Pharmacovigilance Concept Knowledge, Perspectives and Attitudes: A Cross-Sectional Study Among Community Pharmacists.

The concept of pharmacovigilance (PV) is currently highlighted after emergency authorization and worldwide distribution of the urgently launched COVID-19 novel vaccinations. As they typically serve as the initial point of patient contact for medication-related issues, understanding the knowledge, perspectives, and attitudes of community pharmacists in PV and reporting adverse drug reactions (ADRs) is crucial to improving the healthcare system and public health policies. However, previous studies in Jordan have not focused entirely on community pharmacists. This study aimed to assess community pharmacists' knowledge, perspectives, and attitudes on PV and ADRs reporting in Jordan. The applied methodology in this study was based on a cross-sectional study design using a validated questionnaire distributed to a convenient sample of Jordanian community pharmacists. Seventeen questions were designed from different pieces of literature relating to knowledge, perspectives, and attitudes of PV among community pharmacists. Descriptive statistics (frequencies and percentages) were used to report the results data. The study questionnaire was completed by 180 of 325 community pharmacists willing to participate (a response rate of 55.4%). Of them (n = 132, 73%) were aware of the concept of PV. Additionally (n = 84, 47%) of the community pharmacists would use the concept and policy of PV in their everyday work. Nevertheless, only (n = 36, 20.0%) of the community pharmacists thought an ADR should be reported if seen, and approximately 120 pharmacists (67.0%) believed it was essential to report ADRs as patient health matters. Although community pharmacists in Jordan showed a considerable awareness level of PV, they demonstrated a low level of its application. Thus, ADR reporting is not considered a mainstay among them, and the implementation of PV is not yet addressed. The results from this study shed light on community pharmacists' perceptions and attitudes regarding ADR reporting and PV.

Financial indicators utilization among community pharmacists: A comprehensive study for pharmacy management.

BACKGROUND: The financial management of community pharmacies is a critical aspect of healthcare delivery, as pharmacists often operate as healthcare providers and business managers. Understanding pharmacists' awareness, perceptions, and practices related to financial indicators is essential for effective pharmacy management. There is a paucity of research addressing this issue regionally and locally. OBJECTIVES: This study aimed to investigate the perceptions and utilization of financial indicators among community pharmacists in Jordan and identify demographic and contextual factors influencing their financial practices. METHODS: A cross-sectional study was conducted, surveying 353 community pharmacists from various regions of Jordan. The developed and validated survey assessed demographic characteristics, utilizations of financial indicators, and perceptions of their significance. Pharmacists were queried about their financial practices, including the use of various financial indicators. Descriptive and analytical statistics were used to portray the study's findings. RESULTS: The study included a diverse group of community pharmacists in terms of demographic characteristics. Most pharmacists exhibited awareness of financial indicators, with a higher awareness of profitability and liquidity indicators. Pharmacists generally had positive perceptions of the importance of these indicators in daily practice. High agreement was observed in financial practices, including following up on payables and receivables, monitoring changes in monthly revenue, and preparing income statements. There was significant variation in the utilization and perception of financial indicators based on factors such as pharmacy ownership, province, foundation age, and practical experience. CONCLUSION: The findings indicate a positive correlation between utilization and perception, emphasizing the importance of raising awareness of financial indicators among pharmacists. The study also highlights the significance of tailored financial training programs for pharmacists at different stages of their careers and the importance of regional context in financial practices. Understanding these variations can lead to more effective financial management and improved healthcare services in community pharmacies.

Willingness to pay for community pharmacies-based medication review service: perspectives of private health insurance firms

Background: The medication review service (MRS) is a valuable community pharmacies-based health service to patients, ensuring optimal medication use and reducing medication errors. Nevertheless, it remains limited in scope and empowerment without remuneration for providing the service. Objective: This study aimed to assess private health insurance (PHI) and third-party administration (TPA) firms' perspectives regarding the MRS offered by community pharmacies in Jordan and the extent of their willingness to pay for this service. Method: The research was an observational, cross-sectional study conducted using a constructed and validated Arabic questionnaire that was distributed electronically to the key health insurance decision-makers (general managers, operational managers, medical network managers, directors, and supervisors) among all the (22) PHI and TPA active firms that are members of the Jordan Insurance Federation (JIF) and licensed under the insurance administration in the Ministry of Industry and Trade. Participants provided their consent electronically before filling out the questionnaire. Results: 50 health insurance decision-makers agreed to participate in this study. 48% partially (42%) or completely (6%) heard about the medication review service. Most respondents (n=35, 70%) believed the medication review service is expected to reduce the cost of medications. Furthermore, they believed the service is expected to reduce the cost of the medical bill by ensuring the medication is not repeated within a short time unless advised by the doctor, checking the exact dosage regimen of each drug, and using alternative medicines at lower cost (74%, 64%, and 60%) of respondents respectively. Half of the respondents were eager to remunerate for the medication review service, with the majority willing to pay less than 10 Jordanian Dinars (JODs) per patient (AU)

