Assessing Students' Knowledge and Attitudes Regarding the Risks and Prevention of Consanguineous Marriage: A Cross-Sectional Online Survey.

Background: Several studies indicate a correlation between consanguinity and genetic disorders, congenital malformations, harm to reproductive health, and increased child mortality. Objective: To assess students' knowledge and attitudes about risks and prevention of consanguineous marriage. Methods: Demographic details of the participants and data on knowledge and attitudes concerning the risks and prevention of consanguineous marriage were obtained using an online self-administered questionnaire. The factors associated with good knowledge and attitude toward consanguineous marriage were investigated by logistic regression analysis. Results: A total of 667 participants enrolled in the study. The average knowledge score about consanguineous marriage risk and prevention was 78.6% with a 95% confidence interval (CI) [77.3, 79.8], and the average attitude was 79.7% with a 95% confidence interval (CI) [79, 80.6]. A better knowledge score was observed in older participants (OR 1.01; 95% CI 1.004-1.024), females (OR 1.69; 95% CI 1.48-1.94), participants with parental history of consanguinity (OR 1.33; 95% CI 1.17-1.52), participants with family history of consanguineous marriage (OR 5.18; 95% CI 2.19-7.10), and participants with family history of inherited disease (OR 1.52; 95% CI 1.25-1.86). Conclusion: In general, the overall level of knowledge and attitudes toward consanguineous marriage risk and prevention was good among university students. To efficiently control and manage the adverse health impacts associated with consanguineous marriage, there is an urgent need to develop and implement evidence-based counseling and screening programs for consanguineous marriage that would significantly reduce the number of at-risk marriages.

Guideline-directed medical therapy in heart failure patients with reduced ejection fraction in Palestine: Retrospective clinical audit study.

Objectives: To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine. Methods: This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), ß-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT. Results: A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and ß-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen. Conclusion: Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT.

Community pharmacists' perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis.

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care. Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care. Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7 years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%-74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%-79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1-1.019), postgraduates (OR 1.77; 95% CI 1.66-1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11-1.39), pharmacists in charge (OR 1.22; 95% CI 1.01-1.47), pharmacists with >10 years of experience (OR 11.3; 95% CI 6.01-15.62), pharmacists with 6-10 years of experience (OR 4.42; 95% CI 3.90-5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15-1.46). Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients' weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care.

Factors influencing community pharmacists' knowledge about women's issues in epilepsy.

Background: Previous studies have highlighted instances where pharmacists lacked knowledge regarding women's health issues related to epilepsy. Objectives: To assess UAE community pharmacists' knowledge, toward women's issues in epilepsy. Methods: a cross-sectional research method was employed. A team of seven pharmacy students in their final year visited a randomly selected sample of community pharmacies in the UAE and face-to-face interviews were conducted with the pharmacists using a structured questionnaire. The questionnaire includes two parts; Eight questions designed to elicit data about the demographics of the study participants and 12 questions eliciting insights into the participants' knowledge of women's issues in epilepsy. Results: A total of 412 community pharmacist were recruited in the study. The overall level of knowledge about women's issues in epilepsy was good and the average knowledge score was 81% with a 95% confidence interval (CI) [79.1, 82.7%]. The results of multivariate analysis showed higher knowledge scores in chain pharmacies (OR 1.37; 95% CI 1.12-1.67), Chief pharmacists (OR 1.44; 95% CI 1.01-2.06), Pharmacists in charge (OR 3.46; 95% CI 2.7-4.45), pharmacists with 1-5 Years of experience (OR 2.87; 95% CI 1.71-4.82), pharmacists with 6-10 Years (OR 2.63; 95% CI 1.58-4.38), pharmacists with >10 years (OR 3.13; 95% CI 2.03-4.83), graduation form regional universities (OR 1.37; 95% CI 1.12-1.67), graduation form international universities (OR 1.73; 95% CI 1.36-2.20) and receiving a training on epilepsy (OR 1.36; 95% CI 1.12-1.67). Conclusion: While the findings reveal an overall promising level of knowledge among community pharmacists regarding the issues faced by women with epilepsy, pinpointing which clinical and demographic factors have the most significant impact on this knowledge would permit the implementation of tailored educational interventions. Workshops and modules targeting the issues faced by women with epilepsy would further raise the knowledge and competence among community pharmacists in this area, ensuring better pharmaceutical care for this population.

