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.

Exploring Community Pharmacists' Perception and Readiness Toward Telepharmacy Implementation in Jordan: A Cross-Sectional Study.

Objective: The present study was conducted to assess the perceptions and readiness of pharmacists toward implementing "Telepharmacy" in Jordan. Methods: This was a cross-sectional study that was conducted between April and May 2023. Any licensed community pharmacists practicing in Jordan were considered to be eligible to be included in this study. Pharmacists were approached at their pharmacy store using a convenience sampling method. Logistic regression analysis was utilized to identify predictors affecting pharmacists readiness to implement telepharmacy services. Results: Two hundred eighteen community pharmacists volunteered to participate in this study. Roughly around 42% of the pharmacists (n = 91) reported that they have previously used telepharmacy. More than 70% of the pharmacists believed that telepharmacy decreases the patient's visits to hospitals, private clinics, or pharmacies (n = 165, 75.7%). In addition, more than 65% of the pharmacists expressed their concerns that telepharmacy service may increase pharmacists' workload and commitment (n = 150, 68.8%), and it has a higher error rate for medication dispensing and filling (n = 147, 67.4%). Nearly 70% of the pharmacists (n = 153) expressed their readiness to implement telepharmacy. Regression analysis showed that pharmacists who had previous experience in using telepharmacy service and those who showed more positive perception toward telepharmacy showed significantly higher readiness to implement telepharmacy service (p < 0.001 for both). Conclusions: The utilization of telepharmacy by community pharmacists in Jordan is still limited. The adaption of telepharmacy faces many challenges, including a negative attitude from the pharmacist, financial reimbursement, training, regulations, and competency in and access to efficient technology.

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)

ChatGPT in pharmacy practice: a cross-sectional exploration of Jordanian pharmacists' perception, practice, and concerns.

OBJECTIVES: The purpose of this study is to find out how much pharmacists know and have used ChatGPT in their practice. We investigated the advantages and disadvantages of utilizing ChatGPT in a pharmacy context, the amount of training necessary to use it proficiently, and the influence on patient care using a survey. METHODS: This cross-sectional study was carried out between May and June 2023 to assess the potential and problems that pharmacists observed while integrating chatbots powered by AI (ChatGPT) in pharmacy practice. The correlation between perceived benefits and concerns was evaluated using Spearman's rho correlation due to the data's non-normal distribution.Any pharmacists licensed by the Jordanian Pharmacists Association were included in the study. A convenient sampling technique was used to choose the participants, and the study questionnaire was distributed utilizing an online medium (Facebook and WhatsApp). Anyone who expressed interest in taking part was given a link to the study's instructions so they may read them before giving their electronic consent and accessing the survey. RESULTS: The potential advantages of ChatGPT in the pharmacy practice were widely acknowledged by the participants. The majority of participants (69.9%) concurred that educational material about pharmacy items or therapeutic areas can be provided using ChatGPT, with 66.9% of respondents believing that ChatGPT is a machine learning algorithm. Concerns about the accuracy of AI-generated responses were also prevalent. More than half of the participants (55.7%) raised the possibility that AI systems such as ChatGPT could pick up on and replicate prejudices and discriminatory patterns from the data they were trained on. Analysis shows a statistically significant positive link, albeit a minor one, between the perceived advantages of ChatGPT and its drawbacks (r = 0.255, p < 0.001). However, concerns were strongly correlated with knowledge of ChatGPT. In contrast to those who were either unsure or had not heard of ChatGPT (64.2%), individuals who had heard of it were more likely to have strong concerns (79.8%) (p = 0.002). Finally, the results show a statistically significant association between the frequency of ChatGPT use and positive perceptions of the tool (p < 0.001). CONCLUSIONS: Although ChatGPT has shown promise in health and pharmaceutical practice, its application should be rigorously regulated by evidence-based law. According to the study's findings, pharmacists support the use of ChatGPT in pharmacy practice but have concerns about its use due to ethical reasons, legal problems, privacy concerns, worries about the accuracy of the data generated, data learning, and bias risk.