Cross-Sectional Assessment of Pharmacy Students’ Knowledge and Perception of Drug-Drug Interactions with Over the Counter Products

Background: Self-medication with over-the-counter products has dramatically increased following coronavirus disease of 2019 pandemic. For safe public use of these products, Pharmacy and Doctor of Pharmacy students are expected to have proper knowledge and perception towards these products dispensing and associated interactions. Objectives: A cross-sectional survey was developed to assess Pharmacy and Doctor of Pharmacy students’ knowledge and perception towards drug interactions of over the counter products. Methods: Data were collected using a self-administered questionnaire and statistically analyzed. Descriptive statistics (frequency) were analyzed for participants’ demographics. Multivariable logistic regression analysis was used to determine the association between over the counter products and relevant interactions with medications to treat chronic illnesses. A P value < 0.05 was used to determine statistical significance. Results: Responses were 411 and only 389 were included. 76.6% were studying Bachelor of Pharmacy and 86.1% were on a regular study program. Recipients of Pharmacy training were 65.3% and 62.0% of participants studied over the counter course. Orphenadrine muscle relaxant was the mostly identified over the counter product (n= 339, 87.1%). Majority of students (n= 345, 88.7%) consider that OTC products help improving conditions being dispensed for. Bridging students and those who studied over the counter course showed significant knowledge in drug interactions compared to regular-program students and those who did not complete the course (P= 0.004, P< 0.001, respectively). Of the 389 respondents, 79.9% and 79.2% considered hydrochlorothiazide and metformin as over the counter products, respectively, compared to 54.0% for amoxicillin (AU)

Healthcare Professionals' Perceptions, Barriers, and Facilitators towards Adopting Computerised Clinical Decision Support Systems in Antimicrobial Stewardship in Jordanian Hospitals.

Understanding healthcare professionals' perceptions towards a computerised decision support system (CDSS) may provide a platform for the determinants of the successful adoption and implementation of CDSS. This cross-sectional study examined healthcare professionals' perceptions, barriers, and facilitators to adopting a CDSS for antibiotic prescribing in Jordanian hospitals. This study was conducted among healthcare professionals in Jordan's two tertiary and teaching hospitals over four weeks (June-July 2021). Data were collected in a paper-based format from senior and junior prescribers and non-prescribers (n = 254) who agreed to complete a questionnaire. The majority (n = 184, 72.4%) were aware that electronic prescribing and electronic health record systems could be used specifically to facilitate antibiotic use and prescribing. The essential facilitator made CDSS available in a portable format (n = 224, 88.2%). While insufficient training to use CDSS was the most significant barrier (n = 175, 68.9%). The female providers showed significantly lower awareness (p = 0.006), and the nurses showed significantly higher awareness (p = 0.041) about using electronic prescribing and electronic health record systems. This study examined healthcare professionals' perceptions of adopting CDSS in antimicrobial stewardship (AMS) and shed light on the perceived barriers and facilitators to adopting CDSS in AMS, reducing antibiotic resistance, and improving patient safety. Furthermore, results would provide a framework for other hospital settings concerned with implementing CDSS in AMS and inform policy decision-makers to react by implementing the CDSS system in Jordan and globally. Future studies should concentrate on establishing policies and guidelines and a framework to examine the adoption of the CDSS for AMS.

The Impact of Antifungal Stewardship on Clinical and Performance Measures: A Global Systematic Review.

