A retrospective analysis of the pharmacovigilance data registry in a tertiary teaching hospital in Jordan.

Objectives: The study aims to analyse adverse drug reaction (ADR) reporting patterns at Jordan University Hospital to enhance pharmacovigilance practices. Methods: Retrospective analysis of ADR data from February to August 2023 was conducted. Data included patient demographics, drugs implicated, seriousness criteria, and system organ classes affected. Results: Among 1340 ADR reports analysed, females accounted for 67.4% of cases, with adults aged 18 to less than 65 years comprising 95.3% of reports. The majority of ADRs were non-serious, with only 2.1% resulting in hospitalisation or prolonged hospital stay. The most frequently reported ADRs included abdominal pain (8.3%), nausea (6.9%), headache (4.7%), and dizziness (4.7%). Notably, cardiovascular system drugs (16.4%) and alimentary tract and metabolism drugs (16.2%) were commonly associated with ADRs, followed by musculoskeletal system drugs (9.0%). Additionally, among all reported drugs, 99.9% were considered suspects, (suspected ADR cases include patient treatment cases for which a likelihood of being related to a drug therapy was scored as 'possible', 'probable', or 'certain' after causality assessment (by the WHO-UMC system in 2017), with oral administration being the predominant route (89.5%). Conclusion: The study highlights a notable increase in ADR reporting during the study period compared to historical data, indicating heightened awareness and understanding among healthcare providers. Enhanced pharmacovigilance practices, particularly involving pharmacists, are essential for detecting and reporting ADRs effectively. Further investigation into factors contributing to prevalent serious ADRs is warranted to improve patient safety and health outcomes.

Awareness, perspectives and practices of antibiotics deprescribing among physicians in Jordan: a cross-sectional study.

Background: Antibiotics have significantly reduced mortality and improved outcomes across various medical fields; however, the rise of antibiotic resistance poses a major challenge, causing millions of deaths annually. Deprescribing, a process that involves discontinuing unnecessary antibiotics, is crucial for combating this threat. This study was designed to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. Methods: A cross-sectional survey was conducted between January-February 2024 to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. An electronic questionnaire served as the data collection tool. Descriptive analysis was performed using SPSS software version 26. Additionally, logistic regression analysis was carried out to identify independent factors associated with physicians' willingness to deprescribe antibiotics. Results: The study involved 252 physicians, primarily male (n = 168, 67.7%), with a median age of 33 years. Regarding antibiotics deprescribing, 21.8% (n = 55) expressed willingness to deprescribe inappropriate antibiotics.High awareness of deprescribing was evident, with 92.9% (n = 234) familiar with the concept, 94% (n = 237) knowledgeable about appropriate situations, and 96.8% (n = 244) recognising its potential benefits. Furthermore, 81.8% (n = 205) reported having received formal training in antibiotics deprescribing, and 85.3% (n = 215) were informed about the availability of deprescribing tools.Physicians highlighted challenges including insufficient time (44.4%, n = 112) and resistance from patients (41.3%, n = 104) and colleagues (42.1%, n = 106). Despite challenges, a significant proportion regularly assessed antibiotic necessity (46.9%, n = 117) and educated patients about antibiotic-related harms (40.5%, n = 102). Logistic regression analysis revealed no significant demographic factors influencing physicians' willingness to deprescribe antibiotics (p > 0.05). Conclusion: Physicians in Jordan exhibit high awareness of antibiotics deprescribing and recognise its benefits. Challenges such as time constraints and communication barriers need to be addressed to facilitate effective deprescribing practices. Comprehensive guidelines and interdisciplinary collaboration are essential for promoting judicious antibiotic use and combating antimicrobial resistance.

Evaluating community pharmacists awareness, perception and roles in providing emergency contraceptives in Jordan.