Community pharmacists' skills and practice regarding dispensing fiscalized substances: a cross-sectional survey.

Background: The use of drugs containing fiscalized substances is essential in different medical areas, including pain management, obstetric emergencies, and the treatment of mental disorders. However, due to their potential for abuse and negative health effects, the dispensing of these substances demands pharmacists with the requisite skills and practice. Objective: This study assesses the skills and practices of pharmacy personnel in the United Arab Emirates (UAE) regarding the dispensing of tramadol, a medication containing fiscalized substances, in community pharmacies. Methodology: A cross-sectional study was conducted. Community Pharmacies were chosen via random sampling, and seven well-trained final year pharmacy students visited them and conducted face-to-face interviews. The survey tool covered items highlighting the demographic data of the subjects, and items on the practice and skills regarding dispensing the fiscalized substances. The content validity ratio values of all tool questions were more than 0.78, suggesting acceptable validity and the Cronbach's α of 0.75 showed as acceptable internal reliability. The primary outcome measures of interest were the skills and practice regarding dispensing Fiscalized substances. Results: A total of 612 pharmacists were recruited in the study. The average practice score was 80%. There was a statistically significant association (p < 0.05) between practices about dispensing fiscalized substances and gender, age group, pharmacy type, work experience, university of graduation, and receiving training on epilepsy and antiepileptic drugs. Conclusion: The results implied that competency and experience are vital factors for the dispensing of tramadol. Contextually, the majority of the pharmacists evidently have the requisite competencies to provide high-quality and proper medical care, with regards to dispensing tramadol, which will minimize drug abuse and medication errors, and assist outpatients to manage their drugs containing fiscalized substances.

Low back pain management attitudes and pharmacy practice: the impact of community pharmacists’ characteristics

Background: Low back pain (LBP) is one of the most frequent diseases for which patients seek advice in a community pharmacy. There is evidence to suggest that LBP-related negative beliefs are associated with increased levels of pain and impairment. Objective: This study evaluated the attitudes, beliefs, and practices of community pharmacists who advise patients with acute or chronic LBP. Methods: This is a cross-sectional study conducted among licensed community pharmacists, which were selected randomly in Abu Dhabi, Dubai, and the Northern Emirates. The survey took place via a questionnaire and face-to-face interviews. The questionnaire covered questions on demographics and the participants’ attitudes, beliefs, and practices regarding LBP management. Multivariate logistic regression was employed to identify the factors influencing respondents’ practices in relation to LBS therapy, while multivariate linear regression was used to identify the factors influencing respondents’ attitudes toward LBP management. Results: A total of 867 participants enrolled in the study. 63% were female, 53.9% of the surveyed pharmacies were independent pharmacies, 68.9% had more than ten years of experience, 55.7% graduated from regional/international universities, 84.5% were Bachelor’s degree holders, and 63.5% were Pharmacists in charge. Bivariate analysis showed that chain pharmacies (P <0.001), having more than ten years of experience (P< 0.001), graduated from regional/international universities (P < 0.001), and pharmacists in charge (P <0.001) were more likely to score higher in attitude and practice towards the management of LBP. Conclusion: Community pharmacists in the UAE have a positive attitude and practice when it comes to managing lower back pain. Community pharmacists’ recommendations for low back pain care in the UAE largely coincide with clinical practice for low back pain. (AU)

Airport-based pharmacies: Products, services and challenges essential for patients in a global travel landscape.

The role of airport pharmacies has grown in recent years to provide a range of services to travelers, including over-the-counter and prescription medicines, as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics, as seen with the recent coronavirus disease-2019 (COVID-19) pandemic. In addition, offering vaccinations where appropriate. However, this is not universal, and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward include greater research into their activities to enhance their role and address challenges. These include issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services, benefiting airport staff and travelers in the future.

Acceptability and Willingness of UAE Residents to Use OTC Vending Machines to Deliver Self-Testing Kits for COVID-19 and the Implications.

