Treatment-related problems (TRPs) are events associated with patients’ managements adversely affecting the patients’ optimum outcomes. Asthma is a common chronic condition characterised by acute episodes of exacerbation. In Jordan, data regarding TRPs in asthma exacerbations are lacking. This study aimed to identify/classify TRPs among patients hospitalised with asthma exacerbation in Jordan and to estimate their costs. A retrospective observational cohort study (Jan 2017–Jul 2021) was conducted in a tertiary centre in Jordan. TRPs were identified during hospitalisation and at discharge using a standardised classification tool and assessed for their severity. Potential cost savings (the extra cost of medication/procedure associated with TRPs) and potential cost avoidance (the cost avoidable by preventing TRPs and their associated adverse drug events) were investigated. A total of 494 cases were included in the study. A total of 3933 TRPs (2931 during hospitalisation; 1002 at discharge) were identified with a mean of 4.7 ± 2.2 and 2.0 ± 1.2 TRPs during hospitalisation and at discharge, respectively. ‘Unnecessary drug therapy’ (40.8%) and ‘ineffective/incomplete drug therapy’ (44.1%) were the most common TRPs during hospitalisation and at discharge, respectively. In 82% of the cases, systemic corticosteroids were administered for a longer period than recommended. Most of the TRPs were of moderate severity. Potential cost savings and cost avoidance were estimated to be USD 30 919.3 and USD 734 179.9 respectively, with a total cost of USD 766 046.8. The prevalence and cost of TRPs among asthma exacerbations are relatively high. Interventions to reduce such problems are necessary to avoid the negative clinical outcomes of TRPs and their economic burden on patients and healthcare systems.
{"title":"Treatment-related problems and their cost among patients hospitalised with asthma exacerbation","authors":"Haya Tabaza, R. A. Abu Farha, A. Naser, O. Awwad","doi":"10.1093/jphsr/rmad027","DOIUrl":"https://doi.org/10.1093/jphsr/rmad027","url":null,"abstract":"\u0000 \u0000 \u0000 Treatment-related problems (TRPs) are events associated with patients’ managements adversely affecting the patients’ optimum outcomes. Asthma is a common chronic condition characterised by acute episodes of exacerbation. In Jordan, data regarding TRPs in asthma exacerbations are lacking. This study aimed to identify/classify TRPs among patients hospitalised with asthma exacerbation in Jordan and to estimate their costs.\u0000 \u0000 \u0000 \u0000 A retrospective observational cohort study (Jan 2017–Jul 2021) was conducted in a tertiary centre in Jordan. TRPs were identified during hospitalisation and at discharge using a standardised classification tool and assessed for their severity. Potential cost savings (the extra cost of medication/procedure associated with TRPs) and potential cost avoidance (the cost avoidable by preventing TRPs and their associated adverse drug events) were investigated.\u0000 \u0000 \u0000 \u0000 A total of 494 cases were included in the study. A total of 3933 TRPs (2931 during hospitalisation; 1002 at discharge) were identified with a mean of 4.7 ± 2.2 and 2.0 ± 1.2 TRPs during hospitalisation and at discharge, respectively. ‘Unnecessary drug therapy’ (40.8%) and ‘ineffective/incomplete drug therapy’ (44.1%) were the most common TRPs during hospitalisation and at discharge, respectively. In 82% of the cases, systemic corticosteroids were administered for a longer period than recommended. Most of the TRPs were of moderate severity. Potential cost savings and cost avoidance were estimated to be USD 30 919.3 and USD 734 179.9 respectively, with a total cost of USD 766 046.8.\u0000 \u0000 \u0000 \u0000 The prevalence and cost of TRPs among asthma exacerbations are relatively high. Interventions to reduce such problems are necessary to avoid the negative clinical outcomes of TRPs and their economic burden on patients and healthcare systems.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41488251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayat A. Al-Btoush, Shereen M. Aleidi, Hind A Al-Odinat, Nisreen T Qaisi
This study aims to evaluate public knowledge about antibiotic use and resistance among the population in southern Jordan (a deprived region). A cross-sectional study was carried out and 435 participants completed the questionnaire that contained four sections: socio-demographic information, participants’ knowledge and behaviour about antibiotic use, the roles of physicians and pharmacists in antibiotic misuse and the level of participants’ awareness regarding antibiotic resistance. The data were analysed using the statistical package for social science. The Chi-square test of independence was used to compare the categorical variables. Approximately 53% of the participants exhibited negative behaviour towards antibiotic use. The highest proportion was among those with an education level of middle school (73.3%), non-medical field employees (58%) and non-employee participants (60.8%). About 48.0% of the participants have a high level of knowledge and awareness about antibiotic resistance. This was more evident among those of the age group between 17 and 27 years old, who have bachelor’s degrees or work in both the medical and non-medical fields. Nearly 57.5% of the participants were not asked by the physician for diagnostic tests before prescribing antibiotics, and 66.9% obtain antibiotics from the pharmacy without a prescription. Good awareness about antibiotic resistance in the community of southern Jordan does not prevent negative behaviour of antibiotic use. Physicians and pharmacists are strong contributors to antibiotic resistance. This demonstrates the need for regulatory actions to limit the access to and overuse of antibiotics.
