Sainul Abideen Parakkal, Faisal Ahmed Hakeem, Hafees Madathil, H. S. Nemr, Fuad Hamed Ghamdi
Previous studies indicate a higher prevalence of inappropriate drug usage in patients with renal disease in ambulatory care settings and a higher rate of non-compliance with the renal dose adjustment protocol. This study aimed to investigate the number of renal dose adjustments recommended by pharmacists in ambulatory care settings, acceptance rate by the physicians and medications involved. This two-year retrospective study was conducted in an ambulatory care pharmacy in a Saudi Arabian tertiary care hospital. Based on the renal protocol at the study site, the pharmacists recommended dose adjustments for inappropriate medication orders, and the outcomes were documented electronically. A quantitative descriptive analysis of this practice was performed by retrieving the pharmacists’ documentation from electronic health records. Only protocol-compliant recommendations with proper documentation were included in the study. A total of 302 renal dose adjustments were recommended by pharmacists for 269 patients involving 47 medications, with an average of 1.12 recommendations per patient. The average monthly recommendation was 12.58 (median: 11; SD: 5.174; 95% Confidence Interval (CI), 12 to 13.16). Of the 302 recommendations, 219 (72.52%) were accepted by the physician, and 71 (23.51%) were not. The most common medications accepted for renal dosage adjustment included levofloxacin (8.94%), metformin (5.29%), amoxicillin-clavulanate (5.29%), cetirizine (4.97%), diclofenac (4.64%), ciprofloxacin (3.97%) and nitrofurantoin (3.31%). The pharmacist’s renal dose recommendations have a high acceptance rate in ambulatory care. This study demonstrated that ambulatory care pharmacists play a substantial clinical role in reducing inappropriate drug use in patients with renal disease.
{"title":"Pharmacist-driven renal dose optimization practice—outcomes of a retrospective study in ambulatory care settings","authors":"Sainul Abideen Parakkal, Faisal Ahmed Hakeem, Hafees Madathil, H. S. Nemr, Fuad Hamed Ghamdi","doi":"10.1093/jphsr/rmac020","DOIUrl":"https://doi.org/10.1093/jphsr/rmac020","url":null,"abstract":"\u0000 \u0000 \u0000 Previous studies indicate a higher prevalence of inappropriate drug usage in patients with renal disease in ambulatory care settings and a higher rate of non-compliance with the renal dose adjustment protocol. This study aimed to investigate the number of renal dose adjustments recommended by pharmacists in ambulatory care settings, acceptance rate by the physicians and medications involved.\u0000 \u0000 \u0000 \u0000 This two-year retrospective study was conducted in an ambulatory care pharmacy in a Saudi Arabian tertiary care hospital. Based on the renal protocol at the study site, the pharmacists recommended dose adjustments for inappropriate medication orders, and the outcomes were documented electronically. A quantitative descriptive analysis of this practice was performed by retrieving the pharmacists’ documentation from electronic health records. Only protocol-compliant recommendations with proper documentation were included in the study.\u0000 \u0000 \u0000 \u0000 A total of 302 renal dose adjustments were recommended by pharmacists for 269 patients involving 47 medications, with an average of 1.12 recommendations per patient. The average monthly recommendation was 12.58 (median: 11; SD: 5.174; 95% Confidence Interval (CI), 12 to 13.16). Of the 302 recommendations, 219 (72.52%) were accepted by the physician, and 71 (23.51%) were not. The most common medications accepted for renal dosage adjustment included levofloxacin (8.94%), metformin (5.29%), amoxicillin-clavulanate (5.29%), cetirizine (4.97%), diclofenac (4.64%), ciprofloxacin (3.97%) and nitrofurantoin (3.31%).\u0000 \u0000 \u0000 \u0000 The pharmacist’s renal dose recommendations have a high acceptance rate in ambulatory care. This study demonstrated that ambulatory care pharmacists play a substantial clinical role in reducing inappropriate drug use in patients with renal disease.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43806085","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 aim of this study was to assess antipsychotic medication adherence and its relation to Psychiatric symptoms in a sample of patients with schizophrenia in Palestine. Patients were recruited from the governmental psychiatry clinic in Ramallah in a cross-sectional study. The self-reported Morisky–Green–Levine (MGL) scale was used to measure patients’ adherence. Psychiatric symptoms were measured using the expanded Brief Psychiatric Rating Scale (BPRS-E). Of the 130 participants in the study, 78 (60%) were men and mean age was 41.8 ± 9.8 years 70 (53.8%). of the sample participants were classified as low-adherent while 60 (46.2%) of patients classified as high adherent. That negative