OBJECTIVE: This cross-sectional study aimed to assess Jordanian community pharmacists' awareness, perception, and roles concerning emergency contraceptives provision. STUDY DESIGN: We administered a structured questionnaire to community pharmacists in Jordan using convenience sampling. The questionnaire included sections on demographic information, knowledge about emergency contraceptives, perception towards emergency contraceptive, and prior experience in emergency contraceptives provision. RESULTS: A total of 299 community pharmacists responded to the study. Most pharmacists had a Pharm D/BPharm degree (94.6%) and worked in independent community pharmacies (75.6%). While pharmacists demonstrated relatively high knowledge scores regarding emergency contraception, with a median score of 10 out of 14, misconceptions persisted, particularly regarding the mechanism of action and side effects of emergency contraception. Pharmacists expressed mixed perceptions regarding emergency contraception, with a significant proportion advocating for prescription-only access (76.6%) and expressing ethical reservations (48.2%). Only 38.1% reported prior experience in emergency contraceptives provision. Regression analyses revealed that attendance at emergency contraceptives-focused workshops significantly increased the likelihood of pharmacists providing emergency contraceptives (Adjusted Odds Ratio=2.569, p = 0.001). CONCLUSIONS: Jordanian community pharmacists exhibit readiness to provide emergency contraceptives, but persistent misconceptions and regulatory barriers hinder optimal provision. Targeted educational interventions, particularly through workshops, are crucial in enhancing pharmacists' knowledge and promoting emergency contraceptives provision. IMPLICATIONS: Responding pharmacists often reported the misconception that emergency contraceptives can cause abortion. Also, some pharmacists expressed religious or moral objections to prescribing oral emergency contraceptives. Thus, this study underscores the importance of receiving comprehensive training on ethical and religious considerations in healthcare practice.

Acute COPD exacerbations and in-hospital treatment-related problems: An observational study.

BACKGROUND: Treatment-related problems (TRPs) interfere with the ability to attain the desired goals of treatment, adding cost to healthcare systems. Patients hospitalized with acute conditions are at particular risk to experience TRPs. Data investigating such burden in patients with acute exacerbation of COPD (AECOPD) is generally scarce with no studies ever conducted in Jordan. This study aimed to investigate and categorize TRPs among patients hospitalized with AECOPD in Jordan, and to estimate their cost savings and cost avoidance. METHODS: This was a retrospective population-based cohort study. Patients' cases of AECOPD admitted to the study site from Jan 2017 to Jul 2021 were identified from the electronic clinical database and screened for eligibility. TRPs were identified/categorized using AbuRuz tool and assessed for their severity. Cost saving was estimated by calculating all the extra costs. Cost avoidance was estimated according to Nesbit method. RESULTS: A total of 1243 (mean±SD 3.1±1.5) and 503 (mean±SD 1.3±1.2) TRPs were identified during hospitalization and at discharge respectively, of which 49.4% and 66.7% were classified as "unnecessary drug therapy". In 54.5% of the cases, systemic corticosteroid was administered for a period longer than recommended. Most of the TRPs were of moderate severity. The total direct cost saving, and cost avoidance were estimated to be 15,745.7 USD and 340,455.5 USD respectively. CONCLUSION: The prevalence and cost of TRPs among AECOPD patients is a concern requiring attention. The study results implicate integrating interventions such as embracing clinical pharmacists' role in the respiratory care units to optimize patients' management.

Community Pharmacists' Identifying and Counseling of Breastfeeding Women: A Study from Jordan.

Background: This study explored the approaches of Jordanian community pharmacists to identifying and counseling breastfeeding mothers regarding medication usage. Methods: This cross-sectional study used self-administered questionnaires. A convenience sample (n=381) of Jordanian community pharmacists was recruited through social media. The responses were statistically analyzed using IBM SPSS ver. 25.0 (IBM Corp., USA). Results: The majority of recruited pharmacists were female (n=329, 86.4%). Asking every woman was Jordanian pharmacists' preferred approach to identifying breastfeeding women (n=211, 55.4%). The study showed that around one-third of the pharmacists (n=128, 33.6%) reported that they currently experienced queries regarding medication use during breastfeeding on a daily basis. Additionally, the majority (n=325, 85.3%) of pharmacists reported feeling confident, and 67.2% of them (n=256) reported feeling comfortable while giving advice to breastfeeding women. The surveyed pharmacists relied on different resources during their course of practice to answer queries related to medicine usage by breastfeeding mothers. Conclusion: Community pharmacists have continuous interactions with breastfeeding women. Pharmacists require reliable and updated data access to answer queries related to medication use while breastfeeding.

Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study.

This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.

