Indonesian Pharmacists' Application of Beyond-Use Date Interventions to Patients and Its Contributing Factors: A Cross-Sectional Study.

Background: Extemporaneous preparations are commonly used in Indonesia, hence, Beyond-Use Date (BUD) information needs to be delivered by pharmacists to patients to maximize drug stability and enhance safety. Objective: This study aims to evaluate BUD interventions carried out by Indonesian pharmacists. Methods: A cross-sectional design was used, while a validated and reliable questionnaire was given to the samples using the snowballing and purposive sampling methods. The sample criteria were Indonesian pharmacists who had experience serving patients' extemporaneous prescriptions and those that completed the questionnaire. The significance of the relationship between BUD interventions and samples' characteristics was evaluated using the Mann-Whitney U test. Results: From the 221 total respondents, the majority admitted that they always provide BUD labeling on crushed tablets 46%, syrup 50.7%, and ointment 49.6% extemporaneous preparations. Similarly, most of the respondents also affirmed that they always provided BUD verbal information to patients on crushed tablets 66.8%, syrup 68%, and ointment 64% extemporaneous preparations. However, the remaining pharmacists, ranging from 32% to 54%, acknowledged that they did not always deliver both BUD labeling and verbal information to patients. Compared to the community-based, hospital pharmacists provided BUD labeling more frequently on all extemporaneous formulations as demonstrated by P < .05. Additionally, pharmacists found to work in Jakarta and the surrounding areas provided substantially more BUD labeling on crushed tablets and ointment (P < .05) compared to other workplace. Adult pharmacists also provided BUD labeling on crushed tablet formulations more often than the middle-aged (P < .05). Only the crushed tablet preparation was associated with the provision of BUD verbal information (P = .004). Conclusions: Based on the results, not all pharmacists verbally inform patients about BUDs nor provide drug labeling on various extemporaneous preparations. The determinant factors contributing to BUD labeling provisions were the type of practice, workplace location, and age. For the provision of verbal information, the only determinant factor was the type of practice.

Supporting and inhibiting factors of accepting COVID-19 booster vaccination in the elderly in north Jakarta, Indonesia

Background: The risk of fatal infection and death from Coronavirus disease 2019 (COVID-19) exposure increases in the elderly and those with coexisting illnesses such as cardiovascular disease, diabetes, cancer, obesity, and hypertension. The COVID-19 vaccine’s efficacy and safety have been supported by numerous research. However, data from the Ministry of Health of Indonesia revealed that the elderly in North Jakarta had a reclining interest in receiving a booster dose. This research aimed to assess the perception of the elderly living in North Jakarta related to supporting and inhibiting factors in accepting the COVID-19 booster vaccination. Methods: This qualitative research used a grounded theory design. It was conducted from March to May 2022, and data were gathered in North Jakarta’s numerous districts through in-depth interviews until saturation was reached. Furthermore, data were validated using member checking, source triangulation to families of elderly, and vaccination doctors. They were processed to produce transcripts, codes, and finalized themes. Results: Booster vaccination in the elderly was supported by 12 out of 15 informants, and the rest did not agree. The supporting factors include health, family, peer support, doctors, government, administrative requirements, endemic transformation, booster choice, and media coverage. Meanwhile, the inhibiting factors include hoaxes, concerns over the vaccine’s safety and efficacy, political issues, family, and comorbidities. Conclusions: Most of the elderly displayed positive attitudes concerning booster shots, but it was discovered that some barriers need to be removed. (AU)

Curcuminoids for Metabolic Syndrome: Meta-Analysis Evidences Toward Personalized Prevention and Treatment Management.

The metabolic syndrome (MS) is a multifactorial syndrome associated with a significant economic burden and healthcare costs. MS management often requires multiple treatments (polydrug) to ameliorate conditions such as diabetes mellitus, insulin resistance, obesity, cardiovascular diseases, hypertension, and non-alcoholic fatty liver disease (NAFLD). However, various therapeutics and possible drug-drug interactions may also increase the risk of MS by altering lipid and glucose metabolism and promoting weight gain. In addition, the medications cause side effects such as nausea, flatulence, bloating, insomnia, restlessness, asthenia, palpitations, cardiac arrhythmias, dizziness, and blurred vision. Therefore, is important to identify and develop new safe and effective agents based on a multi-target approach to treat and manage MS. Natural products, such as curcumin, have multi-modalities to simultaneously target several factors involved in the development of MS. This review discusses the recent preclinical and clinical findings, and up-to-date meta-analysis from Randomized Controlled Trials regarding the effects of curcumin on MS, as well as the metabonomics and a pharma-metabolomics outlook considering curcumin metabolites, the gut microbiome, and environment for a complementary personalized prevention and treatment for MS management.