{"title":"Assessment of knowledge, behaviour and awareness towards antibiotic use and resistance: a cross sectional study from south Jordanian society","authors":"Hayat A. Al-Btoush, Shereen M. Aleidi, Hind A Al-Odinat, Nisreen T Qaisi","doi":"10.1093/jphsr/rmad024","DOIUrl":"https://doi.org/10.1093/jphsr/rmad024","url":null,"abstract":"\u0000 \u0000 \u0000 This study aims to evaluate public knowledge about antibiotic use and resistance among the population in southern Jordan (a deprived region).\u0000 \u0000 \u0000 \u0000 A cross-sectional study was carried out and 435 participants completed the questionnaire that contained four sections: socio-demographic information, participants’ knowledge and behaviour about antibiotic use, the roles of physicians and pharmacists in antibiotic misuse and the level of participants’ awareness regarding antibiotic resistance. The data were analysed using the statistical package for social science. The Chi-square test of independence was used to compare the categorical variables.\u0000 \u0000 \u0000 \u0000 Approximately 53% of the participants exhibited negative behaviour towards antibiotic use. The highest proportion was among those with an education level of middle school (73.3%), non-medical field employees (58%) and non-employee participants (60.8%). About 48.0% of the participants have a high level of knowledge and awareness about antibiotic resistance. This was more evident among those of the age group between 17 and 27 years old, who have bachelor’s degrees or work in both the medical and non-medical fields. Nearly 57.5% of the participants were not asked by the physician for diagnostic tests before prescribing antibiotics, and 66.9% obtain antibiotics from the pharmacy without a prescription.\u0000 \u0000 \u0000 \u0000 Good awareness about antibiotic resistance in the community of southern Jordan does not prevent negative behaviour of antibiotic use. Physicians and pharmacists are strong contributors to antibiotic resistance. This demonstrates the need for regulatory actions to limit the access to and overuse of antibiotics.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45790550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although an emergency approval for Coronavirus Disease 2019 (COVID-19) vaccine was given for 5- to 15-year-old children, there is a public hesitancy to give it for children. This study aimed to investigate parental willingness to COVID-19 vaccine among 5- to 11-year-old children. A cross-sectional study using a self-administered questionnaire was distributed to parents from Jordan through social media and at the paediatric clinics. Six hundred and sixty-two parents participated. The mean age was 42.3 ± 2.9 years old and 67% of them were mothers. Around 60% of parents had 5- to 11-year-old children, 56% had children under 5 years, and 49.5% had 12- to 18-year-old children. About 89% of parents and 20% of their 12–18 years children had received COVID-19 vaccine. Only 37% of parents thought that COVID-19 vaccines are safe in children. Only 36/399 parents accepted the vaccine for their 5–11 years children and 232/339 rejected it. The acceptance number increased to 171 if the vaccine was a condition for school admission. Potential long-term unknown side effect was the most reported concern. Independent factors correlated with parental willingness to 5–11 years children vaccination were having a high income, having had children vaccinated to influenza vaccine, and trusting information from the government. Whereas concern of side effects was associated with vaccine rejection. Vaccine acceptance for 5- to 11-year-old children is a major issue among parents. The current study could assist the policymakers in Jordan to undertake strategies to encourage children vaccination to confine the spread of the pandemic.