Purpose: Self-testing kits for SARS-CoV-2 appear effective, practical, safe and reliable as well as helping patients with mild-to-moderate symptoms to be successfully managed at home without going to hospital. As a result, ease pressures on hospitals. OTC vending machines offer the potential for SARS-CoV-2 self-testing kits alongside making available OTC treatments to alleviate the symptoms of COVID-19. As a result, providing confidentiality alongside ease of use in case people do not want their status broad casted. Consequently, there was a need to assess the acceptability and willingness regarding the availability of OTC vending machines to dispense self-testing kits for SARS-CoV-2 among UAE residents to provide future direction. Patients and Methods: A cross-sectional survey using a designed questionnaire was based on previous research and expert input and pilot tested. All items in the final questionnaire were seen as acceptable with a satisfactory content validity. A purposive sampling strategy was used in the principal study by primarily sending a link to the questionnaire to UAE universities via Facebook and WhatsApp. Results: A total of 876 respondents participated in the study and completed the whole questionnaire. Most participants were female (63%), Arabic origin (42%) and holding a bachelor's degree (84.5%). There was high acceptability and willingness to use self-testing kits (87.2%), with 88.6% of respondents believing OTC vending machines would be beneficial for patients with actual or suspected SARS-CoV-2. Gender, nationality, educational level, employment status, having relatives infected with SARS-CoV-2 and being vaccinated were significantly associated with attitudes towards the self-testing kits. Recognised barriers include their potential costs, ease of access and help for those who cannot read the instructions. Conclusion: Overall, there was high acceptability and willingness to use OTC vending machines to deliver self-testing kits for SARS-CoV-2 among the surveyed participants. Key barriers will need to be addressed to enhance their use.

Assessing knowledge, attitude and practice of community pharmacists on the pain management and implications in UAE children.

Objective: There are concerns with the optimal management of pain in children, with sub-optimal management negatively impacting on physical, emotional social functioning, exacerbated by pain in children being multi-modal. Community pharmacists across countries play an important role in managing pain in patients including children's pain. Consequently, the objective of this study is to assess knowledge, attitudes and practices (KAP) of pain management in children among community pharmacists in UAE. Methods: A cross-sectional study was conducted using a structured questionnaire that was developed and piloted. The final questionnaire, which comprised two parts, had acceptable validity and internal consistency. Results: 867 out of 922 community pharmacists took part in UAE (94% response rate) and were visited by trained researchers. The most from independent pharmacies (53.9%) and having more than 10 years of experience (68.9%). The overall KAP score was 70%, with gender, pharmacy type, years of experience, educational level and position significantly associated with KAP. Encouraging knowledge areas included pain is one of the vital signs in children (88.6%), the intensity of pain should be rated by a pharmacist before discussing treatment options (92.2%) and the choice of treatment should depend on issues including intensity and duration (87.2%). Areas of concern included the contents of the WHO analgesic ladder (32.0%) and children may sleep in spite of severe pain (42.9%). Conclusion: There were areas of good knowledge of pain management among community pharmacists in UAE. Areas of concern including knowledge of the WHO analgesic ladder need to be addressed as part of future educational input during training and post qualification.

Development and Validation of a Tool to Improve Community Pharmacists' Surveillance Role in the Safe Dispensing of Herbal Supplements.

Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements. Objectives: Developed a new questionnaire that can potentially help community pharmacists identify the extent of falsified herbal supplements. Methods: A 9-month cross sectional study was conducted among 500 community pharmacies across United Arab Emirates. A new 5-factor, 24-itmes scale was developed based on current labelling requirements across countries and piloted. This included seven items on identified uses and contraindication, seven items on hazard identification, four items on product identity, three items on packaging and product insert and three items on product handling and storage. The face and content validity of the scale was assessed via the content validity index (CVI). Its construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was subsequently confirmed through partial confirmatory factor analysis (PCFA). Its reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs). Results: The CVI of the finalized questionnaire was 0.843. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.891, and Bartlett's test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using maximum likelihood analysis with oblimin rotation. The PCFA obtained values was 0.962 for NFI, 0.977 for CFI, and 0.987 for the Tucker Lewis Index. All values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach's alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥0.40. The instrument presented good ICC statistics of 0.940 (0.928-0.950) as well as statistical significance (p < 0.001). Community pharmacists with more than 10 experience years were more likely to identify falsified herbal supplements compared to those with 1-10 years experience (p < 0.001). Conclusion: This study developed and validated a new instrument to identify safe herbal supplements, which should enhance the role of the community pharmacists in the safe and effective treatment of suitable patients with herbal supplements.

