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

Cultural Adaptation and Linguistic Validation of the Beliefs about Medicines Questionnaire in Malaysia

BACKGROUND: Low rate of adherence was found strongly associated with patients' beliefs across the studies about chronic diseases with hypertension. A crucial move is needed to bridge the gap between appropriate assessment tools and local hypertensive patients' medication adherence. OBJECTIVE: To produce a translated version in Malay language of Beliefs about Medicines Questionnaire (BMQ) that was "conceptually equivalent" to the original English version for use in local clinical practice and research. METHODS: The forward translation process was conducted by two independent professional translators and back translation was done by two other independent translators. A reliability analysis was conducted on 238 conveniently selected hypertensive patients. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability for the randomly selected 40 patients in a period of 2 weeks. Discriminant validity was tested through Necessity-Concerns differential, BMQ subscales, and other parameters. RESULTS: The overall Cronbach alpha for the internal consistency was good (0.860). The subscales of the BMQ demonstrated adequate internal consistency, with Cronbach alpha value of 0.759 for Specific-Necessity, 0.762 for Specific Concern, 0.624 for General-Overuse, and 0.756 for General-Harm. The ICC was excellent (0.922). Discriminant validity revealed that BMQ Specific-Necessity score was significantly inversely correlated with the systolic blood pressure level. Systolic and diastolic blood pressure levels (P = 0.038; P = 0.05) were reported to be significantly correlated with the Necessity-Concerns differential, with Necessity score equal or exceeding Concerns score. CONCLUSIONS: The Malay-translated version of BMQ is a reliable and valid tool to assess patient belief about medication, especially medication adherence among the hypertensive patients in Malaysia

Association between Knowledge and Drug Adherence in Patients with Hypertension in Quetta, Pakistan

Purpose: To evaluate the association between patient’s knowledge of hypertension management and medication adherence.Methods: A cross-sectional study was undertaken with 385 hypertensive patients who visited outpatient departments in two public hospitals in Quetta City, Pakistan. Besides demographic and disease-relatedquestions, two validated questionnaires (Hypertension Fact Questionnaire and Drug Attitude Inventory) were used for data collection. Descriptive statistics were to determine the demographic and diseasecharacteristics of the patients while Spearman rank correlation was employed to measure the association between knowledge and drug adherence.Results: Out of 385 patients, 236 (61.3 %) of the patients had average knowledge about hypertension while 249 (64.7 %) were categorized as poor adherent. No patient was considered as good adherent in the study. Correlation coefficient between total score of knowledge and total adherence was – 0.170 (p < 0.001), indicating an inverse association between knowledge scores and adherence level.Conclusion: Although the level of knowledge was average, patients were unsure of the benefits of continuous medication use which resulted in non-adherence to regimens. Educating patients about the benefits of medications and clarifying doubts regarding medication use should result in better control of hypertension

Community pharmacists’ perceptions towards online health information in Kuala Lumpur, Malaysia

Objective: The current study was carried out to assess community pharmacists’ perceptions towards online health information, to examine the type of information seek from Internet and to identify the barriers when they retrieved online health information. Methods: The study was designed as a cross-sectional questionnaire-based survey whereby all (300) community pharmacists practicing in Federal Territory of Kuala Lumpur, Malaysia were targeted for data collection. A 35-itemed questionnaire was posted out along with a stamped addressed envelope, invitation letter and support letter. Responses were also accepted via online response. Both descriptive and inferential statistics were used for data analysis. All statistical analysis was performed using SPSS v. 20.0. Results: A total of 67 responses were received with a response rate of 22.3%. The top three frequently health information searched by respondents were medicine information, general healthcare information and disease-related information. High number of respondents agreed that Internet had too much health information to scan through. Gender (p=0.018) showed significant association with visiting established health websites. Meanwhile, statistical significant was observed between age and searching medicine information (p=0.037), undertaking online continuing professional development (p=0.023), as well as searching clinical guidelines (p=0.047). Respondents’ education level showed significant association with uncertainty about the reliability of online health information (p=0.023) and unsure about filtering the information (p=0.007). Conclusions: Majority of the respondents expressed positive perception with the use of Internet for health information. The findings of the current study showed the widely use of Internet for health information among community pharmacists. Hence, this study provides opportunity for future works to further examine community pharmacist’s retrieval and appraisal skills for online health information, as well as application of this information into their daily pharmacy practice

Evaluation of the Perception of Community Pharmacists Regarding their Role in Pakistan's Healthcare System: A Qualitative Approach

Purpose: To explore the perception of community pharmacists regarding their role in Pakistan's healthcare system.Methods: A qualitative study design was adopted. A semi-structured interview guide was developed and face to face interviews were conducted. The participants were community pharmacists and were recruited through one of the researcher’s personal contacts in two cities of Pakistan (Islamabad and Lahore) from April to June 2008. The interviews were conducted at the pharmacists’ work-place. Arrangements for the time and place of interview were made during initial contacts. Written consent was obtained from the participants prior to the interview.Results: Among the respondents interviewed, seven were male and three female community pharmacists aged between 25 and 50 years. All the participants regularly dispensed &gt; 50 prescriptions daily. Thematic content analysis yielded 5 major themes: (a) provision of pharmacy services to consumers, (b) counseling at pharmacy, (c) application of Good Pharmacy Practice (GPP), (d) Pakistan Pharmacy Association (PPA) contribution towards pharmacy profession, and (e) strategies to improve community pharmacies.Conclusion: Community pharmacies in Pakistan currently face shortage of pharmacists. This has resulted in non-provision of patient counseling; rather services are more focused more on the management of pharmacies than clients. As a result, there is little public awareness of the pharmacist’s role in health care.Keywords: Perception, Community pharmacist, Patient care, Pakistan, Qualitative methodology