Prevalence of pharmacist knowledge on beyond-use date (BUD) of various non-sterile compounding drugs in Indonesia.

Objective: In extemporaneous compounding, drugs' stability is indicated by beyond-use date (BUD), which is different from the expiration date determined by manufacturers, hence, pharmacists are required to provide proper BUD information to patients. A recent study showed that BUD knowledge in the North Jakarta community is low, therefore, this study aims to examine the prevalence of Indonesian pharmacists' BUD knowledge regarding various non-sterile dosage forms. Methods: This cross-sectional study involved Indonesian pharmacists' knowledge of serving extemporaneous prescriptions. Recruitment was carried out through the purposive and snow-balling sampling method, while data were obtained by filling out a validated authors' designed questionnaire, with total 34 questions, and collected in September 2021 and then analyzed using the chi-square test. Results: Among the 221 total respondents, 93.7% had BUD knowledge, while 12.7% responded that BUD and expiration date are similar. Regarding BUD for crushed tablets, dry syrup without preservatives, and ointment without moisture, there were 13.1%, 82.8%, and 29.4% responded rightly, respectively. Furthermore, there was no correlation between BUD knowledge and respondents' characteristics, including health-care workplace and location, as well as gender, and age with p>0.05. Conclusion: Based on the results, the Indonesian pharmacists were considered to have inadequate BUD knowledge, specifically on crushed tablets and ointment, and this might affect drugs' safety.

Prevalence of pharmacist knowledge on beyond-use date (BUD) of various non-sterile compounding drugs in Indonesia

Objective: In extemporaneous compounding, drugs’ stability is indicated by beyond-use date (BUD), which is different from the expiration date determined by manufacturers, hence, pharmacists are required to provide proper BUD information to patients. A recent study showed that BUD knowledge in the North Jakarta community is low, therefore, this study aims to examine the prevalence of Indonesian pharmacists’ BUD knowledge regarding various non-sterile dosage forms. Methods: This cross-sectional study involved Indonesian pharmacists’ knowledge of serving extemporaneous prescriptions. Recruitment was carried out through the purposive and snow-balling sampling method, while data were obtained by filling out a validated authors’ designed questionnaire, with total 34 questions, and collected in September 2021 and then analyzed using the chi-square test. Results: Among the 221 total respondents, 93.7% had BUD knowledge, while 12.7% responded that BUD and expiration date are similar. Regarding BUD for crushed tablets, dry syrup without preservatives, and ointment without moisture, there were 13.1%, 82.8%, and 29.4% responded rightly, respectively. Furthermore, there was no correlation between BUD knowledge and respondents’ characteristics, including health-care workplace and location, as well as gender, and age with p>0.05. Conclusion: Based on the results, the Indonesian pharmacists were considered to have inadequate BUD knowledge, specifically on crushed tablets and ointment, and this might affect drugs’ safety. (AU)

Supporting and inhibiting factors of accepting COVID-19 booster vaccination in the elderly in north Jakarta, Indonesia.

Background: The risk of fatal infection and death from Coronavirus disease 2019 (COVID-19) exposure increases in the elderly and those with coexisting illnesses such as cardiovascular disease, diabetes, cancer, obesity, and hypertension. The COVID-19 vaccine's efficacy and safety have been supported by numerous research. However, data from the Ministry of Health of Indonesia revealed that the elderly in North Jakarta had a reclining interest in receiving a booster dose. This research aimed to assess the perception of the elderly living in North Jakarta related to supporting and inhibiting factors in accepting the COVID-19 booster vaccination. Methods: This qualitative research used a grounded theory design. It was conducted from March to May 2022, and data were gathered in North Jakarta's numerous districts through in-depth interviews until saturation was reached. Furthermore, data were validated using member checking, source triangulation to families of elderly, and vaccination doctors. They were processed to produce transcripts, codes, and finalized themes. Results: Booster vaccination in the elderly was supported by 12 out of 15 informants, and the rest did not agree. The supporting factors include health, family, peer support, doctors, government, administrative requirements, endemic transformation, booster choice, and media coverage. Meanwhile, the inhibiting factors include hoaxes, concerns over the vaccine's safety and efficacy, political issues, family, and comorbidities. Conclusions: Most of the elderly displayed positive attitudes concerning booster shots, but it was discovered that some barriers need to be removed.