Medicinal chemistry and the Bachelor of Pharmacy curriculum: Assessment of student’s perspectives, needs and barriers

Purpose: To identify students’ perspectives, needs and barriers faced when studying medicinal chemistry (MC).Methods: A validated questionnaire was designed to explore pharmacy students understanding of MC courses and their learning outcomes as it relates to the pharmacy degree, as well as identify the barriers leading to their under-performance in examinations. All fourth year MC students were asked to answer the questionnaire. Data was entered into SPSS and analyzed.Results: One hundred and forty-nine students (97 female and 52 males) in the age range of 20 - 23years old completed the questionnaire. A majority of the students (66 %) agreed that MC is an important  topic, while 52.7 % indicated that it meets the objectives stated. Just over a quarter of the students (26.2 %) chose to pursue a career or a postgraduate study related to MC. Students who perceived MC as a ‘dry’ topic (40.3%) with course objectives/learning outcomes being unclear had negative perceptions regarding MC being an important topic for the pharmacy profession. Conclusion: Although pharmacy students believe that MC is an important  topic for the pharmacy profession, many feel that the current courses  provided do not meet its main objective. Despite all barriers revealed in this study regarding students studying MC, a good number of students look forward to pursuing a career/ postgraduate study related to MC.Keywords: Medicinal chemistry, Pharmacy education, Undergraduate education, Educational barrier

Practice of pharmaceutical care in community pharmacies in Jordan

Purpose: To describe the current role played by pharmacists in delivering  pharmaceutical care (PC) in community pharmacies in Jordan (current activities and practices undertaken in the community and extent of provision of PC standards), pharmacists’ perspectives on PC implementation and barriers to implementing PC practices.Methods: This cross sectional study was conducted in 2014 in Amman, the capital of Jordan and Zarqa, the second biggest city in Jordan. The study involved a  validated questionnaire administered at random by trained pharmacy students to 180 community pharmacists. The questionnaire was designed to collect  demographic data, pharmacy practice features displayed by the pharmacists, dispensing activities undertaken, internationally proposed PC practice standards in community pharmacy settings, inter/intra-professional and public heath activities and barriers that may hinder the implementation of PC practice in Jordan.Results: 163 pharmacists agreed to participate in the study (response rate was 90.5 %). Most dispensing activities (98.1%) in the pharmacies were done under the supervision of pharmacists. All pharmacists were willing to implement PC, and nearly all of them (98.8 %) provided basic information about medication use. Nevertheless, only 31.0 % adapted standard procedures for patient’s data collection, 23.1 % formulated a therapeutic plan to be included within the patient’s permanent record in their pharmacy, 24.2 % documented over-the-counter  recommendations, and 29.7 % allocated time to discuss patient’s care plans.  Identified barriers preventing the provision of PC practice included lack of training on the concept (44.9 %) and lack of acceptability from the physicians (43.4 %).Conclusion: Although participating pharmacists showed willingness to implement PC practice, their actual application to the practice was found to be limited. Lack of adequate pharmaceutical training and acceptability by the physicians are the major barriers towards the provision of PC practice in the country.Keywords: Community pharmacists, Pharmaceutical care, Barriers, Jorda

Opinions of pharmacists and herbalists on herbal medicine use and receiving herbal medicine education in Jordan

Purpose: To explore the beliefs of herbalists and community pharmacists on  receiving educational courses in herbal medicine (HM) use by patients at pharmacy schools.Methods: This cross-sectional study was conducted in 2014. Herbalists (n = 48) and pharmacists (n = 163) were randomly recruited into the study. Demographic data, beliefs on HM use by patients, and willingness to attend educational courses were collected using a validated questionnaire and one-onone interviews.Results: The majority of the herbalists (n = 37, 77.1 %) believed that HMs are highly used in Jordan as alternative or add-on therapy to conventional medications, and the majority (n = 39, 81.3 %) reported that they need to be educated on HM use by a professional organization. More than 80 % of the pharmacists believed that they need to be experts on HM use and should apply pharmaceutical care for patients buying registered HMs at their pharmacies; a significantly higher proportion of female pharmacists (p = 0.04) agreed with this concept compared to male pharmacists.Conclusion: Both herbalists and pharmacists showed interest in attending  educational courses on HM use at pharmacy schools to improve their ability to serve their patients.Keywords: Herbalists, Community pharmacists, Herbal medicine, Pharmaceutical car

Improving Syrian refugees’ knowledge of medications and adherence following a randomized control trial assessing the effect of a medication management review service