Audit of adherence to international guidelines (IDSA) in the treatment of infectious meningitis in pediatric patients in Jordan.

OBJECTIVE: This study aims to audit the adherence of Jordanian medical care staff to the guidelines provided by the Infectious Disease Society of America (IDSA) for managing pediatric patients admitted with suspected cases of meningitis. METHODS: A retrospective observational study was conducted at Jordan University Hospital (JUH). All pediatric patients admitted to JUH with suspected meningitis between January 1, 2019, and September 30, 2022, who underwent Cerebrospinal Fluid (CSF) and blood culture tests were recruited in this study unless there was a reason for exclusion. The study collected data on the empiric antibiotics prescribed prior to diagnostic cultures and susceptibility results. Additionally, the length of hospital stay and all-cause mortality were observed. The appropriateness of antibiotics prescription before culture results was compared to IDSA guidelines, and an overall adherence rate was calculated. RESULTS: A total of 332 pediatric patients were included in this study, of whom 12.3% (n = 41) were diagnosed with bacterial meningitis. Among the enrolled pediatric patients, only 27 patients (8.1%) received appropriate treatment adhering to the IDSA guidelines. The remaining 91.9% (n = 305) showed various forms of non-adherence to recommendations. The highest adherence rate was observed for performing CSF culture (n = 330, 99.4%), while the lowest adherence rate was found in selecting the appropriate dose and duration for empiric antibiotics (n = 107, 41.3% and n = 133, 51.0%, respectively). CONCLUSION: This study revealed a low overall adherence in the management of pediatric patients with meningitis in Jordan. Establishing an antimicrobial stewardship program may improve the outcomes of meningitis infections found in Jordan, and prevent dangerous adverse effects and bacterial resistance.

Assessing the predictive value of neutrophil percentage to albumin ratio for ICU admission in ischemic stroke patients.

Background: Acute ischemic stroke (AIS) remains a substantial global health challenge, contributing to increased morbidity, disability, and mortality. This study aimed at investigating the predictive value of the neutrophil percentage to albumin ratio (NPAR) in determining intensive care unit (ICU) admission among AIS patients. Methods: A retrospective observational study was conducted, involving AIS cases admitted to a tertiary hospital in Jordan between 2015 and 2020. Lab data were collected upon admission, and the primary outcome was ICU admission during hospitalization. Descriptive and inferential analyses were performed using SPSS version 29. Results: In this study involving 364 AIS patients, a subset of 77 (21.2%) required admission to the ICU during their hospital stay, most frequently within the first week of admission. Univariable analysis revealed significantly higher NPAR levels in ICU-admitted ischemic stroke patients compared to those who were not admitted (23.3 vs. 15.7, p < 0.001), and multivariable regression models confirmed that higher NPAR (≥19.107) independently predicted ICU admission in ischemic stroke patients (adjusted odds ratio [aOR] = 4.85, 95% CI: 1.83-12.83). Additionally, lower GCS scores and higher neutrophil-to-lymphocyte ratio (NLR) were also associated with increased likelihood of ICU admission. In terms of predictive performance, NPAR showed the highest accuracy with an AUC of 0.885, sensitivity of 0.805, and specificity of 0.854, using a cutoff value of 19.107. NPAR exhibits an AUC of 0.058, significantly outperforming NLR (Z = 2.782, p = 0.005). Conclusion: NPAR emerged as a robust independent predictor of ICU admission in ischemic stroke patients, surpassing the predictive performance of the NLR.

An evaluation of pharmacists' general attitudes, knowledge, and phobias regarding medications that include corticosteroids: a cross-sectional study.

