Disaster Management and Preparedness among Future Jordanian Health Professionals: Exploring Knowledge, Attitude, and Readiness to Practice

Healthcare students as volunteers and future healthcare providers must be prepared to manage disasters. Disasters occurred worldwide and are highly prevalent in the recent time. We examined the level of knowledge (K), attitude (A), and readiness to practice (rP) among Jordanian healthcare university students regarding disaster medicine preparedness. The research goal is to establish a university educational course and training program for the healthcare profession students. A cross-sectional study assessed Jordanian medical, pharmacy, and health science students’ KArP levels using pretested and validated questionnaires. Cronbach’s alpha for the final tool was K = 0.586; A = 0.814, rP = 0.542; KArP = 0.730. Statistical methods to compare means and explore the association were used with an alpha level of 0.05. Participants (n = 267) had a median age of 20 (IQR: 19.0 – 22.0). More female respondents than males; more respondents are in the pharmacy degree program and in the final year of their program. The median (IQR) of the total K, A, rP, and overall KArP scores were K [10.0 (7.0 – 12.0)]; A [39.0 (32.0 – 46.0)]; rP [31.0 (27.0 – 34.0)]; and overall KArP [80.0 (71.0 – 88.5)]. Knowledge and attitude were significant predictors of readiness to practice. Students from Jordan's public and private health colleges have moderate disaster medicine preparedness levels. Knowledge and attitude of students are determinants of readiness to practice. This research has confirmed the findings carried out in other countries (i.e., Qatar, China, Pakistan, Yemen, UAE) and it has used a validated tool that was earlier established in Qatar. Thus, it is evident that a course and training program are required for the healthcare university students

Community pharmacy ethical practice in Jordan: assessing attitude, needs and barriers

Background: Having a local code of ethics, based on moral obligations and virtues, known to all practicing pharmacists is important in order to guide them in relationships with patients, health professionals, and society. Objective: To investigate pharmacists’ attitude and barriers towards applying the ethical principles published by the Jordanian Pharmacists Association in the Jordanian code of ethics. Methods: The study objectives were addressed in a cross-sectional study completed by a convenience sample of community pharmacists, in both cities; Amman and Irbid A questionnaire was used to achieve the study objective. The questionnaire was developed and validated, investigating pharmacists’ socio-demographic and practice characteristics, perceived attitude toward certain practice scenarios, and perceived barriers towards applying the locally published ethical principles while dealing with their patients. The questionnaire was self-completed by pharmacists between January and August 2017. Collected data was analyzed using SPSS version 21. Descriptive statistics and parametric tests were used with p<0.05 set a priori as significant. Results: Seven hundred and four pharmacists (Amman n=486; Irbid n=218) responded to the questionnaire, providing completely answered questionnaires with a response rates of 69.4% in Amman and 99.6% in Irbid. Pharmacists from both cities revealed that they use the Internet as their main resource to obtain ethical information when they need it, to help them deal with their patients (34.0% from Amman and 31.5% from Irbid). More pharmacists in Amman (57.0%) had access to resources regarding ethical information at their practice sites compared to pharmacists in Irbid (24.0%). Significant differences in attitude was found between pharmacists practicing in both cities, as significantly less pharmacists from Amman (37.8%) declared that they would sell a medication for an unreported indication according to national and international guidelines, if recommended by the consultant, compared to pharmacists from Irbid (77.7%, p<0.001). Conclusions: Despite having ethical guidance from the Jordanian Pharmacists Association, the majority of pharmacists in Jordan do not use this resource; instead, most choose to access ethical guidance on-line. Pharmacists from the capital, Amman, reported to adhere more with the guidelines when selling a medication for an unreported indication compared to pharmacists from the smaller city, Irbid. Results of this study call for more actions from the authorities in the country responsible for setting and enforcing the pharmaceutical Code of Ethics

Cost-benefit analysis of clinical pharmacist intervention in preventing adverse drug events in the general chronic diseases outpatients.

Clinical pharmacy services are vital in the prevention of adverse drug events (ADEs) in clinical practice, extending beyond the hospital to chronic disease management in outpatient settings. This study sought to evaluate the cost benefit of a clinical pharmacy intervention in resolving treatment-related problems (TRPs) among hospital outpatients with chronic diseases. From the hospital system perspective, the cost-benefit analysis was based on a randomized clinical trial in the general outpatients of the major hospital in Jordan. Eligible patients were randomly assigned to either an intervention or a control group. TRPs were identified in both study groups, but interventions were delivered only to the intervention group via a home medication management review (HMMR) by a clinical pharmacist. A follow-up in both groups took place 3 months after recruitment. The total economic benefit was the sum of (a) cost savings due to intervention and (b) cost avoidance associated with preventable ADEs. The primary outcome measures were the net benefit and benefit-to-cost ratio with the clinical pharmacist-based HMMR. In both groups, 158 TRPs were identified, and 79 interventions were provided in the study group. The monthly cost of intervention was JD764 (US $1078), and the total monthly benefit was JD4570 (US$6444), leading to a benefit-to-cost ratio of 5.98 and an annual net benefit of JD45 669 (US $64 393). Sensitivity analyses confirmed the robustness of results. The RCT-based cost-benefit evaluation provided evidence-based insight into the economic benefit of a clinical pharmacist-provided HMMR for preventing ADEs in the general chronic diseases outpatients. This intervention method against the TRPs among outpatients is cost beneficial and offers substantial cost savings to the health care hospital payer in Jordan

Primary health care policy and vision for community pharmacy and pharmacists in Jordan

Jordan is considered a low middle-income country with a population of 9.956 million in 2018. It is considered the training center for healthcare professions in the region, as the Jordanian healthcare sector has seen remarkable development. In 2017, the expenditure on health as a percentage of Gross Domestic Product (GDP) was estimated to be around 8%. The healthcare sector is divided into two main sectors; the public and the private sector with both including hospitals, primary care clinics and pharmacies. The Jordanian government has a strong commitment to health and educational programs; hence, an increase in the number of pharmacy schools and pharmacy graduates has occurred in the past few years. Health authorities, such as the Jordan Food and Drug Association (JFDA) and the Jordan Pharmaceutical Association (JPA) have played an important role in ensuring the availability and affordability of medications, and has influenced the practice of pharmacists. Protecting the pharmaceutical market and professional interests, preserving pharmacists' rights, building needed cooperation with the internal federation, and maintaining professional ethics are some of the objectives for the JPA. Hence, the integration of community pharmacists into the primary healthcare system is considered vital to the different health authorities in Jordan, emphasizing the fact that community pharmacists are the most trusted, accessible, and affordable healthcare providers in the country. There have been many developments in the pharmacy practice in the past recent years, including the establishment of ‘Good Pharmacy Practice’, new curricular development based on the international accreditation (the ACPE), a new immunization program, and health services research aimed to save patients’ lives, influence expenses, and improve patients’ quality of life. Although these developments in pharmacy practice are promising, challenges continue to exist, specifically the establishment of an evidence base for pharmaceutical care services such as the medication management review service