Over-the-counter counseling in community pharmacies and job satisfaction among pharmacy professionals: A reflection of current scenario and possible solutions.

Objectives: This study assessed community pharmacist counseling and dispensing practices to determine their relationship with job satisfaction among pharmacists. Methods: A cross-sectional study was conducted between January 2021 and September 2021on a random sample of community pharmacists. The inclusion criteria were licensed community pharmacists with at least3months of professional experience. The researchers conducted face-to-face interviews using a developed structured questionnaire. The research instrument was comprised of two sections: demographic information and dispensing practices. Data were analyzed using SPSS Version 24. Results: a total of 543pharmacists participated in this study. The average age of respondents was 31 ± 7 SD. The average dispensing practice score was 75% with a 95% confidence interval (CI) of [73.3%, 76.7%]. Better dispensing practices were common among older participants (odds ratio (OR)1.010; 95% CI 1.001-1.020), postgraduates (OR 1.191; 95% CI 1.055-1.344), pharmacists from pharmacy chains (OR 1.452; 95% CI 1.285-1.640), participants with more than 10 years of experience (OR 1.286; 95% CI 1.089-1.520), pharmacists who graduated from regional universities (OR 1.200; 95% CI 1.129-1.497), and pharmacists who graduated from international universities (OR 1.413; 95% CI 1.212-1.648). However, poor dispensing practices were common among participants who were not satisfied with their current community pharmacist job (OR 0.487; 95% CI 0.410-0.577). Conclusion: Patient-centered management strategies oriented toward creating a counseling-friendly environment would open more space to achieve professional self-realization through cognitive services. This could benefit patients via consistent counseling services and increase pharmacists' satisfaction with their job and profession.

Assessing knowledge, attitude and practice of community pharmacists on the pain management and implications in UAE children

Objective: There are concerns with the optimal management of pain in children, with sub-optimal management negatively impacting on physical, emotional social functioning, exacerbated by pain in children being multi-modal. Community pharmacists across countries play an important role in managing pain in patients including children’s pain. Consequently, the objective of this study is to assess knowledge, attitudes and practices (KAP) of pain management in children among community pharmacists in UAE. Methods: A cross-sectional study was conducted using a structured questionnaire that was developed and piloted. The final questionnaire, which comprised two parts, had acceptable validity and internal consistency. Results: 867 out of 922 community pharmacists took part in UAE (94% response rate) and were visited by trained researchers. The most from independent pharmacies (53.9%) and having more than 10 years of experience (68.9%). The overall KAP score was 70%, with gender, pharmacy type, years of experience, educational level and position significantly associated with KAP. Encouraging knowledge areas included pain is one of the vital signs in children (88.6%), the intensity of pain should be rated by a pharmacist before discussing treatment options (92.2%) and the choice of treatment should depend on issues including intensity and duration (87.2%). Areas of concern included the contents of the WHO analgesic ladder (32.0%) and children may sleep in spite of severe pain (42.9%). Conclusion: There were areas of good knowledge of pain management among community pharmacists in UAE. Areas of concern including knowledge of the WHO analgesic ladder need to be addressed as part of future educational input during training and post qualification. (AU)

Assessing public knowledge, attitudes and determinants of third COVID-19 vaccine booster dose acceptance: current scenario and future perspectives.

