dilemma of polypharmacy: nurses perceptions of health care professionals' contribution in polypharmacy in Ajman, UAE

Health care professionals do not pay sufficient attention to polypharmacy which is a slowly growing phenomenon. Physician-related factors which contribute to polypharmacy include the use of multiple medications in management of co-morbid illnesses, symptomatic treatment, and the treatment of the adverse effects of drugs. The present study aimed to identify nurses' perceptions of health care professionals' role in polypharmacy. This cross sectional study was conducted among nurses in Gulf Medical College Hospital and Research Centre, Ajman, United Arab Emirates from March to May 2011. A structured self-administered close-ended pilot-tested questionnaire was used as a study instrument. Association between socio-demographic characteristics and items were analyzed using Chi-square test and p<0.05 was considered statistically significant. A total of 92 female and 13 male nurses were included. The most common physician factors identified by nurses were prescribing medications for every symptom [78 [74%]], not conducting medication review [74 [70.5%]], not simplifying medication regimens [62 [59%]] and the influence of pharmaceutical companies 58 [55.2%]. Regarding the pharmacist related factors, nurses opined that inadequate pharmacist-doctor communication [71 [67.6%]] and lack of effective patient counseling [65 [61.9%]] influence polypharmacy. On comparing physician related factors between nurses of different years of experience and also between the genders, prescribing medications for every symptom, and not conducting a medication review with the patient scored the highest in all the groups. A higher number of male nurses [statistically significant at p<0.05] in comparison to female nurses opined that inadequate knowledge of clinical pharmacology [7 [53.8%]], and lack of time to review medications [6 [46%]] contributed to polypharmacy. Healthcare professionals need to be aware of the increase in polypharmacy. Regular assessment of prescribed medications should be carried out to avoid the administration of inappropriate drugs

Use of complementary and alternative medicine among the health care consumers of modern medicine

Complementary and Alternative Medicine is popular across the world and is widely practiced. Utilization pattern and reasons for use and non-use among patients attending tertiary care centre is assessed in this study. One hundred and twenty six patients of different nationalities, above the age 18 years, visiting various outpatient departments of Gulf Medical College Hospital and Research Centre, Ajman, UAE were interviewed using an open ended structured questionnaire. In addition to socio-demographic characteristics, acceptability, utilization pattern, reasons for use and non-use were elicited from the participants after obtaining consent from them. PASW 18 version was used to perform Chi-square test and descriptive statistics. The 135 participants were 20-81 years old, with 49% being below 40 years of age. Among the Indians, who constituted 52% of the sample, 60% were males, 70% having university education, but non working in a medical field of the 29% who had 'ever used' CAM, 54% were females. Those from the Far East used CAM most [85.7%], the next highest homeopathy and the medical condition musculoskeletal problems. A greater percentage of users administered internal preparations. Physicians had advised 30% of the users whereas non-medical information was used as source by the others. A family history of CAM was observed in 13 [10%], the conditions for which it was used being gall stone, renal problems and musculoskeletal conditions and others. Around 70% reported a good outcome for themselves and family, although only 10% recommended it to others. Most of the users [75%] were not sure whether CAM was based on scientific evidence, while 18% felt it was; 46% opined it had fewer side effects, and 44% felt it had long term effect. Good previous experience and less treatment complications were the most common reasons for using CAM. Non-use was due to lack of knowledge or absence of a need