Knowledge and compliance towards alendronate therapy among postmenopausal women with osteoporosis in Palestine.

BACKGROUND: Postmenopausal women compliance to alendronate therapy is suboptimal due to the complex dosing requirements. The poor compliance may increase their potential of fractures and the prevalence of side effects. In this study, the compliance of osteoporotic women on bisphosphonate therapy to the complex dosing instructions and their knowledge of alendronate-interactions were assessed. METHODS: This is a cross-sectional study, using self-administered questionnaire involving 224 osteoporotic women on alendronate therapy, who visited the orthopedic clinics and community pharmacies in the West Bank. Data was collected using a validated questionnaire consisting of 4 sections and analyzed by descriptive statistics. Moreover, associations between patient's socio-demographic characteristics and the extent of compliance and knowledge of alendronate interactions are established in this study. RESULTS: A total of 300 questionnaires were distributed and 224 were completed. The median compliance score to alendronate dosing instructions was 5 out of a possible maximum 7, and the median knowledge score about alendronate interactions was 7 out of a possible maximum 14. Factors found to affect either or both the knowledge and compliance to alendronate dosing instructions were, residency, and the source of instructions. CONCLUSION: This study identified the importance of compliance and knowledge gaps among postmenopausal women treated with alendronate. Therefore, appropriate knowledge about the importance of proper compliance to dosing instructions and avoidance of interactions is of a great benefit for maximizing clinical effectiveness, lowering fracture risk and prevention of adverse effects of alendronate among patients treated with alendronate in Palestine.

Evaluation of the hypoglycemic effect of seven wild folkloric edible plants from Palestine.

Alfa-amylase inhibitors are used to reduce glucose absorption by suppressing carbohydrate digestion. The current study aimed to evaluate seven wild edible Palestinian plants' hydrophilic and lipophilic fractions against porcine pancreatic α-amylase enzyme. The lipophilic fractions of Arum palaestinum, Malva sylvestris, Plantago major, Centaurea iberica, Cichorium endivia, Bituminaria bituminosa, Sisymbrium irio leaves were sequentially separated with a nonpolar solvent hexane, while the hydrophilic fractions of the studied plants were separated with polar solvents ethanol and water. The activity of α-amylase inhibition was carried out by using α-amylase porcine pancreatic enzyme and 3,5-dinitrosalicylic acid (DNSA) method as well as by using Acarbose as a positive control. Among the studied plant's hydrophilic fractions, C. iberica and C. endivia have the highest porcine pancreatic α-amylase inhibitory effect with an IC50 value of 12.33 µg/mL and 9.96 µg/mL, respectively. In addition, among the studied plant's lipophilic fractions, S. irio and A. palaestinum have the highest porcine pancreatic α-amylase inhibitory effect with an IC50 value of 7.72 µg/mL and 25.3 µg/mL, respectively. In fact, these revealed results were near the values of Acarbose. The hydrophilic fractions of M. sylvestris and the lipophilic fractions of P. major plants exhibit remarkable α-amylase inhibitory activity. Hence, these leaves have a potential for use as regular supplements also; further investigations are required to isolate pure pharmacological molecules and to design suitable pharmaceutical dosage forms with anti-diabetic activity.

Evaluation of community pharmacists' knowledge and awareness of food-drug interactions in Palestine.

Background Food-drug interactions can produce undesirable outcomes during the therapy process. The pharmacist is responsible for providing patients counseling about common food-drug interactions. Knowledge of such interactions is important to avoid their occurrence. Objective This study aimed to assess the knowledge and awareness of community pharmacists about common food-drug interactions. Setting Pharmacists working in community pharmacies across Northern Palestine. Method This is a cross-sectional study, which involved a convenience sample of 259 pharmacists working in community pharmacies in Palestine. A self-administered questionnaire consisted of 29 questions (mainly yes/no questions) was used to assess pharmacists' knowledge towards the most common and clinically significant interactions between food and medicines. Main outcome measure Pharmacists' issues related to the knowledge of food drug interactions were evaluated. Results A total of 320 questionnaires were distributed of which 259 were completed providing a response rate 80.9%. One pharmacist from each community pharmacy was asked to complete the questionnaire. The overall knowledge score of food-drug interactions for the pharmacists was 17.9 (61.7%) out of a possible maximum of 29. The pharmacists surveyed in this study have demonstrated good knowledge of some interactions; but poor knowledge of others. Conclusion Pharmacists' knowledge about common food-drug interactions is inadequate. These findings support the need for training and educational courses for pharmacists regarding food-drug interactions.

Determinants and frequency of pharmaceutical compounding in pharmacy practice in Palestine.

OBJECTIVES: The aims of this study were to determine the frequency of prescription compounding by community pharmacists, identify factors that influence pharmacists' decisions to provide compounding services, and evaluate physicians' perspectives on prescribing medications that require compounding. METHODS: The study was a cross-sectional survey administered via face-to-face structured interviews with randomly selected community pharmacists and physicians from different areas of the West Bank. KEY FINDINGS: Of the 260 community pharmacists who were contacted, 212 agreed to participate in the survey, giving a response rate of 81.5%. Overall, 153 (72.2%) of respondent pharmacists provided compounding services. Compounded prescriptions accounted for 1973 (1.55%) of 126,840 prescriptions dispensed in a typical month. Among the compounders, 112 (73.2%) pharmacists reported that their goal in providing full pharmaceutical care to their patients was the most important motivator. The most frequently reported reason for not providing compounding was 'I do not receive prescriptions that require compounding' by 43 out of 59 (72.9%) pharmacists. A total of 179 out of 220 physicians consented to participate in this study giving a response rate of 81.4%. The majority of physicians (142, 79.3%) did not prescribe compounded medicines. The most important reason for their decision to prescribe compounded medicines was the unavailability of the required dosage forms. The most commonly cited reason for not prescribing them was a lack of trust in the quality of the compounded formulations. CONCLUSION: While most respondent pharmacists provide a compounding service this represents only a small percentage of the total volume of dispensed prescriptions. Most responding physicians do not prescribe medications that require compounding because they lack trust in the quality of the compounded formulations.