Factors associated with lipid control in outpatients with heart failure

BackgroundDyslipidemia is common among patients with heart failure, and it negatively impacts clinical outcomes. Limited data regarding the factors associated with poor lipid control in patients with HF patients. Therefore, this study aimed to evaluate lipid control and to explore the factors associated with poor lipid control in patients with HF.MethodsThe current cross-sectional study was conducted at outpatient cardiology clinics at two major hospitals in Jordan. Variables including socio-demographics, biomedical variables, in addition to disease and medication characteristics were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the validated 4-item Medication Adherence Scale. Binary logistic regression analysis was conducted to explore significant and independent predictors of poor lipid control among the study participants.ResultsA total of 428 HF patients participated in the study. Results showed that 78% of the participants had poor lipid control. The predictors that were associated with poor lipid control included uncontrolled BP (OR = 0.552; 95% CI: 0.330–0.923; P < 0.05), higher Hb levels (OR = 1.178; 95% CI: 1.013–1.369; P < 0.05), and higher WBC (OR = 1.133; 95% CI: 1.031–1.246; P < 0.05).ConclusionsThis study revealed poor lipid control among patients with HF. Future intervention programs should focus on blood pressure control in order to improve health outcomes among HF patients with dyslipidemia

Factors associated with anxiety and depression among patients with chronic obstructive pulmonary disease

Objectives: This study investigated factors associated with anxiety and depression in COPD outpatients. Methods: A cross-sectional study of 702 COPD outpatients from two major Jordanian hospitals using the Hospital Anxiety and Depression Scale (HADS) was conducted. Results: Significant associations were found with gender (Anxiety OR: 5.29, 95%CI: 2.38–11.74; Depression OR: 0.20, 95%CI: 0.08–0.51), disease severity (Anxiety OR: 2.97, 95%CI: 1.80–4.91; Depression OR: 15.95, 95%CI: 5.32–52.63), LABA use (Anxiety OR: 16.12, 95%CI: 8.26–32.26; Depression OR: 16.95, 95%CI: 8.33–34.48), medication count (Anxiety OR: 0.73, 95%CI: 0.59–0.90; Depression OR: 0.51, 95%CI: 0.40–0.64), mMRC score (Anxiety OR: 2.41, 95%CI: 1.81–3.22; Depression OR: 2.31, 95%CI: 1.76–3.03), and inhalation technique (Anxiety OR: 0.95, 95%CI: 0.93–0.97; Depression OR: 0.92, 95%CI: 0.90–0.95). Other factors associated with anxiety included high income, urban living, diabetes, hypertension, LAMA use, and fewer COPD medications. Depression was also linked with heart disease, increased age, and longer disease duration. Conclusion: The prevalence of anxiety and depression among COPD patients necessitates targeted interventions. Future research that recruits a more diverse sample in multiple sites and establishes the cause-effect relationship between the study predictors and outcome could provide a more robust conclusion on factors associated with anxiety and depression among COPD patients

Iraqi Parents’ Knowledge, Attitudes, and Practices towards Vaccinating Their Children: A Cross-Sectional Study

The focus of coronavirus disease 2019 (COVID-19) vaccination campaigns has been the adult population, particularly the elderly and those with chronic diseases. However, COVID-19 can also affect children and adolescents. Furthermore, targeting this population can accelerate the attainment of herd immunity. The aim of the current study was to evaluate parental intentions to vaccinate their children and the variables associated with them. An online questionnaire was circulated via generic Iraqi Facebook groups to explore parental intentions regarding the vaccination of their children. Multinomial regression analysis was conducted to evaluate variables associated with parental vaccination acceptance. A total of 491 participants completed the study questionnaire. Only 38.3% of the participants were willing to vaccinate their children against COVID-19, while the rest either refused to vaccinate their children (35.6%) or were unsure whether they would (26.1%). Participants’ perceptions about the effectiveness (OR = 0.726, 95% CI = 0.541–0.975, p = 0.033) and safety (OR = 0.435, 95% CI = 0.330–0.574, p p < 0.0001). There is high refusal/hesitancy among Iraqi parents to vaccinate their children, which is associated with concerns related to the safety and efficacy of COVID-19 vaccines. More efforts, including educational and awareness campaigns to promote the safety and efficacy of COVID-19 vaccines, should be made to increase parental acceptance of childhood COVID-19 vaccinations in Iraq

Health-related quality of life and its associated factors in patients with chronic obstructive pulmonary disease.

ObjectiveThe present study aimed to evaluate HRQOL and to explore the factors associated with poor HRQOL among patients with COPD.MethodsIn the present cross-sectional study, the validated St George's Respiratory Questionnaire for COPD patients (SGRQ-C) was used to evaluate HRQOL among 702 patients with COPD at two major hospitals in Jordan in the period between January and April 2022. Quantile regression analysis was used to explore the factors associated with HRQOL among the study participants.ResultsAccording to SGRQ-C, the HRQOL of the study participants was greatly impaired with a total SGRQ of 55.2 (34-67.8). The highest impairment in the HRQOL was in the impact domain with a median of 58.7 (29-76.3). Increased number of prescribed medications (β = 1.157, PConclusionsIn order to maximize HRQOL in patients with COPD, future COPD management interventions should adopt a multidisciplinary approach involving different healthcare providers, which aims to provide patient-centered care, implement personalized interventions, and improve medication adherence, particularly for patients who are elderly, males, have low socioeconomic status, receive multiple medications and have multiple comorbid diseases

Glycemic control and its associated factors among diabetic heart failure outpatients at two major hospitals in Jordan.

