Journal of Research in Pharmacy Practice最新文献

Objective: Patient satisfaction is considered an essential indicator of the treatment outcomes of pharmaceutical services. This study aimed to assess patient satisfaction with the pharmaceutical services at the Ministry of Health (MOH) hospitals in Makkah city in Saudi Arabia.

Methods: A cross-sectional study was conducted via an interview-based questionnaire that involved patients who visited the outpatient pharmacy in five MOH hospitals from August 2018 to September 2018. The data were collected using a previously published, validated, and reliable questionnaire. The questionnaire was translated and piloted for the local context.

Findings: Data of 295 respondents were analyzed. The overall mean score of satisfaction level with the pharmaceutical services was found to be 2.50 out of a maximum score of 3. The item that the patients were most satisfied with was, "The extent of cleanliness in the waiting area for the provision of pharmaceutical services" (mean = 2.80) whereas the item the patients were least satisfied with was, "The information the pharmacist gives you about the proper storage of your medication" (mean = 2.00). "Illiterate" patients and those who visited the pharmacy first time had significantly higher satisfaction levels compared to those with other educational categories and those who had visited the pharmacy before, respectively.

Conclusion: Our study showed that the overall level of satisfaction of patients with pharmaceutical services was high.

Objective: Aluminum phosphide (ALP) (rice-tablet) is a common cause of adult poisoning in Iran, including Isfahan. So far, no effective treatment has been identified for this poisoning. We aimed to investigate the outcome of ALP poisoned patients admitted to the clinical toxicology ward of Khorshid Hospital in Isfahan from 2017 to 2019.

Methods: This chart-review study was performed on the population of ALP poisoned patients admitted to the clinical toxicology ward of Khorshid University Hospital from 2017 to 2019 treated with the hospital's new treatment protocol, using the complete enumeration approach. The outcomes were determined by reviewing and abstracting medical charts of ALP poisoned patients from the hospital archive.

Findings: The most common complaints at admission were depressed consciousness (41.9%) and vomiting (32.2%). There was no significant change in blood sugar, pH, base excess (BE), and venous blood bicarbonate throughout their hospitalization (P > 0.05). Treatment outcomes had a significant relationship with blood pH 2 h and 6 h after admission and the BE 6 h after admission (P < 0.05). There was also a significant relationship between the outcome and the length of stay, initial ejection fraction (EF), and EF in predischarge echocardiography (P < 0.05). Out of 31 patients, 24 (77.4%) died within 72 h, 5 (16.1%) recovered without any complication, and 2 (6.5%) recovered with some complications.

Conclusion: The mortality rate of ALP poisoned patients was reasonably high and can be attributed to the poor efficacy of the new treatment protocol or the long time it takes for patients to reach the hospital and start receiving treatments.

Objective: Based on previous studies in the sepsis population, Vitamin C could prevent injuries when administered in high doses and before the damage is established. This study aimed to evaluate the protective potentials of high-dose Vitamin C in the progression of coronavirus disease 2019 (COVID-19).

Methods: A double-blind, placebo-controlled clinical trial was conducted. Patients with moderate-to-severe disease severity based on the World Health Organization definition were enrolled and received 12 g/d Vitamin C (high-dose intravenous Vitamin C [HDIVC]) or placebo for 4 days. Sequential Organ Failure Assessment (SOFA) score as a primary outcome, National Early Warning Score, Ordinal Scale of Clinical Improvement, and cytokine storm biomarkers were recorded on days 0, 3, and 5. Survival was also assessed on day 28 after enrollment.

Findings: Seventy-four patients (37 patients in each group) were enrolled from April 5, 2020, to November 19, 2020, and all patients completed follow-up. A lower increase in SOFA score during the first 3 days of treatment (+0.026 vs. +0.204) and a higher decrease in this parameter in the last 2 days (-0.462 vs. -0.036) were observed in the treatment group. However, these differences did not reach a significance level (P = 0.57 and 0.12, respectively). Other indices of clinical and biological improvement, length of hospitalization, and intensive care unit admission days were the same between the two groups. Treatment did not affect the 28-day mortality.

Conclusion: Among patients with moderate-to-severe disease of COVID-19, the use of HDIVC plus standard care resulted in no significant difference in SOFA score or 28-day mortality compared to the standard care alone.

Objective: Tricyclic antidepressants poisoning (TCA) is associated with cardiovascular complications, electrocardiographic abnormalities, and central nervous system toxicity. This study aimed to compare the clinical manifestations of poisoned patients with tricyclic antidepressants alone or with benzodiazepine (BZD) intoxication according to the dose of BZDs.

