A Cross-Sectional Study on Knowledge and Perceptions of Pharmacovigilance among Pharmacy Students of Selected Tertiary Institutions in Jordan

Purpose: To assess the perceptions and knowledge of pharmacovigilance and adverse drug reactions (ADRs) reporting among Bachelor of Pharmacy (BPharm) and Doctor of Pharmacy (PharmD) students of selected tertiary institutions in Jordan.Methods: A cross-sectional study involving 434 pharmacy students from three different Jordanian universities was conducted from March - April 2014. During the study period, a validated structured questionnaire was administered to the participants to assess their knowledge and perceptions regarding pharmacovigilance and ADRs reporting process.Results: Majority of the students had insufficient awareness and lack of knowledge ofpharmacovigilance and ADRs reporting with a mean knowledge score of 4/10. PharmD students had better knowledge about pharmacovigilance and ADRs reporting system than the BPharm students (knowledge score of 5.4 versus 3.2, respectively; p < 0.001). Also, higher knowledge scores were recorded for public university and fifth-year students (p < 0.001). About two-thirds of the students expressed a positive attitude toward pharmacovigilance and ADRs issues and agreed that they would be willing to report ADRs during their clerkship programme.Conclusion: BPharm and PharmD students have insufficient knowledge of the concept ofpharmacovigilance and ADRs reporting. There is a need to incorporate pharmacovigilance into pharmacy curriculum in order to increase its awareness among pharmacy students as this will positively impact on their practice and enhance public health.Keywords: Pharmacovigilance, Adverse drug reactions reporting, Pharmacy students, Knowledge, Perception, Awareness, Attitud

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

Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies

Background: Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies. Methods: This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions. Results: Results revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and ‘in-house’ protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist’s experience (57.8%) and the physician’s order (53.4%). Conclusions: Extemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products

Assessing insomnia management in community pharmacy setting in Jordan: A simulated patient approach.

Insomnia is one of the most common minor ailments to which patients seek advice in a community pharmacy setting. Due to the availability of a wide variety of over-the-counter (OTC) products, community pharmacists are in the front line to safe-guard patients looking for self-medication or advice for treatment of insomnia. The purpose of this study was to assess the content of community pharmacists' interactions with patients seeking advice for insomnia in Jordan. A cross-sectional study using a simulated patient methodology was conducted across a stratified convenience sample of community pharmacies in three major cities in Jordan. The visits were evaluated using pre-defined criteria adapted from published literature relating to content and counseling skills. Visits were audio-recorded using a hidden microphone and the simulated patient completed a data collection form immediately after each visit. A total of 67 community pharmacies (response rate = 93.0%) agreed to participate and were all visited once by the simulated patient. The median duration of the visit was 2 minutes (range: 0.2-4 minutes). The majority (86.6%) of visits resulted in the sale of a drug, most commonly a combination product (paracetamol and diphenhydramine) for 30 recommendations (44.8%). This was followed by a natural plant extract combination product, namely valerian and lemon balm (Melissa officinalis L.) for 23 (34.3%). Pharmacists often did not question medical history or other symptoms prior to product sale. Frequently, the recommended dose (49.3%) and administration time (38.8%) were the only information provided to the patient. No information was provided in relation to potential drug interactions or contraindications. No advice was offered on lifestyle or good sleeping hygiene. This study provided evidence that community pharmacists in Jordan in general did not offer adequate counseling for patients seeking advice for insomnia. Exploration of the reasons and factors contributing to this practice and highlighting professional opportunity and responsibility is recommended

Travelers to U.S.: Zika Virus Knowledge, Attitudes, and Determinants of Practices in the Middle East—Insights for Future Awareness Campaigns

Travelers act as sentinels for the spread of Zika virus. Imported Zika cases and the presence of Zika virus-transmitting mosquitoes have been documented in the Middle East. However, data on travelers’ knowledge, attitude and practices regarding Zika and its prevention measures within the Middle East are scarce. This study aimed to address this issue in a sample of Jordanian and non-Jordanian travelers to U.S. in Jordan. A paper-based questionnaire was distributed to 301 travelers to U.S. in Queen Alia International airport, Amman, Jordan. Only 2.7% of the travelers knew that Zika is associated with birth defects. A total of 10.4% of the participants knew that the bite of infected mosquitoes is a route of Zika transmission. Only 12.6% of respondents correctly identified Zika prevention measures. The level of education and future plans for pregnancy were significantly associated with a high knowledge score (R2 = 0.140, p-value < 0.005). Although 76.2% of the travelers perceived Zika as a health threat, only 11.2% believed in the efficacy of the prevention measures. Formulation of educational campaigns within Middle Eastern countries and development of awareness strategies regarding Zika and its prevention within the airports are required. This is particularly essential with the upcoming 2022 FIFA World Cup in Qatar

Use of secret simulated patient followed by workshop based education to assess and improve inhaler counseling in community pharmacy in Jordan

