Clinical pharmacist role in improving the knowledge and outcomes in patients using isotretinoin: A randomized, controlled study.

Objective: To evaluate the role of a clinical pharmacist in improving knowledge and outcomes among isotretinoin users. Methods: Patients were randomly assigned to an intervention group (received education about isotretinoin by a clinical pharmacist in addition to the physician) and a control group (received routine education by the physician), then followed for three months. Patients' knowledge about isotretinoin optimal use, and side effects and their management and other outcomes were measured in both groups at baseline and at follow up after three months using a validated questionnaire. Results: Two-hundred and three patients completed the study; 103 were in the intervention group and 100 in the control group. The knowledge improvement between baseline score and follow-up score was greater in the intervention group (mean = 2.835 ± 1.329) compared to the control group (mean = 0.530 ± 0.784) with mean differences = -2.30495, P < 0.001. Conclusion: Implementing clinical pharmacy services in dermatology clinics can positively increase patients' level of knowledge about isotretinoin, which could reduce the severity of its side effects. Therefore, improving patients' quality of life, and improvement in acne. Practice implications: Implementing clinical pharmacist services to patients using isotretinoin is feasible in an outpatient setting. Clinical pharmacist counseling and education improve the medication knowledge among patients who use isotretinoin.

Adherence and utilization of short-term antibiotics: Randomized controlled study.

Enhancing adherence to medication has the potential to improve clinical outcomes and decrease healthcare cost. The role of clinical pharmacist-led education on adherence to short-term antibiotic has never been investigated in Jordan. This study aimed to evaluate the impact of an educational intervention on antibiotic short-term adherence and to assess the antibiotic utilization pattern. A prospective, single blinded, randomized controlled study was conducted in a tertiary referral hospital in Jordan. Adult patients diagnosed with acute infection and prescribed a short-term antibiotic course (< 30 day) were included in the study. Recruited patients were randomly allocated into control and intervention groups. Pharmaceutical education about the correct use of antibiotic/s was provided to the intervention group. The results showed that penicillins were the most prescribed antibiotics (38.7%) followed by fluoroquinolones (23.9%) and cephalosporines (20.9%). Patients in the intervention group were more likely to be adherent to the prescribed antibiotics compared to control group (OR = 1.445, 95CI% = 1.029-2.030, p = 0.033). Employed patients, less frequent administration of antibiotic, and searching information related to the prescribed antibiotics were factors associated with better adherence to short-term antibiotic (p<0.05). The most common reasons for non-adherence were feeling better and forgetfulness to take medication. These findings highlighted that pharmacist-led educational intervention significantly enhance adherence to prescribed short-term antibiotics which is a major drive to control antibiotic resistance. Initiatives should be adopted to include patient education as a regular element in the medication dispensing process. Clinical trial registration: The trial is registered at ClinicalTrials.gov (identifier: NCT05293977).

Prevalence and predictors of non-adherence to short-term antibiotics: A population-based survey.

Non-adherence to antibiotics is a well-known, core player to antibiotic resistance. The current adherence behavior toward short-term antibiotic regimens has never been investigated before in Jordan. This study assessed the prevalence and predictors of non-adherence to short-term antibiotics among Jordanians and investigated participants' views about different reasons related to antibiotics non-adherence. A cross-sectional face-to-face survey-based interview was conducted in three hospital pharmacies in Jordan. Adults and mother of children (≤12 years old) who completed their short course treatment (<30 day) of oral antibiotic within the last month were recruited. A total of 2000 participants (adults: 1000 and mothers of children: 1000) were included in the study with a response rate of 91.60%. The prevalence of non-adherence was estimated to be 32.10%. Non-adherent respondents scored a lower Medication Adherence Report Scale [16.76±5.02 vs. 23.04 ±3.24] than adherent respondents (p<0.001). Adults without comorbidity and children with higher number of doses per regimen were significantly less adherent to antibiotic [(OR = 0.615, 95%CI = 0.444-0.853, p = 0.004) and (OR = 0.965, 95%CI = 0.950-0.981, p<0.001)], respectively. Patients-related factors were the most common antibiotic non-adherence reason reported by the participants. The multivariate analysis for all the participants (adults and children), indicated that mothers were 2.6 times more likely to be adherent in giving antibiotics to their children than adults (p<0.001). These findings highlight that more than half of the participants were adherent to short-term antibiotics. However, improving the current prescription-related practices and implementing pharmaceutical consultation services upon antibiotic dispensing are encouraged.

Treatment related problems in Jordanian hemodialysis patients.

Background Treatment related problems are any event or circumstance involving patient treatment that actually or potentially interferes with an optimum outcome for a patient. Hemodialysis patients have on average 5-6 comorbid conditions and require 8-12 medications each day making them vulnerable to treatment related problems. Objective This study aimed to investigate treatment related problems affecting Jordanian hemodialysis patients, as well as assessing the factors associated with them. Setting Three hemodialysis centers in Jordan. Method A cross sectional multi-centered study was conducted. Direct interviews and patient files were used to collect patient information. A validated data collection form was used. Main outcome measure The average number of treatment related problems per patient. Results 160 patients from three different Jordanian dialysis centers were included. The cohort was 53 ± 15.2 years old, been on dialysis for 5.9 ± 5.3 years, had 3.9 ± 1.8 comorbid conditions and took 10.2 ± 2.8 different medications. There were a total of 1018 treatment related problems, a treatment related problem occurred once every 1.47 drug exposures. Adverse events were the most commonly occurring treatment related problems (27%), followed by indication related errors and dosing errors (24% and 21%, respectively). The number of treatment related problems is positively associated with age, the number of comorbid conditions, the number of hospital admissions in the previous year and the number of medications taken by the patient. Conclusion In the Jordanian hemodialysis population, treatment related problems affect virtually all patients. Most patients suffered adverse drug events and/or had drug indication problems. The number of treatment related problems correlated positively with age and the number of medications taken by the patient. Those with more treatment related problems also had higher hospital admissions and longer admission periods. Serious measures should be made in order to reduce the number of treatment related problems affecting this vulnerable population.