Methods: In this case-control study, 120 patients with TCA poisoning were divided into four groups: the first group of TCA poisoning alone, the second group of TCA and BZD poisoning of <7.75 mg, the third group of TCA and B poisoning of 7.75 to 80 mg, and the fourth group of more than 80 mg of TCA and BZD poisoning. Patients' demographic, clinical, and cardiac information was extracted from their records at admission and 6 h after admission.

Findings: Cardiac complications 6 h after referral and total cardiac complications between TCA and TCA low-dose BZD groups were significantly reduced in the low-dose BZD poisoning group. Comparison of TCA and TCA groups with a moderate dose of BZD showed a significant reduction in time six and total cardiac complications. However, due to the significant difference in TCA values between the two groups, the results are not significant. Comparing the two groups of TCA and TCA with a high dose of BZD, both 6-hour cardiac complications and total cardiac complications in the high-dose BZD group, it was significantly reduced. However, the loss of consciousness was also considerably greater in the high-dose BZD group than in the TCA group.

Conclusion: Concomitant BZDs with TCA can reduce cardiovascular complications from TCA poisoning. However, with high doses of BZDs, there is a greater loss of consciousness.

This case report aims to introduce a patient with severe hypokalemia as one of the rare complications of ondansetron injection. The stroke patient was 56 years old and hospitalized in the emergency department with and purulent sputum. The symptoms and lung computed tomography scan confirmed the diagnosis of aspiration pneumonia. A nasogastric tube was inserted, and food gavage was performed for the patient. The treatment was started with meropenem to manage aspiration pneumonia. The patient could not tolerate the gavage. Consequently, ondansetron was prescribed, but severe hypokalemia of 2.5 mEq/l was developed. The causes of hypokalemia were evaluated. The hematological, biochemical, and liver function tests were done, and the potassium level was measured daily. Afterward, causes of hypokalemia was ruled out and with discontinuation of ondansetron the hypokalemia was resolved. Hypokalemia may be caused by ondansetron. It is required that potassium monitoring be always considered during administrating of this medicine.

Objective: One of the most common diseases with high morbidity and mortality rates is chronic kidney disease. Cardiovascular disease affects most patients with chronic kidney disorders, particularly patients undergoing dialysis; hence, appropriate prevention and management approaches are essential. This study aimed to evaluate the reduction of inflammatory biomarkers, especially homocysteine, by omega-3 fatty acids in peritoneal dialysis patients.

Methods: This study enrolled 60 peritoneal dialysis patients who met specified inclusion and exclusion criteria and were randomized to intervention or placebo groups. Omega-3 capsules were given at a dose of 3 g/d for 8 weeks. Inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), homocysteine, albumin, and lipid profile measured before and after the study.

Findings: Results of this trial revealed that the levels of homocysteine, hs-CRP, and albumin did not change significantly during the study. Analysis of lipid profiles before and after intervention showed omega-3 has no significant effect on the level of total cholesterol or low-density lipoprotein cholesterol; However, the level of triglyceride reduced remarkably (P = 0.002). In addition, serum levels of high-density lipoprotein cholesterol increased at the end of the study (P < 0.001).

Conclusion: Omega-3 does not seem to be able to change the inflammatory markers significantly, particularly homocysteine. More extensive trials must be conducted to better understand the impact of omega-3 on inflammatory and nutritional markers, particularly in peritoneal dialysis patients.

Objective: After the commencement of the Internet and the popularity of various electronic devices, cyberloafing has become prevalent in the workplace regardless of professional type, demographic characteristics, and country. Individuals use the Internet for work-irrelevant purposes during work hours, which is believed to have a controversial role in work productivity. However, rare studies have paid attention to the prevalence of cyberloafing behavior among Pakistan pharmacists. Considering pharmacists' essential role in the health sector, this study investigates the prevalence of cyberloafing activities among workplace pharmacists in Pakistan.

Methods: This cross-sectional survey was conducted among 242 registered pharmacists in Pakistan between October 2021 and February 2022 with a structured self-administered online questionnaire. The final sample consisted of 200 valid responses after screening. Data were processed through exploratory factor analysis and confirmatory factor analyses. Pearson Chi-square analysis was also used to test the correlation between factors.

Findings: Descriptive analysis shows that pharmacists spend more time on sharing-related activities and least on gambling/gaming-related activities in the workplace. All the items' Cronbach's alpha values range from 0.923 to 0.927. The analysis indicates that (60%) pharmacists have intermediate Internet skills. The results also suggest that age, Internet usage, and work area have a strong relationship with cyberloafing behaviors which also, in turn, are linked with their perceived Internet skills. This study has important practical implications for pharmacy management in Pakistan.