Patients with heart failure (HF) are generally at higher risk of developing type 2 diabetes and having uncontrolled blood glucose. Furthermore, the prevalence of uncontrolled blood glucose in patients with HF is largely unknown. Identifying the factors associated with poor blood glucose control is a preliminary step in the development of effective intervention programs. The current cross-sectional study was conducted at two major hospitals to explore the factors associated with blood glucose control among patients with heart failure and type 2 diabetes. In addition to sociodemographic, medical records were used to collect medical information and a validated questionnaire was used to evaluate medication adherence. Regression analysis showed that poor medication adherence (OR = 0.432; 95%CI 0.204-0.912; P<0.05) and increased white blood cells count (OR = 1.12; 95%CI 1.033-1.213; P<0.01) were associated with poor glycemic control. For enhancing blood glucose control among patients with HF and diabetes, future intervention programs should specifically target patients who have high WBC counts and poor medication

Artificial intelligence in pharmacy practice: Attitude and willingness of the community pharmacists and the barriers for its implementation

Background: Artificial intelligence (AI) is the capacity of machines to perform tasks that ordinarily require human intelligence. AI can be utilized in various pharmaceutical applications with less time and cost. Objectives: To evaluate community pharmacists’ willingness and attitudes towards the adoption of AI technology at pharmacy settings, and the barriers that hinder AI implementation. Methods: This cross-sectional study was conducted among community pharmacists in Jordan using an online-based questionnaire. In addition to socio-demographics, the survey assessed pharmacists’ willingness, attitudes, and barriers to AI adoption in pharmacy. Binary logistic regression was conducted to find the variables that are independently associated with willingness and attitude towards AI implementation. Results: The present study enrolled 401 pharmacist participants. The median age was 30 (29–33) years. Most of the pharmacists were females (66.6%), had bachelor’s degree of pharmacy (56.1%), had low-income (54.6%), and had one to five years of experience (35.9%). The pharmacists showed good willingness and attitude towards AI implementation at pharmacy (n = 401). The most common barriers to AI were lack of AI-related software and hardware (79.2%), the need for human supervision (76.4%), and the high running cost of AI (74.6%). Longer weekly working hours (attitude: OR = 1.072, 95% C.I (1.040–1.104), P < 0.001, willingness: OR = 1.069, 95% Cl. 1.039–1.009, P-value = 0.011), and higher knowledge of AI applications (attitude: OR = 1.697, 95%Cl (1.327–2.170), willingness: OR = 1.790, 95%Cl. (1.396–2.297), P-value < 0.001 for both) were significantly associated with better willingness and attitude towards AI, whereas greater years of experience (OR = 20.859, 95% Cl (5.241–83.017), P-value < 0.001) were associated with higher willingness. In contrast, pharmacists with high income (OR = 0.382, 95% Cl. (0.183–0.795), P-value = 0.010), and those with<10 visitors (OR = 0.172, 95% Cl. (0.035–0.838), P-value = 0.029) or 31–50 visitors daily (OR = 0.392, 95% Cl. (0.162–0.944), P-value = 0.037) had less willingness to adopt AI. Conclusions: Despite the pharmacists' positive willingness and attitudes toward AI, several barriers were identified, highlighting the importance of providing educational and training programs to improve pharmacists' knowledge of AI, as well as ensuring adequate funding support to overcome the issue of AI high operating costs

Patterns of drug-related problems and the services provided to optimize drug therapy in the community pharmacy setting

Introduction: Drug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes. Objectives: To assess community pharmacists’ knowledge and practice regarding DRP-reduction services, as well as the barriers and factors associated with decreased provision of these services. Methods: This cross-sectional study utilized a validated questionnaire to assess pharmacists’ knowledge, practice, and barriers to the provision of DRP-reduction services in the community pharmacy setting. Binary regression model was used to assess the variables associated with the practice of DRP-reduction services. Results: A total of 412 pharmacists participated in the study. The pharmacists demonstrated strong knowledge but inadequate practice of DRP-reduction services. The most reported DRPs were inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements (52.4%), patients’ inability to understand instructions properly (46.1%), inappropriate drug according to guidelines (43.7%), and too high dose (40.3%). The most common barriers to these services were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). The presence of a counselling area in the pharmacy increased the practice of DRP-reduction services (OR: 3.532, 95%Cl: 2.010–5.590, P < 0.001), while increased weekly working hours (OR: 0.966, 95%Cl: 0.947–0.986), P < 0.01) and serving < 10 patients daily (OR = 0.208, 95%Cl: 0.072–0.601, P < 0.01) decreased it. Conclusions: Community pharmacists’ practice of DRP-reduction services showed a scope for improvement. Future pharmaceutical care initiatives should increase the number of personnel working in the pharmacy and provide them with opportunities for continued education and training in order to improve the provision of DRP services and optimize patients’ outcomes

Multivariate analysis of the variables associated with glycemic control.

Multivariate analysis of the variables associated with glycemic control.</p