{"title":"Parental willingness to COVID-19 vaccination among 5- to 11-year-old children in Jordan","authors":"F. Mayyas","doi":"10.1093/jphsr/rmad022","DOIUrl":"https://doi.org/10.1093/jphsr/rmad022","url":null,"abstract":"\u0000 \u0000 \u0000 Although an emergency approval for Coronavirus Disease 2019 (COVID-19) vaccine was given for 5- to 15-year-old children, there is a public hesitancy to give it for children. This study aimed to investigate parental willingness to COVID-19 vaccine among 5- to 11-year-old children.\u0000 \u0000 \u0000 \u0000 A cross-sectional study using a self-administered questionnaire was distributed to parents from Jordan through social media and at the paediatric clinics.\u0000 \u0000 \u0000 \u0000 Six hundred and sixty-two parents participated. The mean age was 42.3 ± 2.9 years old and 67% of them were mothers. Around 60% of parents had 5- to 11-year-old children, 56% had children under 5 years, and 49.5% had 12- to 18-year-old children. About 89% of parents and 20% of their 12–18 years children had received COVID-19 vaccine. Only 37% of parents thought that COVID-19 vaccines are safe in children. Only 36/399 parents accepted the vaccine for their 5–11 years children and 232/339 rejected it. The acceptance number increased to 171 if the vaccine was a condition for school admission. Potential long-term unknown side effect was the most reported concern. Independent factors correlated with parental willingness to 5–11 years children vaccination were having a high income, having had children vaccinated to influenza vaccine, and trusting information from the government. Whereas concern of side effects was associated with vaccine rejection.\u0000 \u0000 \u0000 \u0000 Vaccine acceptance for 5- to 11-year-old children is a major issue among parents. The current study could assist the policymakers in Jordan to undertake strategies to encourage children vaccination to confine the spread of the pandemic.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48126379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The previous studies underlined the need for specified educational intervention programs to prevent overweight and obesity problems among Malaysians. Therefore, in this context, this study aimed to explore the demographic factors that are associated with BMI and perceptions of body weight management among Malaysians by utilizing the Health Belief Model (HBM). The findings of the study will help in developing effective interventions and provide more specific recommendations on weight management in health education programs to ensure the well-being of the people. A questionnaire-based cross-sectional study was conducted to study the demographical factors and perception of body weight management by the self-administered Health Belief Model Questionnaire (HBMQ). The data were collected using the HBMQ via Google Form link which was promoted on social media platforms to reach out to the public from all over the 13 states in Malaysia. Out of 440 respondents, 44 (10.0%) were obese, 92 (20.90%) were overweight, 60 (13.60%) were underweight and 244 (55.50%) had normal weight. Significant associations were observed between body mass index (BMI) and demographic characteristics such as age range, gender, education level, marital status, employment status, intention to reduce weight, and health issues (P < 0.05). A statistically significant difference was observed between HBM subscales and different demographic characteristics. The regression model explained ~8.3% of the variance in BMI (P < 0.001) and revealed that perceived severity and behavioural intention were the significant variables to predict a person’s BMI. The findings in this study conclude that Malaysians with different demographic characteristics have different perceptions on obesity and weight reduction behaviours.
{"title":"Application of Health Belief Model: demographic factors affecting body mass index (BMI) and perceptions of weight management among Malaysians","authors":"Sivasankari Raman, S. C. Ong, Guat See Ooi","doi":"10.1093/jphsr/rmad018","DOIUrl":"https://doi.org/10.1093/jphsr/rmad018","url":null,"abstract":"\u0000 \u0000 \u0000 The previous studies underlined the need for specified educational intervention programs to prevent overweight and obesity problems among Malaysians. Therefore, in this context, this study aimed to explore the demographic factors that are associated with BMI and perceptions of body weight management among Malaysians by utilizing the Health Belief Model (HBM). The findings of the study will help in developing effective interventions and provide more specific recommendations on weight management in health education programs to ensure the well-being of the people.\u0000 \u0000 \u0000 \u0000 A questionnaire-based cross-sectional study was conducted to study the demographical factors and perception of body weight management by the self-administered Health Belief Model Questionnaire (HBMQ). The data were collected using the HBMQ via Google Form link which was promoted on social media platforms to reach out to the public from all over the 13 states in Malaysia.\u0000 \u0000 \u0000 \u0000 Out of 440 respondents, 44 (10.0%) were obese, 92 (20.90%) were overweight, 60 (13.60%) were underweight and 244 (55.50%) had normal weight. Significant associations were observed between body mass index (BMI) and demographic characteristics such as age range, gender, education level, marital status, employment status, intention to reduce weight, and health issues (P < 0.05). A statistically significant difference was observed between HBM subscales and different demographic characteristics. The regression model explained ~8.3% of the variance in BMI (P < 0.001) and revealed that perceived severity and behavioural intention were the significant variables to predict a person’s BMI.\u0000 \u0000 \u0000 \u0000 The findings in this study conclude that Malaysians with different demographic characteristics have different perceptions on obesity and weight reduction behaviours.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47470872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2021, community pharmacies in England were commissioned to support patients post-discharge through the discharge medicines service (DMS). Past studies described the benefit of DMS in avoiding readmissions. This study aimed to estimate the impact of DMS in this respect, projecting the maximal benefit if all areas mirrored the most active region. A retrospective observational study, including modelling, using DMS claims data from March 2021 to February 2022, obtained from the NHS Business Services Authority (data from all community pharmacies in England for patients discharged where hospital clinicians referred them to community pharmacy). The impact of DMS on reducing readmission during this period was estimated using previous study data and estimated maximal benefit from full implementation of the service across England. In the study period 65 634 completed DMS claims were made. Claims at Integrated Care System (ICS) area level varied from 509/10 000 admissions to <1/10 000 admissions. Combining data from past studies provides a relative risk ratio of 0.756 (95% CI 0.678 to 0.843) for 90 day readmission (DMS versus normal care). DMS is estimated to have resulted in 8393 (95% CI 7061 to 9564) fewer readmissions after 30 days reducing to 5869 (95% CI 3774 to 7740) after 90 days. If all-ICS areas were as active as the highest performing area, DMS would avoid estimated >29 000 readmissions at 90 days each year. DMS has significant potential to reduce readmissions. DMS implementation is currently variable and full implementation across all-ICS areas could increase the benefits five-fold.
