Pharmacists' knowledge and attitudes about natural health products: A mixed-methods study

Objectives: To explore knowledge and attitude of pharmacists in Qatar towards natural health products (NHPs). Methods: The quantitative component of this study consisted of an anonymous, online, self-administered questionnaire to assess knowledge about NHPs among pharmacists in Qatar. Descriptive statistics and inferential analysis were conducted using Statistical Package of Social Sciences (SPSS®). Means and standard deviation were used to analyze descriptive data, and statistical significance was expressed as P-value, where P≤0.05 was considered statistically significant. Associations between variables were measured using Pearson correlation. The qualitative component utilized focus group (FG) meetings with a purposive sample of community pharmacists. Meetings were conducted until a point of saturation was reached. FG discussions were audio-taped and transcribed verbatim. Data were analyzed using a framework approach to sort the data according to emerging themes. Results: The majority of participants had average to poor knowledge about NHPs while only around 7% had good knowledge. In the FG meetings, participants considered the media, medical representatives, and old systems of natural health as major source of their knowledge. They criticized undergraduate pharmacy courses (for inadequately preparing pharmacists to deal with NHPs) and the pharmacy regulations (for being irrelevant). A perception of NHPs as being “safe” still exists among pharmacists. Conclusions: Pharmacists’ ability to provide effective services associated with NHPs is limited by poor access to evidence-based information and poor knowledge. A perception of NHPs and CAM as 'safe' still exists among pharmacists, and regulations related to NHPs require addressing to follow best practice and ensure patient safety.Scopu

Structured Multi-Skill Assessment (SMSA) in pharmacy: A contextual adaptation for authentic assessment for colleges of pharmacy and beyond

There is a need for a contextual adaptation model of the Objective Structured Clinical Examination (OSCE) procedures and assessment methods into diverse contexts with great cultural diversity that is both affordable and achievable. This manuscript aims to describe the principles, organizational structure and theoretical framework of the Structured Multi-Skill Assessment (SMSA), a modified version of the OSCE and a performance-based assessment method developed at the Qatar University College of Pharmacy (QU CPH) that addresses contextual and cultural considerations when used in undergraduate pharmacy curricula

Pharmaceutical care in the Arabic-speaking Middle East: literature review and country informant feedback

The philosophy and practice of pharmaceutical care (PC) has challenged Middle Eastern pharmacists to embrace a new paradigm that focuses on outcomes of care rather than products or tasks. Although the application of PC was found to be associated with a reduction in adverse drug reactions, length of hospital stay and cost of care in the developed world, the status and application of the practice remains less clear in the Arabic-speaking Middle East (ME). The aim of this project was to describe the current status of PC services in a number of Arabic-speaking ME countries. Methods We conducted literature search to identify what had been published on the status of PC in the ME. We also invited individuals who have good understanding of the pharmacy environment in the respective country. The individuals identified were asked to respond to a set of standardized questions relating to PC services in their countries. Results The literature search generated 12 publications in total. Ten country informants agreed to provide information on PC practice and pharmacy practice in general in their respective countries and they ultimately provided information related to these areas. Conclusions The PC concept is still often confused with clinical pharmacy, which remains to be a priority in several countries in the region. Pharmacy education is rapidly changing change in many of the ME. These changes are hoped to reflect a wider recognition and application of PC services in the hospital and community settings.qscienc

Synthesizing and Appraising the Quality of the Evidence on Factors Associated with Medication Adherence in Diabetes: A Systematic Review of Systematic Reviews

Background Nonadherence to medications is a common phenomenon in patients with diabetes. Several studies and systematic reviews have investigated the barriers to medication adherence in diabetes. However, no study has evaluated the quality of the existing literature and synthesized the plethora of evidence with a goal to design holistic conceptual frameworks and interventions. Objectives The aims of this review were to systematically evaluate existing systematic reviews focusing on factors associated with medication adherence in diabetes in an effort to synthesize the evidence, determine their methodological quality, and identify the gaps in the current literature. Methods Fourteen databases and gray literature sources were systematically searched through June 2016. Systematic reviews reporting factors associated with medication adherence (barriers and facilitators) in patients with diabetes were selected on the basis of predetermined criteria. Studies were appraised for quality using AMSTAR (A Measurement Tool to Assess Systematic Reviews). Results Seventeen systematic reviews including 542 primary studies, most of which were cross-sectional quantitative studies, were included. All the reviews were rated as moderate to low quality and exhibited common methodological pitfalls. Factors influencing medication adherence identified were categorized as patient-, medication-, disease-, health care provider-, health care system-, and social-related factors. Conclusions Factors influencing medication adherence are multifactorial with remarkably consistent findings across the existing reviews; yet, most reviews were judged to be of low to moderate quality. Further comprehensive and well-conducted original studies and systematic reviews on this topic shall be conducted taking into consideration the drawbacks of existing ones. 1 2017Scopu

Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial

Background: It had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar. Methods/Design: A prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome. Discussion: If proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden. Trial registration: Clinical Trials NCT02123329.Qatar National Research Fund under its National Priorities Research Program (NPRP)

Pharmacists’ confidence when providing pharmaceutical care on anticoagulants, a multinational survey

Background: Guidelines on the management of orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision.Objective: To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation. Setting Pharmacists in different work settings in different countries.Method: Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class. Validation of the survey was ensured.Results: Responses from 4212 pharmacists originating from 18 countries were obtained. Pharmacists’ level of confidence was significantly higher (p < 0.001) when advising patients on vitamin K antagonists (VKAs) versus non-vitamin K antagonists (NOACs). In general, hospital pharmacists displayed higher confidence levels compared to community pharmacists when advising patients on anticoagulation (p < 0.001). Two distinct patterns of confidence levels emerged relating to basic and advanced pharmaceutical care. Confidence levels when providing advanced pharmaceutical care were significantly higher for Oceania and lower for South America (p < 0.005).Conclusions: Pharmacists felt more confident in supporting patients receiving VKAs compared to the more recently introduced NOACs. With the increasing use of NOACs and the risks pertaining to anticoagulation therapy, it is essential to invest in education for pharmacists to address their knowledge gaps enabling them to confidently support patients receiving oral anticoagulants.The project was funded by the Davie-Ratnoff-Macfarlane (DRM) foundation.info:eu-repo/semantics/publishedVersio

Benchmarking Arabic AI with Large Language Models

With large Foundation Models (FMs), language technologies (AI in general) are entering a new paradigm: eliminating the need for developing large-scale task-specific datasets and supporting a variety of tasks through set-ups ranging from zero-shot to few-shot learning. However, understanding FMs capabilities requires a systematic benchmarking effort by comparing FMs performance with the state-of-the-art (SOTA) task-specific models. With that goal, past work focused on the English language and included a few efforts with multiple languages. Our study contributes to ongoing research by evaluating FMs performance for standard Arabic NLP and Speech processing, including a range of tasks from sequence tagging to content classification across diverse domains. We start with zero-shot learning using GPT-3.5-turbo, Whisper, and USM, addressing 33 unique tasks using 59 publicly available datasets resulting in 96 test setups. For a few tasks, FMs performs on par or exceeds the performance of the SOTA models but for the majority it under-performs. Given the importance of prompt for the FMs performance, we discuss our prompt strategies in detail and elaborate on our findings. Our future work on Arabic AI will explore few-shot prompting, expand the range of tasks, and investigate additional open-source models.Comment: Foundation Models, Large Language Models, Arabic NLP, Arabic Speech, Arabic AI, , CHatGPT Evaluation, USM Evaluation, Whisper Evaluatio