Attitudes and perceptions of Jordanian pharmacy students toward deprescribing: a cross-sectional study

Objective: Pharmacists are in a unique position to identify medications that should be deprescribed. Including deprescribing as part of medical and pharmacy curriculum has been proposed as a substantial change to increase the practice of deprescribing. The aims of this study were to evaluate if pharmacy students were exposed to the term of deprescribing in their classes and how they were taught about it (e.g., lecture, case problems, experiential). We also aimed to assess the deprescribing knowledge, attitudes, abilities, and confidence of pharmacy students in Jordan. Methods: Both paper-based and online questionnaires surveys were distributed to third year pharmacy students and above at 12 schools of pharmacy in addition to graduated student (bachelors and diploma). The survey included three sections, including (i) demographics and questions on their exposure to deprescribing and other experiences within their curriculum; (ii) questions regarding their attitudes, ability, and confidence regarding deprescribing, and (iii) questions to assess the factors that may influence the deprescribing process from the students’ perspectives. Study responses were extracted from Google Form® as an Excel sheet and exported into Statistical Package for Social Sciences version 24.0 (SPSS Inc., Armonk, NY: IBM Corp, USA) for statistical analyses. Descriptive statistics, including frequency and proportions, were calculated and reported appropriately. Results: Around half of the participating students (n=202, 49.5%) were familiar with the term “Deprescribing,” and only 74 (18.1%) students reported exposure to deprescribing instruction through required coursework. Less than half (n=193, 47.3%) reported exposure during elective courses, and fewer (n=47, 11.5%) reported exposure in both required and elective courses. (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.

General Public Perceptions and Perceived Barriers Toward the Use of Telehealth: A Cross-Sectional Study from Jordan.

Background: Telemedicine implies the provision of health care services, such as diagnosis, treatment, and consultation related to different disease states remotely through harnessing a variety of technologies. Aim: Despite the widespread global applications related to telehealth, there are limited research articles exploring the perceptions and barriers related to telehealth implementation in developing countries such as Jordan. Thus, this study was conducted to explore general public perceptions regarding the provision of health care services through different technological devices and to examine perceived barriers and facilitators. Methods: A cross-sectional study was conducted for 6 months. Participants were recruited through different social media portals. A convenient sample from the Jordanian population was approached. A total of 1,136 responses were collected and included in the final analysis, which was done by the Statistical Package for Social Sciences (SPSS version 25). Results: A total of 1,136 responses were valid for further analysis. The results of this study expressed that the public has positive perceptions toward the use of telemedicine with the majority being capable of using telehealth based on having an active internet connection, technological devices, and the ability to use social media accounts or instant messaging services. Logistic regression analysis revealed that those with comorbid diseases and higher summated capability scores (p = -0.017 and p < 0.001, respectively) had a statistically significant relationship with willingness to use telehealth as reflected by stating a clear intention to use telehealth services once available. Conclusion: In conclusion, the Jordanians had positive perceptions toward the use of telehealth services. However, their willingness to use telehealth services was affected by limited knowledge about the service. Telehealth offers the opportunity to provide quality care and improve patient outcomes, especially for the inhabitants of rural areas or in cases where access to health care facilities is compromised such as pandemics.

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.

Prevalence and Predictive Factors of Masked Depression and Anxiety among Jordanian and Palestinian Couples: A Cross-Sectional Study.

Although anxiety and depression are among the most prevalent mental disorders worldwide, they continue to gain less attention than their physical counterparts in terms of health care provision and population mentalisation. This cross-sectional study explores and compares the national prevalence of depression and anxiety signs/symptoms and well as identifying associated socio-demographic factors among Jordanian and Palestinian fertile couples. Four-hundred and sixty-nine participants were eligible for inclusion and agreed to participate in the study. The mean score for HAM-A and BDI-II were 12.3 ± 8.2 and 15.30 ± 10.0, respectively. According to the grading of HAM-A and BDI-II, the majority of the participants have graded themselves to be mildly anxious (N = 323, 68.9%) and around one third of participants (N = 148, 31.6%) moderately to severe depressed. The suicidal intent was remarkable and of concern where around 18.6% of participants had suicidal thoughts and wishes. There was a significant correlation between both HAM-score and BDI-II score and age [p = 0.01, p = 0.011, respectively], body weight [p = 0.01, p = 0.006, respectively], and total monthly income [p < 0.001, p < 0.001, respectively]. Our findings ought to alert healthcare professionals and other interested parties that there is a high burden of anxiety and depression symptoms among Jordanian and Palestinian couples. To support Jordanian and Palestinian couples' mental health, healthcare professionals, researchers, and educators favoured to concentrate on creating efficient and culturally relevant education, preventive, and intervention procedures utilising evidence-based guidelines.

Perceptions toward the use of over-the-counter dietary supplements during the coronavirus disease 2019 pandemic: A cross sectional study of the general public in Jordan.

