community pharmacists. Blood pressure measurements (86%, n = 172) and glucose tests (45%, n = 90) were commonly conducted for clients. Lack of time (71%, n = 142) and lack of teamwork (70%, n = 140) were mentioned as common barriers to participation in public health activities. Conclusions: Community pharmacists had a positive attitude toward public health activities. Health education and routine health tests were important practices of the community pharmacists. Barriers need to be overcome to enable more active participation by community pharmacists in public health activities by consulting with all stakeholders, assessing the situation, considering alternatives and taking action.Scopu

Teaching pharmacovigilance to undergraduate students: Our experience in poor-resource setting

Using medicines associated with adverse drug reactions (ADRs) might cause serious health complications. The pharmacist plays a unique role in monitoring ADRs, either by themselves or with the assistance of other health-care professionals, to diminish the hazards of ADRs by distinguishing, reporting, and evaluating any proposed ADRs. To train future pharmacists who have adequate knowledge of ADRs and related aspects, it is highly recommended to introduce the WHO-ISoP pharmacovigilance (PV) in the core curriculum. In this article, we shared the suggested curriculum in Aden University. It is based on comprehensive outlines and reference books that offer a broad view of all aspects related to PV. A brief student course evaluation was carried out. Fifty students participated in the survey. Students expressed the importance of the course and indicated that they wanted to know more about the types of ADRs and common medication errors. Some of them lacked an understanding of the causal relationship between ADRs and risk assessment and not familiar with the reporting forms. They suggested for PV awareness programs for health-care staff and public. The curriculum should be tailored according to the country's needs because each country has its own medication safety issues and PV program. To reach the ultimate objective, this article reports the initiative to develop PV proficiencies in a university setting

Knowledge, attitude, and practice toward antibiotic use among the general public in a resource-poor setting: A case of Aden-Yemen

Introduction: Antibiotic overuse and misuse can cause serious health issues. These problems have contributed to a rise in bacterial resistance. Hence, our study aims to highlight the existing knowledge and attitudes toward antibiotic usage among the general public in Aden-Yemen. Methodology: A cross-sectional descriptive study of knowledge, attitude, and practice of the general public was conducted in different areas of Aden city–Yemen. The study conveniently selected a sample of 400 general public working in different areas in Aden. Descriptive statistics were used for data analysis. Results: A total of 400 participants were involved in the study. Nearly 88.8% administered antibiotics in all cases of fever, 58.3% thought that antibiotics could cure infections caused by the virus, and 65.5% disagree that antibiotics should be stopped as soon as the complaint disappears. More than 77.5% thought that antibiotics in cases of the common cold are not necessary. However, 46.5% incorrectly thought that "early use of antibiotics in patients with cough, running nose, and sore throat would be cured quickly". Concerning knowledge of antibiotic resistance, 81.5% correctly answered that "overuse of antibiotics increases the risk of resistance. Most respondents reported that physicians were their primary source of information regarding antibiotic use. The most noted among respondents was that 62.7% had antibiotics for treatment without prescription in the last six months. Conclusions: Respondents have adequate knowledge and moderate attitude toward antibiotic use. However, self-medication was common practice among the general public of Aden. Therefore, they had a misunderstanding, misconception, and irrational use of antibiotics

The need of pharmacovigilance activities in Yemen

Adverse drug reactions, medication errors and other drug-related problems are the leading causes of hospitallisation and are associated with a huge economic burden and significant human suffering. This serious issue of medication therapy also contributes to morbidity and mortality. At present, the monitoring of adverse drug reactions was started in Yemen by establishing a pharmacovigilance centre in 2011. Till now there is no published information about its work , number of reports and how they process it. The country and public are facing with many safety problems related to drug smuggling, counterfeit drugs, improper and irrational use of drugs, importation of unnecessary drugs and medical errors. Therefore, it is necessary to make serious steps and active regulations in Yemen to ensure patients and public safety in relation to medicines use

An educational intervention’s effect on healthcare professionals’ attitudes towards pharmacovigilance

BackgroundPharmacovigilance concerns the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. Consumer pharmacovigilance is the involvement of consumers in adverse drug reaction (ADR) reporting. Assessing healthcare professionals’ (HCPs) knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance is integral to strengthening adverse drug reaction reporting systems. AimsTo study knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance among HCPs from KIST Medical College, Lalitpur, Nepal, and to plan an appropriate educational intervention to address deficiencies noted.Methods The study was conducted from February 2013 to December 2013 at KIST Medical College using a self-administered, pretested, structured questionnaire. The maximum possible scores for knowledge, attitude, and total were 100, 95, and 195, respectively. Baseline knowledge and attitude were studied. Two months after the questionnaire, an intervention that used a combination of methods about pharmacovigilance and consumer pharmacovigilance was undertaken. Knowledge and attitudes were studied immediately after the intervention. Scores before and after the intervention were compared using Wilcoxon signed-rank test.Results A total of 105 HCPs participated. The median (interquartile range) knowledge, attitude, and total scores before the intervention were 56 (7), 72 (9), and 127 (16), respectively. After the intervention the scores increased significantly to 72 (8), 75 (11.5), and 146 (16.5) (

