Development and validation of a tool to improve community pharmacists' surveillance role in the safe dispensing of herbal supplements

Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements Objectives Developed a new questionnaire that can potentially help community pharmacists with identifying the extent of falsified herbal supplements. Methods: A cross sectional study conducted over nine months among 500 community pharmacies in the UAE. Face-to-face interviews were undertaken using a structured questionnaire, which was subjected to face and content validity, with the content validity index (CVI) computed. Construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was then confirmed through Partial confirmatory factor analysis (PCFA). Reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs). Results: An instrument compromised of five domains with a 24-item scale was developed with CVI of 0.843. The KMO measure of sampling adequacy was 0.891, and Bartlett’s test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using MLA with oblimin rotation. The PCFA obtained values of 0.962 for NFI, 0.977 for CFI, and 0.987 for TLI; all values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach’s alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥ 0.40. The instrument presented good ICC statistics of 0.940 (0.928 – 0.950) as well as statistical significance (p < 0.001). Those participants who had more than 10 experience years more likely to identify falsified herbal supplements compared to those who have 1 to 10 experience years (p < 0.001). Conclusions: This study developed and validated a new instrument to identify safe herbal supplements products, which will help enhance the role of the community pharmacists in safe and effective treatment of suitable patients with herbal supplements

Community pharmacists’ perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care.Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care.Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7 years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%–74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%–79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p &lt; 0.001), pharmacy position (p = 0.004), work experience (p &lt; 0.001), number of patients served per day (p &lt; 0.001) and being trained on CVD prevention and management (p &lt; 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1–1.019), postgraduates (OR 1.77; 95% CI 1.66–1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11–1.39), pharmacists in charge (OR 1.22; 95% CI 1.01–1.47), pharmacists with &gt;10 years of experience (OR 11.3; 95% CI 6.01–15.62), pharmacists with 6–10 years of experience (OR 4.42; 95% CI 3.90–5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15–1.46).Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients’ weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care

Guideline-directed medical therapy in heart failure patients with reduced ejection fraction in Palestine: Retrospective clinical audit study

Objectives: To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine. Methods: This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), β-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT. Results: A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and β-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen. Conclusion: Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT

Assessing knowledge, attitude and practice of community pharmacists on the pain management and implications in UAE children

Objective: There are concerns with the optimal management of pain in children, with sub-optimal management negatively impacting on physical, emotional social functioning, exacerbated by pain in children being multi-modal. Community pharmacists across countries play an important role in managing pain in patients including children's pain. Consequently, the objective of this study is to assess knowledge, attitudes and practices (KAP) of pain management in children among community pharmacists in UAE. Methods: A cross-sectional study was conducted using a structured questionnaire that was developed and piloted. The final questionnaire, which comprised two parts, had acceptable validity and internal consistency. Results: 867 out of 922 community pharmacists took part in UAE (94% response rate) and were visited by trained researchers. The most from independent pharmacies (53.9%) and having more than 10 years of experience (68.9%). The overall KAP score was 70%, with gender, pharmacy type, years of experience, educational level and position significantly associated with KAP. Encouraging knowledge areas included pain is one of the vital signs in children (88.6%), the intensity of pain should be rated by a pharmacist before discussing treatment options (92.2%) and the choice of treatment should depend on issues including intensity and duration (87.2%). Areas of concern included the contents of the WHO analgesic ladder (32.0%) and children may sleep in spite of severe pain (42.9%). Conclusion: There were areas of good knowledge of pain management among community pharmacists in UAE. Areas of concern including knowledge of the WHO analgesic ladder need to be addressed as part of future educational input during training and post qualification

Access to non-prescription medicines via vending machines : key considerations to help transfer the self-care concept to the next generation while managing safety risks

Objectives: Non-prescription vending machines are automated self-service systems that are increasingly used to dispense these medicines. Whilst regulatory health academics have devoted considerable attention to non-pharmacy medication outlets in Gulf Cooperation Council countries and others, the public health literature on these vending machines remains lacking. Whilst non-prescription vending machines undoubtedly provide a number of benefits, they are not without their risks, which include polypharmacy and medication interactions. Methods: The purpose of this article is to provide a framework for further investigation of the function, advantages, and practical constraints of non-prescription vending machines. Key findings: Overall, more research is required to determine the optimal balance between achieving the benefits of non-prescription vending machines whilst avoiding unnecessary constraints on regulatory bodies and vending machine providers but minimizing patient harm. Conclusions: Further studies are also required to assess the consequences of these policy experiments. Specifically, there is a need to better understand the extent to which vending machines can provide beneficial and reasonable access to non-prescription medicines to enhance the quality of life of the population especially during pandemics

Assessing public knowledge, attitudes and determinants of third COVID-19 vaccine booster dose acceptance:current scenario and future perspectives