symptom scores of high adherence group are significantly lower than low adherence group (12.5 vs. 15.0, P = 0.002) and lower depression anxiety scores (18.3 vs. 22.1, P < 0.001) indicated that high adherence group had lower depression, anxiety, social isolation, anxiety and suicidal ideation symptoms than low-adherence group. The multivariate regression model demonstrated that four variables remain significant and associated with nonadherence; no formal education (OR = 2.11; CI: 0.8–3.8; P = 0.04), age (OR = 2.88; CI: 1.2–4.4; P = 0.01), having comorbidity (OR = 3.2; CI: 1.9–4.3; P = 0.01) and having higher negative symptoms scores (OR = 2.5; CI: 1.2–3.9; P = 0.03); as they are positively correlated to nonadherence. Medication nonadherence was significant, and it was linked to poor psychiatric outcomes and adherence scores were unaffected by medication-related variables.
{"title":"Evaluation of antipsychotic medication adherence and its relation to negative and positive psychiatric symptoms","authors":"Maher R. Khdour, A. Salman","doi":"10.1093/jphsr/rmac019","DOIUrl":"https://doi.org/10.1093/jphsr/rmac019","url":null,"abstract":"\u0000 \u0000 \u0000 The aim of this study was to assess antipsychotic medication adherence and its relation to Psychiatric symptoms in a sample of patients with schizophrenia in Palestine.\u0000 \u0000 \u0000 \u0000 Patients were recruited from the governmental psychiatry clinic in Ramallah in a cross-sectional study. The self-reported Morisky–Green–Levine (MGL) scale was used to measure patients’ adherence. Psychiatric symptoms were measured using the expanded Brief Psychiatric Rating Scale (BPRS-E).\u0000 \u0000 \u0000 \u0000 Of the 130 participants in the study, 78 (60%) were men and mean age was 41.8 ± 9.8 years 70 (53.8%). of the sample participants were classified as low-adherent while 60 (46.2%) of patients classified as high adherent. That negative symptom scores of high adherence group are significantly lower than low adherence group (12.5 vs. 15.0, P = 0.002) and lower depression anxiety scores (18.3 vs. 22.1, P < 0.001) indicated that high adherence group had lower depression, anxiety, social isolation, anxiety and suicidal ideation symptoms than low-adherence group. The multivariate regression model demonstrated that four variables remain significant and associated with nonadherence; no formal education (OR = 2.11; CI: 0.8–3.8; P = 0.04), age (OR = 2.88; CI: 1.2–4.4; P = 0.01), having comorbidity (OR = 3.2; CI: 1.9–4.3; P = 0.01) and having higher negative symptoms scores (OR = 2.5; CI: 1.2–3.9; P = 0.03); as they are positively correlated to nonadherence.\u0000 \u0000 \u0000 \u0000 Medication nonadherence was significant, and it was linked to poor psychiatric outcomes and adherence scores were unaffected by medication-related variables.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49642866","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}
M. Zaini, R. A. Abu Farha, R. Abutayeh, Wesam Alsaud, A. Hammoudeh, A. Al-Shudifat, Thamer Al-Kharabsheh
The aim of this study was to assess Jordanian physicians’ awareness about venous thromboembolism (VTE) risk among COVID-19 patients and its treatment protocol. This was a cross-sectional-based survey that was conducted in Jordan in 2020. During the study period, a convenience sample of physicians working in various Jordanian hospitals were invited to participate in this study. Physicians’ knowledge was evaluated and physicians gained one point for each correct answer. Then, a knowledge score out of 23 was calculated for each. In this study, 102 physicians were recruited. Results from this study showed that most of the physicians realize that all COVID-19 patients need VTE risk assessment (n = 69, 67.6%). Regarding VTE prophylaxis, the majority of physicians (n = 91, 89.2%) agreed that low molecular weight heparin (LMWH) is the best prophylactic option for mild-moderate COVID-19 patients with high VTE risk. Regarding severe/critically ill COVID-19 patients, 75.5% of physicians (n = 77) recognized that LMWH is the correct prophylactic option in this case, while 80.4% of them (n = 82) knew that mechanical prevention is the preferred prophylactic option for severe/critically ill COVID-19 patients with high bleeding risk. Moreover, 77.5% of physicians (n = 79) knew that LMWH is the treatment of choice for COVID-19 patients diagnosed with VTE. Finally, linear regression analysis showed that consultants had an overall higher knowledge score about VTE prevention and treatment in COVID-19 patients compared with residents (P = 0.009). All physicians knew about VTE risk factors for COVID-19 patients. However, consultants showed better awareness of VTE prophylaxis and treatment compared with residents. We recommend educational workshops be conducted to enhance physicians’ knowledge and awareness about VTE thromboprophylaxis and management in COVID-19 patients.