BACKGROUND: Corticosteroid-containing medications are widely accessible in various forms, including topical, injectable, and inhaled formulations. Due to uncertain safety profiles, healthcare providers, including pharmacists, often express apprehension when dispensing these drugs. This cross-sectional study assesses the knowledge, attitudes, and phobia of Jordanian pharmacists regarding corticosteroid-containing medications. METHODS: Conducted through a self-administered online questionnaire. RESULTS: the study reveals that dermatological conditions and respiratory disorders are the primary indications for prescribing corticosteroid-containing drugs. The most reported side effects among pharmacists' patients include increased appetite, diabetes, and skin thinning. Pharmacists generally exhibit acceptable knowledge, with a median score of 9.0 out of 11.0 (IQR = 3.0). Over two-thirds of pharmacists (69.9%) achieve a high knowledge score (Bloom's cut-off point ≥ 8.8). However, only 55.7% are aware that corticosteroids may induce mood changes. High phobia scores, particularly concerning increased blood pressure and osteoporosis risks, indicate pharmacist reservations in corticosteroid dispensing. Interestingly, pharmacists in rural areas display lower knowledge scores, while those working outside community pharmacies exhibit lower phobia scores compared to their counterparts in urban areas and community pharmacies, respectively. CONCLUSION: Despite generally good knowledge levels, the study underscores high phobia scores among Jordanian pharmacists regarding corticosteroid dispensing, particularly due to concerns about blood pressure elevation and osteoporosis risks. This suggests a potential need for targeted educational interventions and support systems to enhance pharmacist confidence and optimize corticosteroid usage while minimizing associated risks.

Exploring Community Pharmacists' Perception and Readiness Toward Telepharmacy Implementation in Jordan: A Cross-Sectional Study.

Objective: The present study was conducted to assess the perceptions and readiness of pharmacists toward implementing "Telepharmacy" in Jordan. Methods: This was a cross-sectional study that was conducted between April and May 2023. Any licensed community pharmacists practicing in Jordan were considered to be eligible to be included in this study. Pharmacists were approached at their pharmacy store using a convenience sampling method. Logistic regression analysis was utilized to identify predictors affecting pharmacists readiness to implement telepharmacy services. Results: Two hundred eighteen community pharmacists volunteered to participate in this study. Roughly around 42% of the pharmacists (n = 91) reported that they have previously used telepharmacy. More than 70% of the pharmacists believed that telepharmacy decreases the patient's visits to hospitals, private clinics, or pharmacies (n = 165, 75.7%). In addition, more than 65% of the pharmacists expressed their concerns that telepharmacy service may increase pharmacists' workload and commitment (n = 150, 68.8%), and it has a higher error rate for medication dispensing and filling (n = 147, 67.4%). Nearly 70% of the pharmacists (n = 153) expressed their readiness to implement telepharmacy. Regression analysis showed that pharmacists who had previous experience in using telepharmacy service and those who showed more positive perception toward telepharmacy showed significantly higher readiness to implement telepharmacy service (p < 0.001 for both). Conclusions: The utilization of telepharmacy by community pharmacists in Jordan is still limited. The adaption of telepharmacy faces many challenges, including a negative attitude from the pharmacist, financial reimbursement, training, regulations, and competency in and access to efficient technology.

Community Pharmacists' Current Practice and Educational Needs in Breastfeeding Support in Jordan: A Cross-Sectional Study.

BACKGROUND: Improving breastfeeding practices is a worldwide priority. Pharmacists have the opportunity to actively promote breastfeeding and educate parents as well as the general public about its benefits. RESEARCH AIMS: The aims of this study are to investigate Jordanian pharmacists' present breastfeeding support practices and perceptions regarding their need for education and training in breastfeeding support. METHODS: To examine sociodemographic characteristics of community pharmacists in Jordan and their current breastfeeding support practices and educational needs, a descriptive cross-sectional online (self-report) survey was conducted. Through social media, pharmacists working in community pharmacies in Jordan were recruited between August 2021 and February 2022. The level of breastfeeding support participants had been provided with was measured using eight items in a 5-point Likert scale ranging from 5 (Always) to 1 (Never). Each participant self-reported the frequency of advice/information given to breastfeeding women in each of these areas. Univariate and multivariable linear regression models were used to identify factors associated with the level of breastfeeding support. RESULTS: Participants (N = 381) reported a high level of breastfeeding support, but expressed a need for training and education for further improvement. The breastfeeding support score of female participants was found to be 0.12 higher than that of males (Beta = 0.12, p = .02), 0.16 higher in married participants compared to non-married participants (Beta = 0.16, p = .03), and 0.10 higher in participants working in rural areas compared to those working in urban areas (Beta = 0.10, p = .04). CONCLUSION: While community pharmacists generally report a high level of breastfeeding support, our findings revealed demographic differences. Attention to specific areas of need might enhance what pharmacists could offer; however, additional research would be required to guide the specific educational content.