Problems and challenges faced in consumer reporting of adverse drug reactions in developing countries – A case study of Yemen, Nepal and Malaysia

Background: Pharmacovigilance is the “science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems”. The most commonly used adverse drug reaction (ADR) reporting system worldwide is spontaneous and voluntary reporting, which forms the backbone of reporting systems. Aims: To explore the current status of consumer involvement in the pharmacovigilance program in three developing countries, Yemen, Nepal and Malaysia. Method: An analysis was carried out for these three countries based on the current status of pharmacovigilance and involvement of consumers in their pharmacovigilance programs. Results: Malaysia has a good system for involving consumers in their national pharmacovigilance system, whereas Yemen still lacks the well-formed national drug policy. Lack of legislation and regulation which govern the import and distribution of drugs in Yemen is a limiting factor for development of consumer pharmacovigilance. Despite establishment of a pharmacovigilance centre, no reports have been released by the centre. The status of pharmacovigilance in Nepal is still in infancy. The regulatory body is assigned to be a national pharmacovigilance center, and coordinates with seven regional centers for pharmacovigilance activities. Nepal also lacks the involvement of consumers in the national pharmacovigilance program. Conclusion: Consumer reporting may be important for developing countries to implement a proper and effective pharmacovigilance program that can reduce morbidity and mortality rates, as well as reducing the economic burden of ADRs

Do health professionals have positive perception towards consumer reporting of adverse drug reactions?

Aim: The aim of this study was to evaluate the perceptions of general practitioners (GPs) and community pharmacists (CPs) in Penang, Malaysia, towards consumer reporting of Adverse Drug Reactions (ADRs). Methodology: A cross-sectional mail survey was adopted for the performance of the study. Survey questionnaires were sent to 192 CPs and 400 GPs in the state of Penang, Malaysia. Reminders were sent to all the non-respondents after 3 weeks of the initial mailing. Data which were collected from the questionnaires were analyzed by using the Statistical Package for Social Science (SPSS), version 15. The Chi-square test was used to determine as to whether there was any significant difference between expected and observed frequencies at the alpha level of 0.05. Results: Only 104 respondents (47 CPs and 57 GPs) returned the survey, with a response rate of 18.0%- a figure which could be considered to be low. This study indicated that GPs and CPs were aware about the importance and benefits of consumer reporting. A majority of them (88.0%) thought that consumer reporting would add more benefits to the existing pharmacovigilance program. Similarly, 97% of the respondents agreed that reporting of ADRs was necessary and 87.0% respondents had seen ADRs among their patients. However, 57 of them (6.0%), had not been aware that the national program in Malaysia allowed consumers to report ADRs. A majority of them (97.0%) agreed that consumers needed more education regarding ADR reporting. Most of them (84.0%) thought that consumers could not write valid reports which were similar to reports which were made by healthcare professionals (HCPs). A majority of the respondents (68.0%) had not heard about the consumer reporting program in Malaysia and half of them did not believe that consumer reporting could overcome under-reporting, which was the main problem of the national pharmacovigilance program in Malaysia. Conclusion: The GPs and CPs were aware about the importance and benefits of consumer reporting. Such reporting will add more benefits to the existing programmes in Malaysia, although the barrier that we are facing now is the doubt that they hold over patients' ability to write valid reports which are similar to reports which are made by healthcare professionals (HCPs). Therefore, the consumers need to be educated more about their medications, on how to validate any complaints that they had about the drug consumption and on how to file a proper report and channel it to the 'right' person or bodies. Equally importantly, the media and the non-governmental organizations (NGOs) should play an important role in determining the success of consumer reporting.Scopu

Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

Background. There is a rapid deterioration in the effectiveness of antibiotics due to the global prevalence of bacterial antimicrobial resistance (AMR). AMR can cause an increase in mortality and morbidity due to treatment failures and a lack of effective therapy. Objective. The purpose of this study was to evaluate the AMR pattern of different bacterial isolates at hospitals and laboratories. Materials and Methods. A cross-sectional study from March 2019 to June 2019 was conducted at different governmental and private hospitals and laboratories in Aden, Yemen. Age, sex, specimen type, bacterial isolates, and antibiotic susceptibility pattern were collected using a data extraction sheet. Descriptive statistics were used for data analysis. Result. Data were recorded for 412 patients from whom 20 clinical specimens were collected and analyzed. The most common bacteria isolated were Staphylococcus spp. (n=172, 41.74%), E. coli (n=164, 39.80%), Pseudomonas spp. (n=37, 8.98%), and Klebsiella pneumoniae (n=18, 4.36%); other bacteria were less common. The overall bacterial resistance was highest against the combination of sulfamethoxazole with trimethoprim (73.12%), followed by amoxicillin and clavulanate (65.19%). The cephalosporin antibiotics also showed high resistance rates. The study also showed moderate bacterial resistance to gentamycin (32.65%), azithromycin (29.92%), cefoxitin (62.65%), and ciprofloxacin (25.60%). Ertapenem (16.67%) and levofloxacin (15.56%) had the lowest resistance rates. Conclusion. There was a high percentage of bacteria resistant to several antibiotics. Antibiotic susceptibility testing is a prerequisite guide for the selection of appropriate antibiotic therapy for bacterial infections