Conclusion: Cyberloafing behavior is prevalent among Pakistan pharmacists. Our findings could inspire how managers and all other relevant stakeholders could improve the pharmacy system in Pakistan.

Objective: This study aimed to assess the community pharmacists' knowledge of antibiotics, their attitude toward antibiotic usage and antibiotic resistance, and their nonprescription dispensing practices of antibiotics.

Methods: A cross sectional-questionnaire-based study was conducted among 75 community pharmacists practicing in a selected city of South India. Data on their age, years of experience, and educational qualifications were obtained. A modified, 33-items, prevalidated structured questionnaire was used to assess the community pharmacists knowledge, attitude, and nonprescription antibiotic dispensing practices knowledge, attitudes and practices (KAP). The responses obtained were expressed in descriptive statistics. The association between years of experience and their KAP was assessed using Pearson's correlation.

Findings: Most pharmacists (60%) agreed that antibiotics are used for bacterial infections, and 35% believed that antibiotics could be given for pain and inflammation. Fourty-one percentage of pharmacists agreed that dispensing antibiotics without prescription increases the risk of antibiotic resistance. Seventy-two percentage agreed that they are responsible for taking a prominent role in antimicrobial resistance and infection-control programs in healthcare. Only 46% of pharmacists stated that they always dispensed antibiotics only with a prescription, and 56% dispensed antibiotics for longer than the doctor prescribed. Amoxicillin, metronidazole, and cephalexin were the most commonly dispensed antibiotics without a prescription. The most common reason for dispensing antibiotics without a prescription was the fear of losing customers.

Conclusion: The study identified an average KAP interquartile range 1 among community pharmacists, indicating a lack of awareness of antibiotic resistance and dispensing antibiotics without a prescription.

Identification of the severe acute respiratory syndrome coronavirus 2 in humans toward the end of 2019 triggered a rapid, intensive effort to develop a vaccine. Among the first three COVID-19 vaccines granted emergency use authorization by the U. S. Food and Drug Administration (FDA) were two mRNA vaccines, never used on a large scale in humans, and one replication-incompetent human adenovirus vector vaccine. Since the beginning of the vaccination efforts in December 2020, almost 220,000 adverse events (AEs) have been reported through the Vaccine Adverse Event Reporting System, a reporting platform administered jointly by the FDA and the Centers for Disease Control to monitor vaccine-related AEs. We queried this database twice (04/23/21 and 05/14/21) and identified the AE reports with valid manufacturer-specific lot numbers (n = 76,336), a subset representing 33.54% of the total reported AEs. Using vaccine and demographic characteristics at the time of each query date, a model was generated to predict significant AEs, such as death. Our regression analysis revealed that the average age (IRR 1.08) and the number of doses administered in an assisted living facility (IRR 1.01) were significantly associated with the number of deaths observed in each lot, whereas the proportion of remaining vaccine shelf-life (IRR 1.30) and the vaccine manufacturer (IRR 1.09) were not. Studies such as this one are vital, as one of the best answers to vaccine hesitancy is reliable data confirming that the available COVID-19 vaccines are safe and not associated with a significantly higher risk of AEs than vaccines for other conditions.

Objective: This study aimed to measure patient satisfaction with community pharmacy in Isfahan, Iran, in 2019.

Methods: In this cross-sectional study (2019), we selected 104 pharmacies located in the second largest city of Iran (Isfahan) based on systematic random sampling and at least five clients at different times of a day who finished the process of obtaining medications from the pharmacies were randomly selected for a short and structured interview using the Persian version of the MacKeigan and Larson questionnaire for measuring patients' satisfaction with pharmacy services.

Findings: The reliability of the questionnaire was confirmed after distributing 520 among the patients (r = 0.958). No significant difference was observed between sex, marital status, housing status, and total satisfaction score based on the results. In addition, there was a significant difference between educational levels, location, job status, insurance status, real income, and total score of satisfaction (P < 0.05). Our results revealed acceptable satisfaction in some aspects, such as paying attention to pharmacists, the general condition of the pharmacy, and their technical competence. On the other hand, the patients were not satisfied enough in different aspects, for example, counseling, accessibility to their needed drugs, and expenses.

Conclusion: Patient satisfaction needs to be improved and enhanced in the case of counseling the patients on their medications, and drug accessibility and expenses remain the primary source of dissatisfaction in the studied population, which should be noted by the Iranian Food and Drug Organization and other related authorities.