{"title":"Predicting the potential value of the new discharge medicines service in England","authors":"Nick Thayer, A. Mackridge, S. White","doi":"10.1093/jphsr/rmad020","DOIUrl":"https://doi.org/10.1093/jphsr/rmad020","url":null,"abstract":"\u0000 \u0000 \u0000 In 2021, community pharmacies in England were commissioned to support patients post-discharge through the discharge medicines service (DMS). Past studies described the benefit of DMS in avoiding readmissions. This study aimed to estimate the impact of DMS in this respect, projecting the maximal benefit if all areas mirrored the most active region.\u0000 \u0000 \u0000 \u0000 A retrospective observational study, including modelling, using DMS claims data from March 2021 to February 2022, obtained from the NHS Business Services Authority (data from all community pharmacies in England for patients discharged where hospital clinicians referred them to community pharmacy). The impact of DMS on reducing readmission during this period was estimated using previous study data and estimated maximal benefit from full implementation of the service across England.\u0000 \u0000 \u0000 \u0000 In the study period 65 634 completed DMS claims were made. Claims at Integrated Care System (ICS) area level varied from 509/10 000 admissions to <1/10 000 admissions. Combining data from past studies provides a relative risk ratio of 0.756 (95% CI 0.678 to 0.843) for 90 day readmission (DMS versus normal care). DMS is estimated to have resulted in 8393 (95% CI 7061 to 9564) fewer readmissions after 30 days reducing to 5869 (95% CI 3774 to 7740) after 90 days. If all-ICS areas were as active as the highest performing area, DMS would avoid estimated >29 000 readmissions at 90 days each year.\u0000 \u0000 \u0000 \u0000 DMS has significant potential to reduce readmissions. DMS implementation is currently variable and full implementation across all-ICS areas could increase the benefits five-fold.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42746581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several medications were proposed for the treatment and prophylaxis of COVID-19 but with limited supporting evidence. Herein, we assessed trends in the volume of projected total retail dispensed prescriptions for 12 agents proposed for treatment and prevention of COVID-19 before and after March 2020 in Canada. We conducted a cross-sectional study using monthly prescription volumes obtained from IQVIA’s CompuScript database. We used joinpoint regression to identify significant inflection points and calculate the monthly percent change (MPC). Dispensations peaked after March 2020 for several medications, including hydroxychloroquine, fluvoxamine, ivermectin, colchicine, tocilizumab, sarilumab and famotidine. Although most peaks were short lived, large increases were observed for ivermectin (MPC from September 2020 to January 2021 = 28%) and famotidine (MPC from June 2021 to October 2021 = 14%). Overall, Canadian prescribing patterns were mostly consistent with recommendations from guidelines and health regulatory bodies. Nonetheless, active monitoring of trends should continue.