BACKGROUND: Antimicrobial stewardship programs (ASP) have been proposed as an opportunity to optimize antifungal use. The antifungal resistance is a significant and emerging threat. The literature on antifungal stewardship (AFS) and its influence on performance and clinical outcome measures is scarce. This study aimed to examine global evidence of the impact of AFS on patients and performance measures. METHODS: The "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) was used for the flow of identification, screening, eligibility, and inclusion. PubMed and MEDLINE were searched using the term ''antifungal stewardship'' on 15 February 2023. Search terms included antifungal stewardship, antimicrobial stewardship, candida, candidemia, candiduria, and invasive fungal disease. Of the 1366 records, 1304 were removed since they did not describe an antifungal stewardship intervention. Among the 62 full texts assessed, 21 articles were excluded since they were non-interventional studies and did not include the outcome of interest. Thus, 41 articles were eligible for systematic review. Eligible studies were those that described an AFS program and evaluated clinical or performance measures. RESULTS: Of the 41 included studies, the primary performance measure collected was antifungal consumption (22 of 41), and mortality (22 of 41), followed by length of stay (11 of 41) and cost (9 of 41). Most studies were single-center, quasi-experimental, with varying interventions across studies. The principal finding from most of the studies in this systematic review is a reduction in mortality expressed in different units and the use of antifungal agents (13 studies out of 22 reporting mortality). Antifungal consumption was significantly blunted or reduced following stewardship initiation (10 of 22). Comparing studies was impossible due to a lack of standard units, making conducting a meta-analysis unfeasible, which would be a limitation of our study. CONCLUSION: It has been shown that AFS interventions may improve antifungal consumption and other performance measures. According to available published studies, antifungal consumption and mortality appear to be the possible performance measures to evaluate the impact of AFS.

Factors Influencing Public Willingness to Reuse the Unused Stored Medications in Jordan: A Cross-Sectional Study.

The reissuing, redispensing, redistributing, or even recycling of the returned unused stored medicines is referred to as medicine reuse. A few studies have examined people's willingness to reuse unused stored medicines. This study aims primarily to explore the public's willingness to reuse unused stored medicines in the future and the factors affecting their decisions, and to assess the pharmacological types and formulations of the unused stored medicines by the public. A cross-sectional study was conducted using a convenient sampling technique over three weeks (February-March 2022) among Jordanian populations. Data were collected from 681 participants who agreed to fill out a questionnaire, which was distributed online. Participants showed a positive perception of reusing any of the unused stored medicines in the future; of those, 79.6% (n = 400) believed that reusing "unused medicines" has economic benefits and 50% (n = 251) believe there are environmental benefits. Moreover, more than half of the participants believed that reusing "unused medicines" is safe (n = 256, 51%), but provided that a pharmacist or a doctor evaluates their quality or that the unused medicines are stored well. Results from this study show that the public positively endorses the idea of reusing unused stored medicines if the quality and safety are assured. However, future studies are needed to evaluate the Jordanian healthcare professionals' perceptions towards medicine reuse and pharmaceutical companies' willingness to be a part or facilitator of medicine reuse.

Public perceptions about pharmacists' role in prescribing, providing education and delivering medications during COVID-19 pandemic era.

COVID-19 is a pandemic disease with a significant threat to public health. Public knowledge and perception significance in tackling pandemics have been evidenced in the previous research. This study aimed to explore public perceptions about pharmacists' educational and prescribing role, and the medication delivery service provided during COVID-19 outbreak. A cross-sectional study was conducted among the general population of Jordan using a convenient sampling technique for 10 days (15-25 May 2020). Data were collected from 578 participants who agreed to fill the questionnaire, which was distributed online. The questionnaire items were piloted using face validity and reliability. Participants showed a positive perception about the impact of pharmacists and pharmacy services provided during COVID-19 outbreak. More than half of the participants (61.1%) believed that pharmacists could prescribe over-the-counter medications, and only 15.7% believed that pharmacists could prescribe both over-the-counter and prescribed medications. Linear regression was performed to assess the factors that affect the participants' perception of pharmacists' prescribing and educational role and delivering medication during COVID-19. Females have lower perception scores towards medication delivery services compared with males (P value = .008). However, male participants, those aged less than 50 years, those with postgraduate degrees and those from non-medical profession showed a significantly higher perception score towards the impact of pharmacists and pharmacy services provided during COVID-19 outbreak compared with others (P value < .05 for all). This study indicates that the public positively endorsed the impact of the educational role of the pharmacist, medication delivery services and extending pharmacists' prescribing authority during COVID-19 pandemic. Also, findings from this study provide a platform to examine the perception of the public towards pandemic diseases and inform policy decision-makers to react by updating their regulation to allow extending pharmacy services and prescribing role during COVID-19 pandemic.