NAFLD and nutraceuticals: a review of completed phase III and IV clinical trials

BackgroundNonalcoholic Fatty Liver Disease (NAFLD) has become a significant public health concern, affecting approximately one-fourth of the population. Despite its prevalence, no FDA-approved drug treatments specifically target NAFLD.AimTo provide a review of clinical trials investigating the use of herbal remedies and dietary supplements in NAFLD management, utilizing the ClinicalTrials.gov database.MethodsThis review evaluates the current evidence by examining completed phase III and IV clinical trials registered on ClinicalTrials.gov. An exhaustive search was performed on April 17, 2023, using the terms “Nonalcoholic Fatty Liver Disease” and “NAFLD.” Two independent reviewers appraised eligible trials based on pre-defined inclusion and exclusion criteria.ResultsAn initial search yielded 1,226 clinical trials, with 12 meeting the inclusion criteria after filtration. The majority of trials focused on Omega-3 fatty acids (20.0%) and vitamin D (26.7%), followed by caffeine, chlorogenic acid, ginger, phosphatidylcholine, Trigonella Foenum-graecum seed extract, vitamin C, and vitamin E (each 6.7%). Most studies were Phase 3 (75.0%) and used a parallel assignment model (91.7%). Quadruple masking was the most prevalent technique (58.3%), and Iran was the leading country in terms of trial locations (25.0%). These interventions constitute two herbal interventions and nine supplement interventions.ConclusionThis reveals a diverse range of nutraceuticals, with Omega-3 fatty acids and vitamin D being predominant in the management of NAFLD. The global distribution of trials highlights the widespread interest in these therapeutics. However, more rigorous, large-scale trials are needed to establish safety, efficacy, and optimal dosages

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 < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 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 >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

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 >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