{"title":"Trends in estimated total retail dispensed prescriptions of purported COVID-19 treatments and preventions in Canada","authors":"Wajd Alkabbani, J. Gamble","doi":"10.1093/jphsr/rmad023","DOIUrl":"https://doi.org/10.1093/jphsr/rmad023","url":null,"abstract":"\u0000 \u0000 \u0000 Several medications were proposed for the treatment and prophylaxis of COVID-19 but with limited supporting evidence. Herein, we assessed trends in the volume of projected total retail dispensed prescriptions for 12 agents proposed for treatment and prevention of COVID-19 before and after March 2020 in Canada.\u0000 \u0000 \u0000 \u0000 We conducted a cross-sectional study using monthly prescription volumes obtained from IQVIA’s CompuScript database. We used joinpoint regression to identify significant inflection points and calculate the monthly percent change (MPC).\u0000 \u0000 \u0000 \u0000 Dispensations peaked after March 2020 for several medications, including hydroxychloroquine, fluvoxamine, ivermectin, colchicine, tocilizumab, sarilumab and famotidine. Although most peaks were short lived, large increases were observed for ivermectin (MPC from September 2020 to January 2021 = 28%) and famotidine (MPC from June 2021 to October 2021 = 14%).\u0000 \u0000 \u0000 \u0000 Overall, Canadian prescribing patterns were mostly consistent with recommendations from guidelines and health regulatory bodies. Nonetheless, active monitoring of trends should continue.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47962548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid Alshehri, D. Palm, N. Wehbi, Hyo Jung Tak, Wael ElRayes
To address the usability challenge of Prescription Drug Monitoring Program (PDMP) among office-based physicians in the USA imposed by the difficulty barrier for the system usage, we sought: (1) to estimate the association between the PDMP difficulty of use and reducing or eliminating controlled substance prescriptions; and (2) to test the mediating effect of the frequency of PDMP check in the association between the PDMP difficulty of use and the reduction of controlled substance prescriptions. We conducted a cross-sectional study using nationally representative data from the 2019 National Electronic Health Records Survey with a weighted sample of 214 889 office-based physicians. Weighted bivariate chi-square tests and multivariate logistic regressions with a confidence interval of 95% were performed. Bootstrap technique was used to conduct the causal mediation analysis. A PDMP that is easier to use was significantly associated with a higher reduction or elimination of controlled substance prescriptions (OR = 1.68; 95% CI: 1.01, 2.77). Easier PDMP use was also significantly associated with more frequent PDMP check prior to prescribing a controlled substance to a patient for the first time (OR = 6.39; 95% CI: 3.36, 12.15). About third (29.79%) of the observed association between PDMP difficulty of use and reducing or eliminating controlled substance prescriptions was mediated through the frequency of PDMP check. The difficulty of PDMP limits the system’s usability which undermines the process of mitigating controlled substance prescriptions. Future efforts are needed to re-assess and regulate facilitators for difficult PDMP usage to maximise the success of this system and reach the goals behind its implementation.
{"title":"The difficulty of using prescription drug monitoring program among office-based physicians in the USA: a challenge to mitigate controlled substance prescriptions","authors":"Khalid Alshehri, D. Palm, N. Wehbi, Hyo Jung Tak, Wael ElRayes","doi":"10.1093/jphsr/rmad016","DOIUrl":"https://doi.org/10.1093/jphsr/rmad016","url":null,"abstract":"\u0000 \u0000 \u0000 To address the usability challenge of Prescription Drug Monitoring Program (PDMP) among office-based physicians in the USA imposed by the difficulty barrier for the system usage, we sought: (1) to estimate the association between the PDMP difficulty of use and reducing or eliminating controlled substance prescriptions; and (2) to test the mediating effect of the frequency of PDMP check in the association between the PDMP difficulty of use and the reduction of controlled substance prescriptions.\u0000 \u0000 \u0000 \u0000 We conducted a cross-sectional study using nationally representative data from the 2019 National Electronic Health Records Survey with a weighted sample of 214 889 office-based physicians. Weighted bivariate chi-square tests and multivariate logistic regressions with a confidence interval of 95% were performed. Bootstrap technique was used to conduct the causal mediation analysis.\u0000 \u0000 \u0000 \u0000 A PDMP that is easier to use was significantly associated with a higher reduction or elimination of controlled substance prescriptions (OR = 1.68; 95% CI: 1.01, 2.77). Easier PDMP use was also significantly associated with more frequent PDMP check prior to prescribing a controlled substance to a patient for the first time (OR = 6.39; 95% CI: 3.36, 12.15). About third (29.79%) of the observed association between PDMP difficulty of use and reducing or eliminating controlled substance prescriptions was mediated through the frequency of PDMP check.