BACKGROUND: People with weakened immune systems may not develop adequate protection after taking two doses of the mRNA-combined COVID-19 vaccine. The additional dose may improve the level of protection against Covid-19. OBJECTIVES: Current study aimed to evaluate the knowledge, attitude and determents of third COVID-19 vaccine booster dose acceptance among population in the UAE. METHODS AND MATERIALS: This is online descriptive cross-sectional community-based study conducted among the students and faculty of Ajman University from 25 August to 20 October 2021. The questionnaire, which was in the English language, encompassed two sections containing 22 items. Section one gathered the demographic details of the respondents, while Section two used 13 questions to evaluate the respondents’ knowledge of and attitude to the third COVID-19 vaccine booster dose. RESULTS: 614 respondents participated in this study. The average knowledge score was 44.6% with a 95% confidence interval (CI) of [41%, 49%]. Better knowledge scores were observed in postgraduates (OR 4.29; 95% CI 2.28–8.11), employees in the healthcare sector (OR 1.62; 95% CI 1.05–2.51), participants who had relatives infected with the Covid-19 (OR 1.46; 95% CI 1.05–2.02), participants who had infected with Covid-19 (OR 2.21; 95% CI 1.43–3.43) and participants who had received first two doses of the COVID-19 vaccine (OR 2.08; 95% CI 1.40–3.11). The average attitude score was 70.2% with a 95% confidence interval (CI) of [69.2%, 71.2%]. CONCLUSION: Necessary steps should be taken by the government and public health authorities, in line with the local culture, to increase vaccination acceptance and foster positive attitudes towards the vaccine. A suitable approach to this would be to develop an educational framework that could demonstrate the risks of vaccine avoidance or delay to the general population. Moreover, health authorities should pay more attention to the false information being disseminated across the internet, especially social media. Also, healthcare workers should be trained in vaccinology and virology to make sure that they are able to understand important developments in these fields and convey the findings to their patients

Factors influencing community pharmacists’ knowledge about women’s issues in epilepsy

BackgroundPrevious studies have highlighted instances where pharmacists lacked knowledge regarding women’s health issues related to epilepsy.ObjectivesTo assess UAE community pharmacists’ knowledge, toward women’s issues in epilepsy.Methodsa cross-sectional research method was employed. A team of seven pharmacy students in their final year visited a randomly selected sample of community pharmacies in the UAE and face-to-face interviews were conducted with the pharmacists using a structured questionnaire. The questionnaire includes two parts; Eight questions designed to elicit data about the demographics of the study participants and 12 questions eliciting insights into the participants’ knowledge of women’s issues in epilepsy.ResultsA total of 412 community pharmacist were recruited in the study. The overall level of knowledge about women’s issues in epilepsy was good and the average knowledge score was 81% with a 95% confidence interval (CI) [79.1, 82.7%]. The results of multivariate analysis showed higher knowledge scores in chain pharmacies (OR 1.37; 95% CI 1.12–1.67), Chief pharmacists (OR 1.44; 95% CI 1.01–2.06), Pharmacists in charge (OR 3.46; 95% CI 2.7–4.45), pharmacists with 1–5 Years of experience (OR 2.87; 95% CI 1.71–4.82), pharmacists with 6–10 Years (OR 2.63; 95% CI 1.58–4.38), pharmacists with &gt;10 years (OR 3.13; 95% CI 2.03–4.83), graduation form regional universities (OR 1.37; 95% CI 1.12–1.67), graduation form international universities (OR 1.73; 95% CI 1.36–2.20) and receiving a training on epilepsy (OR 1.36; 95% CI 1.12–1.67).ConclusionWhile the findings reveal an overall promising level of knowledge among community pharmacists regarding the issues faced by women with epilepsy, pinpointing which clinical and demographic factors have the most significant impact on this knowledge would permit the implementation of tailored educational interventions. Workshops and modules targeting the issues faced by women with epilepsy would further raise the knowledge and competence among community pharmacists in this area, ensuring better pharmaceutical care for this population

Acceptability and willingness of UAE residents to use OTC vending machines to deliver self-testing kits for Covid-19 and the implications

Purpose: Self-testing kits for SARS-CoV-2 appear effective, practical, safe and reliable as well as helping patients with mild to moderate symptoms to be successfully managed at home without going to hospital. As a result, ease pressures on hospitals. OTC vending machines offer the potential for SARS-CoV-2 self-testing kits alongside making available OTC treatments to alleviate the symptoms of COVID-19. As a result, providing confidentiality alongside ease of use. Consequently, there was a need to assess the acceptability and willingness regarding the availability of OTC vending machines to dispense self-testing kits for SARS-CoV-2 among UAE residents to provide future direction. Patients and methods: Cross-sectional survey using a designed questionnaire based on previous research and expert input and pilot tested. All items in the final questionnaire were seen as acceptable with a satisfactory content validity. A purposive sampling strategy was used in the principal study by primarily sending a link to the questionnaire to UAE universities via Facebook and WhatsApp. Results: A total of 876 respondents participated in the study and completed the whole questionnaire. Most participants were female (63%), Arabic origin (42%) and holding a Bachelor degree (84.5%). There was high acceptability and willingness to use self-testing kits (87.2%), with 88.6% of respondents believing OTC vending machines would be beneficial for patients with actual or suspected SARS-CoV-2. Gender, nationality, educational level, employment status, having relatives infected with SARS-CoV-2 and being vaccinated were significantly associated with attitudes towards the self-testing kits. Recognised barriers include their potential costs, ease of access and help for those who cannot read the instructions. Conclusion: Overall, there was high acceptability and willingness to use OTC vending machines to deliver self-testing kits for SARS-CoV-2 among the surveyed participants. Key barriers will need to be addressed to enhance their use