A national survey of knowledge, attitude, practice, and barriers towards pharmacovigilance and adverse drug reaction reporting among hospital pharmacy practitioners in the United Arab Emirates.

BACKGROUND: Pharmacovigilance (PV) is an essential component of patient safety and pharmacists are expected to be aware of the PV processes and willing to report ADRs. This study assessed the hospital pharmacists' knowledge, attitude, and practice toward PV, barriers faced by them in ADR reporting, and factors influencing ADR reporting. METHOD: A cross-sectional nationwide questionnaire survey was conducted among randomly chosen hospital pharmacists across UAE from March to July 2022. The filled questionnaires were assessed both descriptively [median (IQR scores), maximum 5 for Likert type and 1 for knowledge questions] and inferentially using the Mann-Whitney U test (for dichotomous variables) and the Kruskal-Wallis test (for variables with more than two responses) at alpha value = 0.05. Post hoc analyses and correlations were performed wherever applicable. RESULTS: Of the 342 respondents, the majority were knowledgeable about the concepts of PV (93.3%; n = 319) and ADRs (86.8%; n = 297). The overall median (IQR) knowledge score was 5 (3-7)/9. Knowledge levels within 'qualification groups' varied significantly (p-value < 0.001) and participants 'between 10 and 14 years of experience' had more knowledge than those 'with < 5 years of experience' (p-value < 0.001, Bonferroni test). The overall median (IQR) attitude score was 22 (20-24)/30. Most respondents (90.6%; n = 311) were willing to spare time to review patients' ADR reports. The overall median (IQR) practice score was 17.5 (11-21)/24. Although 71.1% (n = 243) noticed ADRs during the previous year, only 53.2% (n = 182) reported an ADR, the reasons for underreporting being mainly due to a lack of proper training [median IQR score 4(4-5)/5]. The 'clinical pharmacists' engaged themselves more in pharmacovigilance than 'pharmacists' (p-value = < 0.001), and 'inpatient pharmacists' reported more ADRs than 'pharmacists' (p-value = 0.018); Bonferroni test. The overall median (IQR) barrier score was 26 (23-29)/40 and the common barrier was 'lack of awareness about the national ADR reporting system 4 (4-5)'. The pharmacists in this study suggested incentives for reporting ADRs (69.3%; n = 237). CONCLUSION: The authors concluded professional training courses for practicing pharmacists and educational curriculums related to PV and ADR reporting processes are to be considered for future pharmacists in order to inculcate ADR reporting culture and practices.

A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education.

OBJECTIVE: To implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students' abilities to manage patients with low HL. METHODS: Students virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman's rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. RESULTS: A total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the "gathering information" domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the "patient management" domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. CONCLUSION: An HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.

Knowledge, attitude, and readiness towards disaster management: A nationwide survey among healthcare practitioners in United Arab Emirates.

Health professionals are expected to be knowledgeable on disaster medicine and prepared to deal with medicine disasters. This study aimed to assess the level of knowledge, attitude, and readiness to practice disaster medicine among health care workers in the United Arab Emirates (UAE) and determine the influence of sociodemographic factors on the practice of disaster medicine. A cross-sectional survey conducted among various healthcare professionals in different healthcare facilities in the UAE. An electronic questionnaire was used and randomly distributed throughout the country. Data were collected from March to July 2021. The questionnaire consisted of 53 questions distributed among four sections: demographic information, knowledge, attitude and readiness to practice. The questionnaire distribution involved a 5-item of demographic information, a 21-item of knowledge, a 16-item of attitude and an 11-item of practice. A total of 307 (participation rate ~80.0%, n = 383) health professionals practicing in the UAE responded. Of these, 191 (62.2%) were pharmacists, 52 (15.9%) were physicians, 17 (5.5%) were dentists, 32 (10.4%) were nurses, and 15 (4.9%) were others. The mean experience was 10.9 years [SD ±7.6] (median 10, IQR 4-15). The median (IQR) overall knowledge level was 12 (8-16) and the maximum knowledge level was 21. The overall knowledge level differed significantly between the age groups of the participants (p = 0.002). The median (IQR) of overall attitude was (57, 50-64) for pharmacists, (55, 48-64) for physicians, (64, 44-68) for dentists, (64, 58-67) for nurses, and (60, 48-69) for others. The total attitude score differed significantly between the different professional groups (p = 0.034), gender (p = 0.008) and workplace (p = 0.011). In terms of readiness to practice, respondents' scores were high and not significantly related to age (p = 0.14), gender (p = 0.064), professional groups (p = 0.0.762), and workplace (p = 0.149). This study showed that health professionals in the UAE have moderate levels of knowledge, positive attitudes, and high readiness to engage in disaster management. Gender and place of work can be considered as influencing factors. Professional training courses and educational curriculums related to disaster medicine can be beneficial to further reduce the knowledge-attitude gap.