\u0000 \u0000 \u0000 \u0000 The difficulty of PDMP limits the system’s usability which undermines the process of mitigating controlled substance prescriptions. Future efforts are needed to re-assess and regulate facilitators for difficult PDMP usage to maximise the success of this system and reach the goals behind its implementation.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45436164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bassam Abdul Rasool Hassan, A. H. Mohammed, W. M. Al-Jewari, A. Blebil, J. Dujaili, Abdulrasool M. Wayyes, Diana Malaeb, Mariam Dabbous, G. Othman, Abdelhaleem Mustafa Madani, Ahmed Talib Al-Zaabi, Amira Zerrouki, R. Darwish, Sara Abu Alhija, C. Drira, Fazaa Ikram, A. Jaber, Amna Mohamed Mohamed Alsahi Al-Zaabi, Neveen A. Kohaf, Safa Omran, Enas Abdelaziz Mohamed, Muhammed Hassan Nasr, A. Fathelrahman, Ali Alshahrani, A. Alsammarraie, Musaab Kadhim Alabboodi, H. Al-Tukmagi, Omar Abdulwahid Al-Ani
Antibiotic usage has evolved over the years among the Arab population, and it has also gone under misuse resulting in the development of antimicrobial resistance (AMR). Therefore, the current study aimed to address this issue by evaluating the level of knowledge and attitude of Arab population towards antibiotic usage and AMR to develop a pathway to reduce the risk of antibiotic resistance. A cross-sectional study was carried out among Arab population, including 11 countries from the Middle East and North Africa. A validated and translated questionnaire, consisting of 34 questions, was adopted to achieve the study objectives. Two phases of data collection (online and offline) were performed, and SPSS was used for data analysis. Three thousand three hundred and nineteen participants were successfully recruited, and the mean age was 37.6 ± 11.73. Approximately 63% of participants wrongly answered they should stop antibiotics when they feel better, and 73.3% of them thought antibiotics could treat cold and flu. Nearly half of the respondents indicated that they were uncertain of how antibiotic resistance affects the body (48.1%), and they were unaware if it could affect them or their families (63.1%). While the majority of the respondents were prescribed antibiotics by a doctor, over half of them were not given any advice on how to take them. Our data showed a significant relationship between respondents’ demographic data (e.g. country, age and education) and their knowledge and attitude. Participants had poor knowledge of antibiotics and AMR; thus, efforts are needed to conduct health campaigns in public places and create and implement programmes aiming to raise knowledge and awareness of people in the Arab regions. These could aid to curb the risk of antibiotic resistance and increase the chance of successful treatment for infectious diseases.
{"title":"Knowledge and attitude towards antibiotic use and resistance among Arab population: a questionnaire-based study of 11 countries from the Middle East and North Africa","authors":"Bassam Abdul Rasool Hassan, A. H. Mohammed, W. M. Al-Jewari, A. Blebil, J. Dujaili, Abdulrasool M. Wayyes, Diana Malaeb, Mariam Dabbous, G. Othman, Abdelhaleem Mustafa Madani, Ahmed Talib Al-Zaabi, Amira Zerrouki, R. Darwish, Sara Abu Alhija, C. Drira, Fazaa Ikram, A. Jaber, Amna Mohamed Mohamed Alsahi Al-Zaabi, Neveen A. Kohaf, Safa Omran, Enas Abdelaziz Mohamed, Muhammed Hassan Nasr, A. Fathelrahman, Ali Alshahrani, A. Alsammarraie, Musaab Kadhim Alabboodi, H. Al-Tukmagi, Omar Abdulwahid Al-Ani","doi":"10.1093/jphsr/rmad014","DOIUrl":"https://doi.org/10.1093/jphsr/rmad014","url":null,"abstract":"\u0000 \u0000 \u0000 Antibiotic usage has evolved over the years among the Arab population, and it has also gone under misuse resulting in the development of antimicrobial resistance (AMR). Therefore, the current study aimed to address this issue by evaluating the level of knowledge and attitude of Arab population towards antibiotic usage and AMR to develop a pathway to reduce the risk of antibiotic resistance.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was carried out among Arab population, including 11 countries from the Middle East and North Africa. A validated and translated questionnaire, consisting of 34 questions, was adopted to achieve the study objectives. Two phases of data collection (online and offline) were performed, and SPSS was used for data analysis.\u0000 \u0000 \u0000 \u0000 Three thousand three hundred and nineteen participants were successfully recruited, and the mean age was 37.6 ± 11.73. Approximately 63% of participants wrongly answered they should stop antibiotics when they feel better, and 73.3% of them thought antibiotics could treat cold and flu. Nearly half of the respondents indicated that they were uncertain of how antibiotic resistance affects the body (48.1%), and they were unaware if it could affect them or their families (63.1%). While the majority of the respondents were prescribed antibiotics by a doctor, over half of them were not given any advice on how to take them. Our data showed a significant relationship between respondents’ demographic data (e.g. country, age and education) and their knowledge and attitude.\u0000 \u0000 \u0000 \u0000 Participants had poor knowledge of antibiotics and AMR; thus, efforts are needed to conduct health campaigns in public places and create and implement programmes aiming to raise knowledge and awareness of people in the Arab regions. These could aid to curb the risk of antibiotic resistance and increase the chance of successful treatment for infectious diseases.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44914617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. D. Tran, Ba Kien Tran, D. T. Huynh, Thanh Yen Nguyen, Thi My Thao Nguyen, Thi My Tien Pham, Quang Loc Duyen Vo, V. V. Dorofeeva, R. S. Dewey, D. T. Pham
