Knowledge, perceptions and attitudes toward complementary and alternative therapies among Kuwaiti medical and pharmacy students.

OBJECTIVE: To determine the knowledge, perceived effectiveness and harmfulness of complementary and alternative medicine (CAM) modalities, general attitude and the need for education in the use of CAM therapies among medical and pharmacy students. METHODS: A descriptive and cross-sectional study was performed using a pre-tested questionnaire on a randomly selected sample of 250 students in Faculties of Medicine and Pharmacy, Kuwait University. Descriptive and logistic regression analyses were used in data analysis. RESULTS: The response rate was 88.4%. CAM usage was reported by 122 (55.2%) of students, and mostly associated with females (OR 4.4, 95% CI 1.7-11.3). Herbal products were the most commonly used (83, 37.6%). Knowledge about 11 CAM modalities was generally poor, even among the respondents who claimed to know them most. The knowledge about herbal products was significantly better among 58 pharmacy students (49.2%) than 32 medical students (31.4%) (OR 2.0, 95% CI 1.1-3.6). Massage, herbal products and prayer/Qur'an reciting were perceived as being the most effective, while cauterization as the most harmful. Attitude toward CAM was positive, with 176 (79.7%) believing that CAM includes ideas and methods from which conventional medicine could benefit. Lack of trained professionals and lack of scientific evidence were the most perceived barriers for CAM implementation. 198 (89.6%) admitted the importance of knowledge about CAM for them as future healthcare practitioners. CONCLUSION: The students acknowledged the need to be well educated about CAM to better advise their patients in the future.

Improving rational drug use in Africa: the example of Sudan.

The aim of this review is to determine the extent of irrational drug use and contributing factors in Sudan and to identify the interventions that need to be strengthened to promote the rational use of drugs in the country and to evaluate the impact of different types of intervention. We present an overview of studies describing patterns of drug prescribing, dispensing and self-medication. Rates for inappropriate prescribing and dispensing practices and prevalence of self-medication with antimicrobials and herbal products were alarmingly high. Indicators of rational drug use have worsened over the past decade despite the implementation of managerial, regulatory and training interventions. Multifaceted interventions have proved effective in changing suboptimal prescribing practices. Educational interventions are needed to address self-medication and adherence.

Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan.

OBJECTIVE: A major problem with inappropriate use of antibiotics is the emergence of resistance. Thus, cost-effective interventional strategies are required to improve their use. This study aimed to evaluate the effect of multifaceted interventions on prescribing practices of antibiotics in health centers of Khartoum State, Sudan. METHODS: Twenty health centers were randomly assigned to receive: (1) no intervention; (2) audit and feedback; (3) audit and feedback + seminar; or (4) audit and feedback + academic detailing. A total of 1,800 patient encounters, 30 from each health center, were randomly collected. The total number of encounters with antibiotics prescribed were determined in each health center and they were evaluated with regard to antibiotic choice, dose and duration of therapy before the study and at 1 and 3 months post-intervention. RESULTS: In comparison to the control group, the prescriber targeted interventions involving audit and feedback, together with academic detailing (4), reduced the mean number of encounters with an antibiotic prescribed by 6.3 and 7.7 (p<0.001) at 1 and 3 months post-intervention, respectively. In addition, the mean number of encounters with an inappropriate antibiotic with respect to diagnosis, doses and/ or duration of therapy was reduced by 5.3 and 5.9 (p<0.001) at 1 and 3 months post-intervention, respectively. For audit and feedback together with seminars (3) and for audit and feedback alone (2), the corresponding reductions were 5.3, 7.1, 4.4 and 5.1 (p<0.001) and 1.4, 2.8, 1.8 and 1.9 (p>0.05), respectively. CONCLUSION: Inappropriate prescribing patterns of antibiotics in health centers of Khartoum State, Sudan, are alarmingly high. Multifaceted interventions involving audit and feedback combined with either academic detailing or seminars appear more effective in changing prescribing practices of antibiotics than audit and feedback alone.

Changing the prescribing patterns of sexually transmitted infections in the White Nile Region of Sudan.

BACKGROUND: The number of inappropriate prescriptions for sexually transmitted infections (STIs) in Sudan is suspected to be high. Simple multifaceted interventions directed at prescribers may improve prescribing patterns in the Sudan. OBJECTIVE: To evaluate the effect of multifaceted interventions on prescribing for STIs in the White Nile State, Sudan. METHODS: The study involved 20 health centres randomly assigned to four different multifaceted interventions to improve prescribing. RESULTS: Prescriber targeted interventions involving audit and feedback together with academic detailing and practice guidelines reduced the number of inappropriate prescriptions by 50% (p < 0.001). Audit and feedback together with seminars and practice guidelines reduced inappropriate prescriptions by 43% (p < 0.001). Audit and feedback alone reduced inappropriate prescriptions by 16% (p = 0.127). CONCLUSION: Prescribing for STIs in the White Nile State of Sudan needs improving. Multifaceted interventions appear effective in improving prescribing.