Objectives: To assess inhaler technique demonstration skills of community pharmacists located in Amman, Jordan via incorporating the trained secret simulated patient (SSP) approach. Secondly, to evaluate the effectiveness of a 2-hour educational workshop focused on SSP feedback. Methods: This cross-sectional study involved community pharmacies located in Amman, Jordan. Initially, a trained SSP was involved to enact baseline visits requesting advice on how to use Ventolin® (a pressurized metered-dose inhaler; pMDI) and Pulmicort® (a Turbohaler inhaler, TH). Immediately after each visit, the SSP completed an inhaler technique evaluation form with inhaler checklists based on previously published checklists (consisting of 9 and 10 items for pMDI and TH respectively). The SSP invited all participating pharmacists to a 2-hour workshop that included feedback on their demonstration skills, and the second evaluation of their inhaler technique. The workshop included a summary of the initial visits’ results highlighting pharmacists’ performance. Results: Sixty pharmacies were visited and 120 inhaler assessments were completed. During baseline assessment, pharmacists scored an average of 4.5 out of 9 for pMDI and 4.9 out of 10 for TH. Only 11 pharmacists (18.3%) attended the workshop. During the workshop, inhaler technique demonstration skills significantly improved, as scores improved from 5.4 (SD 1.6) to 7.8 (SD 0.9) (p=0.008) and from 4.6 (SD 2.5) to 9.9 (SD 0.6) (p=0.003) for pMDI and TH respectively.  Conclusions: The SSP approach revealed a lack of ability to demonstrate correct inhaler technique for pMDI and TH inhalers by community pharmacists in Amman, Jordan. A focused educational workshop based on SSP feedback improved inhaler technique significantly

Before and after case reporting: A comparison of the knowledge, attitude and practices of the Jordanian population towards COVID-19.

Coronavirus disease- 2019 (COVID-19) is an emerging contagious infectious disease. It is pandemic and has affected more than 21 million people and resulted in more than 750,000 deaths worldwide (https://www.worldometers.info/coronavirus/#countries; 14/08/20). Our research group initiated a study to ascertain the knowledge, attitude and practices (KAP) of Jordanians toward COVID-19 prior to any initial case report in Jordan. This project was underway when the first Jordanian case was reported. We extended our study to identify how case reporting would alter public KAP towards COVID-19. This cross-sectional study randomly selected and recruited 2104 Jordanian adults. A four-section questionnaire was devised to address the sociodemographic characteristics of the subjects and their KAP toward COVID-19. The mean knowledge score for the study population was 15.9 ± 2.2 (out of the 20 knowledge questions), with 60.9% of the participants having good knowledge about COVID-19. Participants' practices to prevent transmission of COVID-19 were adequate in more than 60% of participants. Most participants had positive attitudes regarding their role in preventing COVID-19 and many of the participants' attitudes and practices changed to more appropriate ones after reporting the first case of COVID-19 in Jordan. The percentage of participants who trust the government in confronting COVID-19 increased significantly (p value < 0.001). However, one alarming and unexpected finding was that the prevention practice score of participants working in the medical field was similar to those from the general population. This may necessitate stricter training and guidelines for this group who will be in the frontline in combating the disease. Impact of this study: The data generated from this study shows that when cases of disease were reported, the public's attitudes and practices improved in many aspects, and that confidence in the government to contain the disease was boosted. We believe that this study is important in allowing other, international governments to develop an understanding of public KAP during pandemic disease outbreaks

Doctor of pharmacy as a career option: a cross-sectional study exploring PharmD students and practitioners expectations in Jordan

Abstract Objective This study aimed to (1) investigate the expectations and preferences of PharmD students and practitioners regarding their role in the health care system, and (2) to contrast those expectations and preferences of PharmD practitioners with real-life practice in Jordan. Methods Two cross-sectional descriptive questionnaires were used to collect data from PharmD students and PharmD practitioners in Jordan. A total number of 330 students and 280 practitioners were interviewed. The responses to all questions were encoded, entered, and summarized as frequencies and percentages or as means and standard deviations. Comparisons between groups were performed using Chi-square test. A p-value of < 0.05 was considered significant. Results Both PharmD students and practitioners chose working as a clinical pharmacist in a hospital as their first-choice job. However, their second and third jobs choices were significantly different as practitioners opted for income as a main criterion for job selection. Interestingly, salary expectations by PharmD students were significantly higher than the reality as reported by PharmD practitioners. Both students and practitioners placed the work environment as the highest priority criterion for making a work choice on the work environment. In general, both students and practitioners agree on the ideal roles of PharmD graduate with the issues of prescribing and compounding responsibilities being the ones with the highest disparity between practitioners and students. Significant differences were found between the student’s and practitioner’s perceptions of the ideal role of a PharmD in and the current professional practice in Jordan. Conclusion Job preferences and salary expectations differ significantly between students and practitioners. Professional orientation of PharmD. students should be implemented to minimize misconceptions of their job nature, availability, and compensations. The fact that students do not prefer to work in a community pharmacy should be addressed by educational institutions and professional organizations. The prescribing and compounding responsibilities of pharmacists should be also emphasized in the curricula of pharmacy schools and worked in by professional organization to achieve optimal implementation in real-life practice