Background and Aims: Over-the-counter (OTC) dietary supplements gained popularity during the COVID-19 pandemic as a preventive measure. Lack of complete understanding among the general population of the pathophysiologic mechanisms underlying the severity and progression of infection with coronavirus disease 2019 (COVID-19) has further encouraged the use of supplements. The present study aimed to assess the perceptions of the general public toward the efficacy and safety of the use of OTC dietary supplements as immune enhancers during the COVID-19 pandemic. The factors impacting these perceptions were also explored. Methods: This was an online survey-based, cross-sectional study conducted in Jordan over 4 months. A validated survey which comprised 28 questions covering aspects related to the respondents' demographic characteristics, their perceptions toward the efficacy of OTC dietary supplements and their awareness regarding the safety of popular OTC supplements and healthy dietary habits was used to collect responses. Associations between patient characteristics with perception and awareness were explored. Results: A total of 1487 responses were included in the analysis. Ascorbic acid, zinc, and vitamin D were the most popular OTC supplements, as indicated by the percentages of users (48.8%, 38.6%, and 34.6%, respectively). Perceptions toward OTC supplement use were suboptimal, with a reported mean perception score of 27.82 ± 8.56 (range 0-45). The multivariate analysis showed that participants who were of older age (>65 years) (AOR = 6.29, 95% CI = 2.2-17.9), had an income level >1500 (AOR = 1.84, 95% CI = 1.80-3.56), and used chronic medications had better perceptions than did younger participants, those with no income, and non-users of chronic medications, respectively. The mean safety awareness score was 5.36 ± 1.58 (maximum 7), with a significant direct relationship identified between perceptions and safety awareness scores (Spearman's correlation = 0.136, p < 0.001). Conclusion: This study highlighted the needs to organize educational campaigns that promote general public perceptions toward the safe use of OTC supplements to enhance immunity during COVID-19.

Healthcare Providers' Perspectives Toward the Integration of over the Counter Supplements During COVID-19 Pandemic: A Cross-Sectional Study from Jordan.

Objective: During COVID-19 pandemic, healthcare providers (HCPs) have been inundated with consultations related to over the counter (OTC) dietary supplements' protective role. Thus, the present study focused on assessing HCPs perceptions toward OTC products integration during the COVID-19 outbreak. Methods: Pertinent data was collected using validated-online survey comprising four sections: demographics, OTC supplementation perceptions, awareness related to safety of OTC supplements, confidence in recommending dosage and counseling to patients regarding OTC supplements' safety, and some health-related behaviors. Quantified perception score represented by corrected confidence-concern ratio was used in assessing perceptions, and associations between demographics with perception and awareness were explored. Results: A total of 600 responses were included in the final analysis. Vitamin C, zinc, and vitamin D were the most popularly recommended OTC supplements. Most respondents indicated positive perceptions toward dietary supplementation while around 60% of respondents reported reluctance about the protective role of COVID-19 vaccination. Bachelor's degree holders (AOR = 4.39, 95% CI = 2.25-10.33), pharmacists (AOR = 2.17, 95% CI = 1.5-9.5), and junior HCPs (<1 year experience) had improved perceptions compared to college graduates, physicians, and senior practitioners (AOR = .17, 95% CI = .04-.78 and AOR = .15, 95% CI = .02-.93), respectively. Conclusion: Suboptimal knowledge among HCPs toward the safety and hazards associated with integration of different OTC supplements during the COVID-19 pandemic dictates further education to ensure the safe integration of OTC supplements.

Barriers to Medication Review Process Implementation-Cross-Sectional Study among Community Pharmacists in Jordan.

The medication review process (MRP) is an extended, vital role of community pharmacists in improving health outcomes of medication use, yet it is neither systematically nor comprehensively provided bycommunity pharmacies in Jordan. This study aimed to identify the potential barriers hinderingMRP implementation bycommunity pharmacists in Jordan. A total of 550 community pharmacists electronically received a previously constructed and validated Arabic questionnaire explicitly developed to assess the current medication review practices and factors hindering the MRP, of whom 417 answered the questionnaire, giving a response rate of 75.8%. Among the investigated six categories' seventeen barriers tothe implementation of the MRP, the highest rating was found for remuneration barriers (55.8%), followed by barriers related to regulations and patients, which scored 52.3% and 48.8%, respectively. Resource-related barriers were recognizedby 44.6% of participants, while qualifications and barriers related to physicians scored 42.9% and 41.8%, respectively. Although community pharmacists in Jordan are eager to extend their roles from traditional to more patient-centered ones, they encounter various barriers hinderingsuch development. Regulation adjustments accompanied by cost-effective remuneration and proper training are strong facilitators for community pharmacists to initiate the medication review service; make available the needed resources; and invest efforts, time, and money to operate it.

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.

Epidemiology of depression and anxiety among undergraduate students.