Perceived Stress and Quality of Life Among Final-Year Pharmacy Students in the United Arab Emirates During COVID-19 Pandemic Lockdown.

BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic has caused huge disruptions worldwide affecting most people including university students. The impact of the pandemic lockdown on pharmacy students' stress levels and quality of life (QoL) is not well studied. This study assessed the impact of COVID-19 lockdown on perceived stress levels and QoL among final-year undergraduate pharmacy students at Ajman University, United Arab Emirates (UAE). METHODS: A cross-sectional electronic survey was conducted among final-year Bachelor of Pharmacy students at Ajman University during the COVID-19 lockdown period. The perceived stress scale and World Health Organization Quality of Life Instrument (WHOQOL-BREF) were administered through Google Forms. The filled responses were exported to IBM SPSS statistics, Version 26, scored as per the standard scoring procedures, and analyzed to answer the study objectives. Since the data were not distributed normally (p=0.000, Kolmogorov-Smirnov test), non-parametric tests (Mann-Whitney test and Kruskal-Wallis test) were performed to compare the median (IQR) scores with demographic parameters at an alpha value of 0.05. RESULTS: Of the eligible 94 students, 81 (male=16, 19.8%, female = 65, 80.2%) responded. The perceived stress level due to COVID-19 among the participants of a score of 24 suggests that the students suffered a "moderate" level of stress with no statistical significance between genders regardless of the place of residence in the seven Emirates (p=0.371) of the UAE. During the previous month of conducting the survey, 40.7% (n=33) of the respondents "very often" felt nervous and 22% (n=18) "fairly often" felt nervous with a median (IQR) score 3 (2-4); 3 denotes 'sometimes'. Of the respondents, 6.2% (n=14) "very often" and 21% (n=17) "fairly often" felt that things were going their own way. Regarding the QoL statements, a median (IQR) score of 3 (3-4) was obtained for the question on "How much do you enjoy life?", and the median scores were "4 (very much)" for more than half of the statements overall denoting a better QoL. The study reported females to have more physical pain, which may prevent them from carrying out their daily activities, than males (p=0.001) reflecting a better QoL among males over females during the lockdown. It also reflects a higher need for medications among females compared to males (p=0.014). All participants showed negative feelings, which is more apparent among male participants (4, 3-4.5) when compared to female participants (3, 2-3) (P = 0.001). CONCLUSION: The impact of COVID-19 lockdown on perceived stress and self-reported QoL is minimum. Age, gender and other demographic factors had little or no effect on stress levels, but gender influenced "experience of physical pain" and "requirement for medications", with more likelihood in females. Student friendly educational approaches and proper implementation of educational reforms can help minimizing student stress and improving QoL during vulnerable times like lockdowns.

Assessing the need for native language in pharmacy education and practice: a survey in the UAE.

OBJECTIVES: To evaluate pharmacists' opinions on the need for Arabic in pharmacy education and practice in the United Arab Emirates (UAE). METHODS: A questionnaire was developed to address the study objectives and hand delivered to a stratified sample of community pharmacists and a convenience sample of pharmacists in other areas of practice in the UAE. Pharmacists' responses were measured on a 5-point Likert-type scale (strongly disagree to strongly agree) towards teaching of the following topics in Arabic: management of chronic diseases and minor ailments, screening for diseases and counselling on smoking cessation, exercise, weight management, diet and nutrition and complementary/alternative medicine. Topics related to communication skills were also assessed. Descriptive statistics on participant responses were calculated and chi-square test of independence examined inter-relationships among pharmacist and pharmacy variables. KEY FINDINGS: A total of 351 pharmacists completed the questionnaire. Almost 50% of pharmacists considered Arabic in health sciences education a cultural and/or practice necessity. In pharmacy undergraduate curricula, preferred topics to be taught in Arabic included counselling on complementary/alternative medicine (67.4%), management of cold/flu (65.5%), counselling on weight management (64.2%), communication in special situations (63.2%), vocabulary (63.2%) and listening and empathic responding (62.6%). For continuing education, topics included management of cold/flu (69.8%) and skin conditions (69.2%), counselling on smoking cessation (68.9%), communicating with physicians and other professionals (54.8%), communication in special situations (54.7%) and vocabulary (50.9%). CONCLUSIONS: For all assessed topics and communication skills, more than half of the pharmacists agreed that they needed to be included in pharmacy education. A blended learning approach that combines integrated content for native language within an English curriculum could be explored.