Perceptions and Knowledge of Public Towards Emerging Human Monkeypox in Yemen: A Cross-Sectional Study.

Background: The spread of monkeypox (mpox) worldwide poses a severe threat to human life. This virus leads to a disease with symptoms similar to smallpox in humans. To combat this threat, improving public knowledge and perception toward mpox is vital for public health preventive measures. Methods: A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables. Results: A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351). Conclusion: The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.

ChatGPT and Clinical Training: Perception, Concerns, and Practice of Pharm-D Students.

Background: The emergence of Chat-Generative Pre-trained Transformer (ChatGPT) by OpenAI has revolutionized AI technology, demonstrating significant potential in healthcare and pharmaceutical education, yet its real-world applicability in clinical training warrants further investigation. Methods: A cross-sectional study was conducted between April and May 2023 to assess PharmD students' perceptions, concerns, and experiences regarding the integration of ChatGPT into clinical pharmacy education. The study utilized a convenient sampling method through online platforms and involved a questionnaire with sections on demographics, perceived benefits, concerns, and experience with ChatGPT. Statistical analysis was performed using SPSS, including descriptive and inferential analyses. Results: The findings of the study involving 211 PharmD students revealed that the majority of participants were male (77.3%), and had prior experience with artificial intelligence (68.2%). Over two-thirds were aware of ChatGPT. Most students (n= 139, 65.9%) perceived potential benefits in using ChatGPT for various clinical tasks, with concerns including over-reliance, accuracy, and ethical considerations. Adoption of ChatGPT in clinical training varied, with some students not using it at all, while others utilized it for tasks like evaluating drug-drug interactions and developing care plans. Previous users tended to have higher perceived benefits and lower concerns, but the differences were not statistically significant. Conclusion: Utilizing ChatGPT in clinical training offers opportunities, but students' lack of trust in it for clinical decisions highlights the need for collaborative human-ChatGPT decision-making. It should complement healthcare professionals' expertise and be used strategically to compensate for human limitations. Further research is essential to optimize ChatGPT's effective integration.

Acinetobacter baumannii: assessing susceptibility patterns, management practices, and mortality predictors in a tertiary teaching hospital in Lebanon.

BACKGROUND: Acinetobacter baumannii is a major nosocomial pathogen capable of causing life-threatening infections. This bacterium is highly resistant to antibiotics and associated with high mortality rates. Therefore, this study aimed to evaluate A. baumannii's susceptibility patterns to antimicrobials, assess the appropriateness of the initiated antimicrobial therapy, determine the mortality rate, and identify predictors associated with mortality. METHODS: A retrospective observational study was conducted among patients infected with A. baumannii at a university hospital in Lebanon through the revision of medical records. Kaplan-Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality. RESULTS: The records of 188 patients were screened, and 111 patients with A. baumannii infection were enrolled. Almost all isolates were resistant to carbapenem, and 43% of the isolates were extensively-drug resistant. Almost half of the patients received initial inappropriate antimicrobial therapy (n = 50, 45.1%). The 30-day mortality rate associated with A. baumannii infection was 71.2% (79/111). The time to mortality in patients who received inappropriate antimicrobial therapy (5.70 ± 1.07 days) was significantly shorter than in those who received appropriate antimicrobial therapy (12.43 ± 1.01 days, P < 0.01). Binary logistic regression revealed that inappropriate antimicrobial therapy (adjusted odds ratio [AOR] = 16.22, 95% CI 2.68-9.97, P = 0.002), mechanical ventilation (AOR = 14.72, 95% CI 3.27-6.61, P < 0.001), and thrombocytopenia (AOR = 8.82, 95% CI 1.12-9.75, P = 0.003) were more likely associated with mortality. CONCLUSIONS: A. baumannii exhibits an alarming mortality rate among infected patients. Thrombocytopenia, mechanical ventilation, and inappropriate antibiotic administration are associated with mortality in patients infected with A. baumannii. The prompt initiation of appropriate antimicrobial therapy, infection control measures, and effective stewardship program are crucial to reduce the incidence of A. baumannii and improve the treatment outcomes.