{"title":"Assessment of Jordanian physicians’ knowledge about venous thromboembolism risk and management among COVID-19 patients","authors":"M. Zaini, R. A. Abu Farha, R. Abutayeh, Wesam Alsaud, A. Hammoudeh, A. Al-Shudifat, Thamer Al-Kharabsheh","doi":"10.1093/jphsr/rmac021","DOIUrl":"https://doi.org/10.1093/jphsr/rmac021","url":null,"abstract":"\u0000 \u0000 \u0000 The aim of this study was to assess Jordanian physicians’ awareness about venous thromboembolism (VTE) risk among COVID-19 patients and its treatment protocol.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional-based survey that was conducted in Jordan in 2020. During the study period, a convenience sample of physicians working in various Jordanian hospitals were invited to participate in this study. Physicians’ knowledge was evaluated and physicians gained one point for each correct answer. Then, a knowledge score out of 23 was calculated for each.\u0000 \u0000 \u0000 \u0000 In this study, 102 physicians were recruited. Results from this study showed that most of the physicians realize that all COVID-19 patients need VTE risk assessment (n = 69, 67.6%). Regarding VTE prophylaxis, the majority of physicians (n = 91, 89.2%) agreed that low molecular weight heparin (LMWH) is the best prophylactic option for mild-moderate COVID-19 patients with high VTE risk. Regarding severe/critically ill COVID-19 patients, 75.5% of physicians (n = 77) recognized that LMWH is the correct prophylactic option in this case, while 80.4% of them (n = 82) knew that mechanical prevention is the preferred prophylactic option for severe/critically ill COVID-19 patients with high bleeding risk. Moreover, 77.5% of physicians (n = 79) knew that LMWH is the treatment of choice for COVID-19 patients diagnosed with VTE. Finally, linear regression analysis showed that consultants had an overall higher knowledge score about VTE prevention and treatment in COVID-19 patients compared with residents (P = 0.009).\u0000 \u0000 \u0000 \u0000 All physicians knew about VTE risk factors for COVID-19 patients. However, consultants showed better awareness of VTE prophylaxis and treatment compared with residents. We recommend educational workshops be conducted to enhance physicians’ knowledge and awareness about VTE thromboprophylaxis and management in COVID-19 patients.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41948447","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}
{"title":"Conspiracy theories, misinformation and the decline for respect of science","authors":"A. Wertheimer","doi":"10.1093/jphsr/rmac003","DOIUrl":"https://doi.org/10.1093/jphsr/rmac003","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43926905","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac006","DOIUrl":"https://doi.org/10.1093/jphsr/rmac006","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61661335","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac015","DOIUrl":"https://doi.org/10.1093/jphsr/rmac015","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61662492","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac002","DOIUrl":"https://doi.org/10.1093/jphsr/rmac002","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61660944","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac004","DOIUrl":"https://doi.org/10.1093/jphsr/rmac004","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61660997","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac012","DOIUrl":"https://doi.org/10.1093/jphsr/rmac012","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61661935","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}
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/jphsr/rmac013","DOIUrl":"https://doi.org/10.1093/jphsr/rmac013","url":null,"abstract":"","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61662084","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}
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