Recent years have seen the development and advancement of pharmaceutical care services using telecommunications, termed telepharmacy, in a variety of countries and settings. This study investigated the motivations/facilitators and barriers to pharmacists implementing telepharmacy at pharmacies/drugstores in the Mekong Delta region, Vietnam. A descriptive cross-sectional online survey was conducted from March to May 2022, on 747 pharmacists, at pharmacies in all 13 cities/provinces in the Mekong Delta area, Vietnam. Of the 747 respondents, 74% participants had experience of using telepharmacy. Having a university degree in pharmacy (aOR = 1.86; 95% CI = 1.11–3.12; P = 0.018) and a monthly income >8.4 million VND (~357 USD) (aOR = 2.00; 95%CI = 1.16–3.42; P = 0.012) were factors positively associated with telepharmacy use. The factor reported as most greatly motivating telepharmacy use was its ability to provide healthcare services to people in remote/rural areas and those unable to travel (82.3%). The main barrier to telepharmacy use was cited as a lack of policies and regulations on the implementation, application and support of telepharmacy practice (76.8%). More than 75% of those without telepharmacy experience reported that they would like to use it in the future. Telepharmacy use in Vietnam is familiar with the community pharmacists, although the use of telecommunications in pharmacy was only recently adopted in this country. Vietnamese government bodies and policy-makers must issue detailed regulations and instructions governing telepharmacy practice to support these advancements to the healthcare system in Vietnam.
{"title":"Facilitators and barriers to telepharmacy use among community pharmacists in the Mekong Delta, Vietnam","authors":"V. D. Tran, Ba Kien Tran, D. T. Huynh, Thanh Yen Nguyen, Thi My Thao Nguyen, Thi My Tien Pham, Quang Loc Duyen Vo, V. V. Dorofeeva, R. S. Dewey, D. T. Pham","doi":"10.1093/jphsr/rmad009","DOIUrl":"https://doi.org/10.1093/jphsr/rmad009","url":null,"abstract":"\u0000 \u0000 \u0000 Recent years have seen the development and advancement of pharmaceutical care services using telecommunications, termed telepharmacy, in a variety of countries and settings. This study investigated the motivations/facilitators and barriers to pharmacists implementing telepharmacy at pharmacies/drugstores in the Mekong Delta region, Vietnam.\u0000 \u0000 \u0000 \u0000 A descriptive cross-sectional online survey was conducted from March to May 2022, on 747 pharmacists, at pharmacies in all 13 cities/provinces in the Mekong Delta area, Vietnam.\u0000 \u0000 \u0000 \u0000 Of the 747 respondents, 74% participants had experience of using telepharmacy. Having a university degree in pharmacy (aOR = 1.86; 95% CI = 1.11–3.12; P = 0.018) and a monthly income >8.4 million VND (~357 USD) (aOR = 2.00; 95%CI = 1.16–3.42; P = 0.012) were factors positively associated with telepharmacy use. The factor reported as most greatly motivating telepharmacy use was its ability to provide healthcare services to people in remote/rural areas and those unable to travel (82.3%). The main barrier to telepharmacy use was cited as a lack of policies and regulations on the implementation, application and support of telepharmacy practice (76.8%). More than 75% of those without telepharmacy experience reported that they would like to use it in the future.\u0000 \u0000 \u0000 \u0000 Telepharmacy use in Vietnam is familiar with the community pharmacists, although the use of telecommunications in pharmacy was only recently adopted in this country. Vietnamese government bodies and policy-makers must issue detailed regulations and instructions governing telepharmacy practice to support these advancements to the healthcare system in Vietnam.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47896641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30eCollection Date: 2023-06-01DOI: 10.1093/jphsr/rmad010
Joseph Garuccio, Chi Chun Steve Tsang, Jim Y Wan, Ya Chen Tina Shih, Marie A Chisholm-Burns, Samuel Dagogo-Jack, William C Cushman, Xiaobei Dong, Jamie A Browning, Rose Zeng, Junling Wang
Objectives: Racial/ethnic disparities have been found in prior literature examining enrolment in Medicare medication therapy management programs. However, those studies were based on various eligibility scenarios because enrolment data were unavailable. This study tested for potential disparities in enrolment using actual MTM enrolment data.