Background Syrian refugees living in Jordan have many chronic conditions and use many medications. Pharmacists delivering the Medication Management Review (MMR) service can have a role in improving this growing global refugees’ problem. Objectives To assess the effect of the MMR service on adherence to treatment therapy and knowledge of chronic medications for Syrian refugees residing in Jordan. Methods This randomized intervention control single-blinded study was conducted in Jordan. Syrian refugees were recruited and randomized into intervention and control groups. Two home visits were delivered to each participant, at baseline and three months later. All participants completed questionnaires regarding adherence and knowledge. As a part of the MMR service, treatment-related problems (TRPs) were recognized for all patients; recommendations to resolve these TRPs were only delivered to intervention group refugees’ physicians; TRPs were corrected. At follow-up, TRPs assessment, adherence and medication knowledge were assessed for all refugee participants. Results Participants (n = 106; intervention n = 53, control n = 53) had a number of medications and diagnosed chronic diseases of 5.8 ± 2.1 and 2.97 ± 1.16 per participant respectively. A significant improvement in the adherence and knowledge scores were noted in the intervention (P < 0.001 for both) but not the control group (P = 0.229, P = 0.07 respectively). Conclusion The MMR service can significantly improve refugees’ TRPs, adherence to therapy and knowledge of chronic medications. If this approach was extended to the large scale, many refugees in need would be able to access a quality essential health-care service; a step towards achieving universal health coverage

Animal use in pharmacy undergraduate pharmacology laboratories: Students’ perceptions and need assessments

Background: During the undergraduate years, laboratory practical classes using experimental animals are important in pharmacy schools. Limitations for experimental use of animals exist, including the procurement of animals, the difficulty in performing animal experiments, ethical considerations, and more often students' preferences. Objective: To evaluate pharmacy students’ perceptions, barriers, and confidence regarding animal use in the pharmacology laboratory course, and the effect of animal handling on their confidence. Methods: This observational pre- and post-course parallel group design study was conducted during the Pharmacology laboratory involving 3rd-year pharmacology students from one school of pharmacy in Jordan. A questionnaire was designed and validated to collect students’ demographic characteristics, perceived barriers and perceptions regarding animal handling during the lab, and the level of confidence pre- and post-course, assessing differences between those who handled and those who did not handle animals. Results: All Pharmacology lab students (n = 212) with a mean age of 21.11 (SD 1.32) and the majority being females (77.0%) were enrolled. Students who refused to handle animals (n = 105, 49.5%) stated phobia as the main barrier. Students who accepted to handle animals agreed more with the importance of seeing and practicing animal handling, with animal handling being essential to understand the effect of drugs on animals and in its importance to gain skills, than those who refused. More than half of students (55.9%) reported feeling confident/somewhat confident in animal handling and in giving animals injections (50.8%) at baseline. At the end of the course, students who accepted animal handling reported significantly higher confidence. Conclusion: This study revealed important students’ barriers and perspectives to animal handling. Those who handled the animals reported better confidence in certain areas at the end of the course than those who refused. Engaging students when making decisions regarding educational practices paves the way for change to the current traditional paradigm in the education of future scholars. Keywords: Animal use, Pharmacy, Tertiary education, Pharmacology laborator

The Impact of the Coronavirus Pandemic on the Learning Process among Students: A Comparison between Jordan and Turkey

COVID-19 was declared by the WHO as a pandemic affecting several aspects of human lives. Follow-up investigations showed that the pandemic affected tertiary education. This study was designed to assess the online learning process among students living in Turkey and Jordan during the COVID-19 pandemic. This descriptive cross-sectional study was conducted via an online survey. The survey was followed by a focus group. Data were analyzed using the Statistical Package for Social Science (SPSS). A total number of 214 students participated in this study. Most of the participants were female, single, and undergraduates. Regarding the theory courses, the percentage of Turkish and Jordanian students who evaluated the online learning as ‘excellent’ or ‘very good’ or ‘good’ was greater than that for the practical courses. With regards to the practical training, more than half of the Turkish students (57.5%) ranked their experience in practical training as ‘excellent’ or ‘very good’ or ‘good’, while a lower proportion was reported by Jordanian students (47.7%). During the focus group, the cons of online learning were more numerous than the pros. The tertiary education in Turkey and Jordan was affected during the pandemic

Inhaler technique education and asthma control among patients hospitalized for asthma in Jordan