ChatGPT in pharmacy practice: a cross-sectional exploration of Jordanian pharmacists' perception, practice, and concerns.

OBJECTIVES: The purpose of this study is to find out how much pharmacists know and have used ChatGPT in their practice. We investigated the advantages and disadvantages of utilizing ChatGPT in a pharmacy context, the amount of training necessary to use it proficiently, and the influence on patient care using a survey. METHODS: This cross-sectional study was carried out between May and June 2023 to assess the potential and problems that pharmacists observed while integrating chatbots powered by AI (ChatGPT) in pharmacy practice. The correlation between perceived benefits and concerns was evaluated using Spearman's rho correlation due to the data's non-normal distribution.Any pharmacists licensed by the Jordanian Pharmacists Association were included in the study. A convenient sampling technique was used to choose the participants, and the study questionnaire was distributed utilizing an online medium (Facebook and WhatsApp). Anyone who expressed interest in taking part was given a link to the study's instructions so they may read them before giving their electronic consent and accessing the survey. RESULTS: The potential advantages of ChatGPT in the pharmacy practice were widely acknowledged by the participants. The majority of participants (69.9%) concurred that educational material about pharmacy items or therapeutic areas can be provided using ChatGPT, with 66.9% of respondents believing that ChatGPT is a machine learning algorithm. Concerns about the accuracy of AI-generated responses were also prevalent. More than half of the participants (55.7%) raised the possibility that AI systems such as ChatGPT could pick up on and replicate prejudices and discriminatory patterns from the data they were trained on. Analysis shows a statistically significant positive link, albeit a minor one, between the perceived advantages of ChatGPT and its drawbacks (r = 0.255, p < 0.001). However, concerns were strongly correlated with knowledge of ChatGPT. In contrast to those who were either unsure or had not heard of ChatGPT (64.2%), individuals who had heard of it were more likely to have strong concerns (79.8%) (p = 0.002). Finally, the results show a statistically significant association between the frequency of ChatGPT use and positive perceptions of the tool (p < 0.001). CONCLUSIONS: Although ChatGPT has shown promise in health and pharmaceutical practice, its application should be rigorously regulated by evidence-based law. According to the study's findings, pharmacists support the use of ChatGPT in pharmacy practice but have concerns about its use due to ethical reasons, legal problems, privacy concerns, worries about the accuracy of the data generated, data learning, and bias risk.

Predictors of stroke-associated pneumonia and the predictive value of neutrophil percentage-to-albumin ratio.

BACKGROUND: Early recognition of stroke-associated pneumonia (SAP) is critical to reducing morbidity and mortality associated with SAP. This study investigated the predictors of SAP, and the predictive value of the neutrophil percentage-to-albumin ratio (NPAR) for SAP. METHODS: This retrospective cohort study was conducted among stroke patients admitted to Jordan University Hospital from January 2015 to May 2021. Multivariable logistic regression was used to identify independent predictors for SAP. The predictive performance was assessed using C-statistics, described as the area under the receiver-operating characteristic curve (AUC, ROC) with a 95% confidence interval. RESULTS: Four hundred and six patients were included in the analysis, and the prevalence of SAP was 19.7%. Multivariable logistic analysis showed that males (Adjusted Odds Ratio (AOR): 5.74; 95% Confidence Interval (95%CI): 2.04-1 6.1)], dysphagia (AOR: 5.29; 95% CI: 1.80-15.5), hemiparesis (AOR: 3.27; 95% CI: 1.13-9.47), lower GCS score (AOR: 0.73; 95% CI: 0.58-0.91), higher levels of neutrophil-lymphocyte ratio (NLR) (AOR: 1.15; 95% CI: 1.07-1.24), monocyte-lymphocyte ratio (MLR) (AOR: 1.49; 95% CI: 1.13-1.96), and neutrophil percentage to albumin ratio (NPAR) (AOR: 1.53; 95% CI: 1.33-1.76) were independent predictors of SAP. The NPAR demonstrated a significantly higher AUC than both the NLR (0.939 versus 0.865, Z = 3.169, p = 0.002) and MLR (0.939 versus 0.842, Z = 3.940, p < 0.001). The AUCs of the NLR and MLR were comparable (0.865 versus 0.842, Z = 1.274, p = 0.203). CONCLUSION: Male gender, dysphagia and hemiparesis were the strongest predictors of SAP, and NPAR has an excellent performance in predicting SAP which was better than high NLR and MLR.