AIMS: Depression and anxiety are the most common and prevalent mental health issues among undergraduate students. This study aimed to investigate the prevalence of anxiety and depression, their associated predictors, and to assess knowledge and use of antidepressant medications among university students in Jordan. METHODS: A cross-sectional survey-based study was conducted in Jordan among undergraduate students from all levels of study. Istilli et al's questionnaire, the PHQ-9 and generalised anxiety disorder (GAD) scales were used in this study to explore the study objectives. Logistic regression analysis was used to identify predictors of anxiety and depression. RESULTS: A total of 1582 undergraduate students participated in the study. Prevalence of depression was 22.3% (n = 330), with proportions of minimal, mild, moderate, moderately severe and severe depression to be 15.9%, 32.4%, 29.5%, 14.7% and 7.6%, respectively. Prevalence of anxiety was 15.8% (n = 173), with proportions of mild, moderate and severe anxiety to be 46.4%, 37.8% and 15.8%, respectively. Female students and those with low income (<500 JD) had higher depression mean scores compared with others. Females, arts and engineering students, divorced and those who have four or more children had higher anxiety mean scores compared with others. CONCLUSION: Findings of this study addressed the importance of taking serious measures and interventions to prevent the development of severe mental illness among university students.

The Validity of the Theory of Planned Behaviour for Understanding People's Beliefs and Intentions toward Reusing Medicines.

BACKGROUND: many factors can impact a person's behaviour. When the behaviour is subject to prediction, these factors can include, for example, the perceived advantages and disadvantages of performing the behaviour, normative beliefs, and whether the behaviour is thought to be achievable. This paper examines intentions to engage in medicines reuse, i.e., to accept medicines that are returned unused to a pharmacy to be reused. The paper aims to outline the validity of the Theory of Planned Behaviour (TPB) for understanding people's intentions to engage in medicines reuse by examining this against other long-standing health-related psychological theories of behavioural change. Thus, the Health Belief Model (HBM), Protection Motivation Theory (PMT), Trans-Theoretical Model of Health Behaviour Change (TTM/SoC), Theory of Reasoned Action (TRA), and TPB are examined for their application in the study of medicines reuse. DISCUSSION: the HBM, PMT, TTM/SoC, TRA, and TPB were assessed for their relevance to examining medicines reuse as a behaviour. The validity of the TPB was justified for the development of a Medication Reuse Questionnaire (MRQ) to explore people's beliefs and intention toward reusing medicines. CONCLUSION: TPB has been widely used inside and outside of health-related research and it was found to have more accurately defined constructs, making it helpful in studying medicines reuse behaviour.

Medicines as Common Commodities or Powerful Potions? What Makes Medicines Reusable in People's Eyes.

BACKGROUND: Medicines reuse involves dispensing quality-checked, unused medication returned by one patient for another, instead of disposal as waste. This is prohibited in UK community pharmacy because storage conditions in a patient's home could potentially impact on the quality, safety and efficacy of returned medicines. Our 2017 survey examining patients' intentions to reuse medicines found many favoured medicines reuse. Our aim was to analyse the qualitative comments to explore people's interpretations of what makes medicines (non-)reusable. METHODS: Thematic analysis was used to scrutinize 210 valid qualitative responses to the survey to delineate the themes and super-ordinate categories. RESULTS: Two categories were "medicines as common commodities" versus "medicines as powerful potions". People's ideas about medicines aligned closely with other common commodities, exchanged from manufacturers to consumers, with many seeing medicines as commercial goods with economic value sanctioning their reuse. Fewer of the comments aligned with the biomedical notion of medicines as powerful potions, regulated and with legal and ethical boundaries limiting their (re)use. CONCLUSION: People's pro-medicines-reuse beliefs align with perceptions of medicines as common commodities. This helps explain why patients returning their medicines to community pharmacies want these to be recycled. It could also explain why governments permit medicines reuse in emergencies.

Barriers to implementing pharmacoeconomics: interview study.

Background: Pharmacoeconomics estimates the value of pharmaceutical products and services and provides healthcare decision-makers with valuable information. Pharmacoeconomic evaluations have not been found to be influential in the Jordanian health care system. Although pharmacoeconomics as a concept is becoming more recognized in the pharmaceutical world, there are still some barriers to its implementation. Objective: To establish the perceived barriers to the implementation of pharmacoeconomics in Jordan. Method: A qualitative study with semi-structured interviews was conducted. Participants were chosen if they might benefit from the application of pharmacoeconomics; such as members of Pharmacy and Therapeutics Committees (PTCs) in public, private, and teaching hospitals; administrative pharmacists on drug pricing committees; those who produce pharmacoeconomic data such as academics; and administrative pharmacists in the Joint Procurement Department (JPD). The interviews were recorded and transcribed. Transcripts were analyzed using a thematic analysis approach. Result: Three main barriers to the implementation of pharmacoeconomics were identified. These were related to the nature of the decision-making process, the lack of pharmacoeconomic data, and inadequate knowledge about pharmacoeconomics. Conclusion: The current use and impact of pharmacoeconomic evaluations in Jordanian healthcare decision-making is restricted, in part, due to the barriers outlined by the respondents.