Objectives: To investigate the effect of inhaler technique education delivered by a clinical pharmacist to patients hospitalised for asthma, on inhaler technique scores and asthma control at three months post-discharge. Methods: This pre-post interventional study in Jordan enrolled patients who had been admitted for asthma and were using controller medication by Accuhaler [Diskus] (ACC), Turbuhaler (TH) or Pressurized metered dose inhalers (pMDI). Inhaler technique was assessed using published checklists (score 0–9). Asthma symptom control was assessed by Asthma Control Test (ACT, range 5–25). Patients were assessed on admission (baseline), pre-discharge, and 3 months later. All patients received a ‘Show-and-Tell’ inhaler technique counseling service prior to discharge. Results: Baseline data were available for 140 patients, 71% females, mean age 52.7 (SD 16.64) years, mean ACT score 10.0 (SD 4.8). Mean inhaler score was 7.5 (SD 1.52) with no significant difference between the inhaler groups (p = 0.174). After pre-discharge training, all patients had correct technique (score 9/9). After 3 months, mean inhaler scores were significantly higher than at baseline (8.14 (SD 0.87, p < 0.001), with mean change significantly higher for TH 1.21 (SD 2.25) and ACC 0.85 (SD 0.97) than pMDI (0.16; SD 0.72), p = 0.001. Symptom control improved significantly for all patients, with a mean increase in ACT score of 7.54 (SD 8.18), with no significant difference between the inhaler device groups (p = 0.326). Conclusions: Patients hospitalized for asthma achieved correct inhaler technique after training by a pharmacist, and maintained better technique at 3 months than on admission. Significant improvements in ACT scores were documented for all inhaler groups. Keywords: Inhaler technique, Asthma control, Asthma knowledge, Pharmaceutical care, Hospitalized asthma patients, Jorda

Doctor of Pharmacy in Jordan: Students' Career Choices, Perceptions and Expectations

Purpose: To explore Jordanian Pharm.D students' career choices, perceptions and expectations.Methods: This observational study was conducted during June 2013 at the University of Jordan. A total of 192 undergraduate Pharm.D students were invited to complete a questionnaire prepared and validated by the research team. The questionnaire investigated student’s demographics, the reasons behind choosing to study Pharm.D, satisfaction with the Pharm.D course, student’s future plans following graduation, and student’s perceptions about the Pharm.D specialty. Data collected were encoded and analyzed by SPSS database for Windows version17.Results:The majority (93%) of respondents was females,aspired to work as hospital clinical pharmacists (83%) and many (68%) believed that Pharm.D graduates are well respected by the general public. Results indicated that students are unaware of the current Pharm.D salaries and have higher expectations than what is being currently offered in the country.Conclusions:A generation of Pharm.D students from Jordan reported a future aspiration to work as hospital clinical pharmacists. Students have unrealistic salary expectations compared with the current salaries offered in Jordan. ‘Awareness workshops’ targeting students’ knowledge about the Pharm.D degree is required

Carnosine to Combat Novel Coronavirus (nCoV): Molecular Docking and Modeling to Cocrystallized Host Angiotensin-Converting Enzyme 2 (ACE2) and Viral Spike Protein

Aims: Angiotensin-converting enzyme 2 (ACE2) plays an important role in the entry of coronaviruses into host cells. The current paper described how carnosine, a naturally occurring supplement, can be an effective drug candidate for coronavirus disease (COVID-19) on the basis of molecular docking and modeling to host ACE2 cocrystallized with nCoV spike protein. Methods: First, the starting point was ACE2 inhibitors and their structure&ndash;activity relationship (SAR). Next, chemical similarity (or diversity) and PubMed searches made it possible to repurpose and assess approved or experimental drugs for COVID-19. Parallel, at all stages, the authors performed bioactivity scoring to assess potential repurposed inhibitors at ACE2. Finally, investigators performed molecular docking and modeling of the identified drug candidate to host ACE2 with nCoV spike protein. Results: Carnosine emerged as the best-known drug candidate to match ACE2 inhibitor structure. Preliminary docking was more optimal to ACE2 than the known typical angiotensin-converting enzyme 1 (ACE1) inhibitor (enalapril) and quite comparable to known or presumed ACE2 inhibitors. Viral spike protein elements binding to ACE2 were retained in the best carnosine pose in SwissDock at 1.75 Angstroms. Out of the three main areas of attachment expected to the protein&ndash;protein structure, carnosine bound with higher affinity to two compared to the known ACE2 active site. LibDock score was 92.40 for site 3, 90.88 for site 1, and inside the active site 85.49. Conclusion: Carnosine has promising inhibitory interactions with host ACE2 and nCoV spike protein and hence could offer a potential mitigating effect against the current COVID-19 pandemic