The prevalence of Carbapenem Resistance Gram negative pathogens in a Tertiary Teaching Hospital in Jordan.

BACKGROUND: With the absence of new antimicrobial drugs being developed to replace those facing resistance, bacterial resistance continues to grow. Despite previous studies conducted in various countries, there is a lack of comprehensive local reporting on the occurrence of carbapenem resistance among gram-negative bacteria. OBJECTIVE: This study aims to identify the prevalence of carbapenem-resistant gram-negative bacterial isolates. METHOD: A retrospective cross-sectional study was conducted at an academic hospital in Jordan over an eight-month period, spanning from November 2021 to June 2022. The study involved screening electronic medical records to identify patients with clinical cultures showing the growth of Gram-negative bacteria. Antimicrobial susceptibility results of the Gram-negative isolates were recorded. RESULTS: A total of 1,043 isolated Gram-negative bacteria were analyzed for carbapenem susceptibility. Among the species tested, the most common carbapenem-resistant bacteria were Acinetobacter baumannii (153/164, 93.3%), followed by Klebsiella pneumonia (184/311, 59.2%), and Pseudomonas aeruginosa (67/160, 41.9%). The least commonly isolated species resistant to carbapenem were Escherichia coli (25/361, 6.9%) and Proteus mirabilis (1/30, 3.3%). None of Serratia marcescens or Proteus vulgaris isolates were resistant to carbapenem (0%). Overall, the prevalence of carbapenem-resistance gram-negative isolates was 41.2% (430 out of 1,043). CONCLUSION: This study provides population-specific data that are crucial for guiding empirical antimicrobial treatment decisions not only within the participating hospital but also in other nearby healthcare facilities. The results underscore the urgent need for coordinated efforts to address antibiotic resistance in Jordan. Comprehensive measures such as strict infection control methods, annual nationwide surveillance programs, and effective antimicrobial stewardship programs at the national level are imperative to reduce the overuse of broad-spectrum antibiotics.

Evaluation of knowledge, experiences, and fear toward prescribing and dispensing corticosteroids among Egyptian healthcare professionals: A cross-sectional study.

Background: Corticosteroids (CS) are essential drugs in the treatment of several medical conditions. Assuming different roles, physicians and pharmacists play a primary role in prescribing and dispensing these medications to optimize patients' clinical management. The data on assessing knowledge and experience of healthcare professionals toward CS is scarce. Therefore, this study aimed to assess and compare knowledge, experience, and fears towards CS among Egyptian physicians and pharmacists. Methods: A cross-sectional, self-administrated, validated online questionnaire was used to collect the data from Egyptian healthcare professionals. The questionnaire consisted of four sections with multiple choice questions: sociodemographic (7 questions), knowledge about CS (13 questions), experience with CS prescription/dispensing (5 questions), and fears and preferences toward CS prescription/dispensing (13 questions). Descriptive and inferential statistics were used to analyze the data. Results: A total of 600 responses were analyzed in this study. The study sample was almost two-half of healthcare providers: 303 (50.5%) pharmacists and 297 (49.5%) physicians. Pharmacists had marginally higher knowledge scores as compared to those recorded for physicians (11.29 versus 10.16, respectively; P = 0.047). Physicians had more experience choosing corticosteroids in treatment plans based on their experience (51.8% vs 38.5%) and guideline recommendations (72.8% vs 50.9%) than pharmacists. However, pharmacists had more experience dealing with corticosteroid use based on patients' preferences (19.5% vs 4.9%) and showed a broader scope of experiencing side effects of corticosteroids with their patients. The two professions demonstrated high levels of fear, with pharmacists acknowledging significantly lower concerns about CS than physicians (3.72 versus 4.0, respectively; P = 0.003). Conclusion: Discrepancies exist among healthcare professionals in knowledge and experience, favoring better scientific knowledge of pharmacists related to corticosteroids. Based on these findings, the interprofessional collaborative efforts would provide comprehensive, patient-centered care that maximizes the benefits of CS while minimizing their risks.