Methods: Medicare Parts A&B claims, Medication Therapy Management Data Files, and the Area Health Resources File from 2013 to 2014 and 2016 to 2017 were analysed in this retrospective analysis. An adjusted logistic regression compared odds of enrolment between racial/ethnic minorities and non-Hispanic Whites (Whites) in the total sample and subpopulations with diabetes, hypertension, or hyperlipidaemia. Trends in disparities were analysed by including interaction terms in regressions between dummy variables for race/ethnic minority groups and period 2016-2017.
Key findings: Disparities in MTM enrolment were detected between Blacks and Whites with diabetes in 2013-2014 (Odds Ratio = 0.78, 95% Confidence Interval = 0.75-0.81). This disparity improved from 2013-2014 to 2016-2017 for Blacks (Odds Ratio=1.08, 95% Confidence Interval = 1.04-1.11) but persisted in 2016-2017 (Odds Ratio = 0.84, 95% Confidence Interval = 0.81-0.87). A disparity was identified between Blacks and Whites with hypertension in 2013-2014 (Odds Ratio = 0.92, 95% Confidence Interval = 0.89-0.95) but not in 2016-2017. Enrolment for all groups, however, declined between periods. For example, in the total sample, the odds of enrolment declined from 2013-2014 to 2016-2017 by 22% (Odds Ratio=0.78, 95% Confidence Interval=0.75-0.81).
Conclusions: Racial disparities in MTM enrolment were found between Blacks and Whites among Medicare beneficiaries with diabetes in both periods and among individuals with hypertension in 2013-2014. As overall enrolment fell between periods, concerns about program enrolment remain.
{"title":"Racial and ethnic disparities in the enrolment of medicare medication therapy management programs.","authors":"Joseph Garuccio, Chi Chun Steve Tsang, Jim Y Wan, Ya Chen Tina Shih, Marie A Chisholm-Burns, Samuel Dagogo-Jack, William C Cushman, Xiaobei Dong, Jamie A Browning, Rose Zeng, Junling Wang","doi":"10.1093/jphsr/rmad010","DOIUrl":"10.1093/jphsr/rmad010","url":null,"abstract":"<p><strong>Objectives: </strong>Racial/ethnic disparities have been found in prior literature examining enrolment in Medicare medication therapy management programs. However, those studies were based on various eligibility scenarios because enrolment data were unavailable. This study tested for potential disparities in enrolment using actual MTM enrolment data.</p><p><strong>Methods: </strong>Medicare Parts A&B claims, Medication Therapy Management Data Files, and the Area Health Resources File from 2013 to 2014 and 2016 to 2017 were analysed in this retrospective analysis. An adjusted logistic regression compared odds of enrolment between racial/ethnic minorities and non-Hispanic Whites (Whites) in the total sample and subpopulations with diabetes, hypertension, or hyperlipidaemia. Trends in disparities were analysed by including interaction terms in regressions between dummy variables for race/ethnic minority groups and period 2016-2017.</p><p><strong>Key findings: </strong>Disparities in MTM enrolment were detected between Blacks and Whites with diabetes in 2013-2014 (Odds Ratio = 0.78, 95% Confidence Interval = 0.75-0.81). This disparity improved from 2013-2014 to 2016-2017 for Blacks (Odds Ratio=1.08, 95% Confidence Interval = 1.04-1.11) but persisted in 2016-2017 (Odds Ratio = 0.84, 95% Confidence Interval = 0.81-0.87). A disparity was identified between Blacks and Whites with hypertension in 2013-2014 (Odds Ratio = 0.92, 95% Confidence Interval = 0.89-0.95) but not in 2016-2017. Enrolment for all groups, however, declined between periods. For example, in the total sample, the odds of enrolment declined from 2013-2014 to 2016-2017 by 22% (Odds Ratio=0.78, 95% Confidence Interval=0.75-0.81).</p><p><strong>Conclusions: </strong>Racial disparities in MTM enrolment were found between Blacks and Whites among Medicare beneficiaries with diabetes in both periods and among individuals with hypertension in 2013-2014. As overall enrolment fell between periods, concerns about program enrolment remain.</p>","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9722997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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