BACKGROUND: People with weakened immune systems may not develop adequate protection after taking two doses of the mRNA-combined COVID-19 vaccine. The additional dose may improve the level of protection against Covid-19. OBJECTIVES: Current study aimed to evaluate the knowledge, attitude and determents of third COVID-19 vaccine booster dose acceptance among population in the UAE. METHODS AND MATERIALS: This is online descriptive cross-sectional community-based study conducted among the students and faculty of Ajman University from 25 August to 20 October 2021. The questionnaire, which was in the English language, encompassed two sections containing 22 items. Section one gathered the demographic details of the respondents, while Section two used 13 questions to evaluate the respondents' knowledge of and attitude to the third COVID-19 vaccine booster dose. RESULTS: 614 respondents participated in this study. The average knowledge score was 44.6% with a 95% confidence interval (CI) of [41%, 49%]. Better knowledge scores were observed in postgraduates (OR 4.29; 95% CI 2.28-8.11), employees in the healthcare sector (OR 1.62; 95% CI 1.05-2.51), participants who had relatives infected with the Covid-19 (OR 1.46; 95% CI 1.05-2.02), participants who had infected with Covid-19 (OR 2.21; 95% CI 1.43-3.43) and participants who had received first two doses of the COVID-19 vaccine (OR 2.08; 95% CI 1.40-3.11). The average attitude score was 70.2% with a 95% confidence interval (CI) of [69.2%, 71.2%]. CONCLUSION: Necessary steps should be taken by the government and public health authorities, in line with the local culture, to increase vaccination acceptance and foster positive attitudes towards the vaccine. A suitable approach to this would be to develop an educational framework that could demonstrate the risks of vaccine avoidance or delay to the general population. Moreover, health authorities should pay more attention to the false information being disseminated across the internet, especially social media. Also, healthcare workers should be trained in vaccinology and virology to make sure that they are able to understand important developments in these fields and convey the findings to their patients.

Over-the-counter counseling in community pharmacies and job satisfaction among pharmacy professionals: A reflection of current scenario and possible solutions

Objectives: This study assessed community pharmacist counseling and dispensing practices to determine their relationship with job satisfaction among pharmacists. Methods: A cross-sectional study was conducted between January 2021 and September 2021on a random sample of community pharmacists. The inclusion criteria were licensed community pharmacists with at least3months of professional experience. The researchers conducted face-to-face interviews using a developed structured questionnaire. The research instrument was comprised of two sections: demographic information and dispensing practices. Data were analyzed using SPSS Version 24. Results: a total of 543pharmacists participated in this study. The average age of respondents was 31 ± 7 SD. The average dispensing practice score was 75% with a 95% confidence interval (CI) of [73.3%, 76.7%]. Better dispensing practices were common among older participants (odds ratio (OR)1.010; 95% CI 1.001–1.020), postgraduates (OR 1.191; 95% CI 1.055–1.344), pharmacists from pharmacy chains (OR 1.452; 95% CI 1.285–1.640), participants with more than 10 years of experience (OR 1.286; 95% CI 1.089–1.520), pharmacists who graduated from regional universities (OR 1.200; 95% CI 1.129–1.497), and pharmacists who graduated from international universities (OR 1.413; 95% CI 1.212–1.648). However, poor dispensing practices were common among participants who were not satisfied with their current community pharmacist job (OR 0.487; 95% CI 0.410–0.577). Conclusion: Patient-centered management strategies oriented toward creating a counseling-friendly environment would open more space to achieve professional self-realization through cognitive services. This could benefit patients via consistent counseling services and increase pharmacists’ satisfaction with their job and profession. (AU)

Online medication purchasing during the Covid-19 pandemic: potential risks to patient safety and the urgent need to develop more rigorous controls for purchasing online medications, a pilot study from the United Arab Emirates.

BACKGROUND: Since the WHO announced that Covid-19 had become a global pandemic, online pharmacies have emerged as an extremely popular way to purchase medication due to the quarantine measures introduced by numerous countries to prevent the virus's spread. AIM: The aim of this study was to collect information regarding the extent of online medication purchasing in the UAE and to assess the factors that motivating the purchase of medications from the internet. METHOD: A convenience sampling of people living in the UAE was used to conduct an online descriptive cross-sectional study. Respondents were solicited using the social media platforms WhatsApp and Facebook, whereby they were asked to fill in a validated web-based questionnaire. The number of people buying medications from online pharmacies was calculated using a percentage with 95% CIs. RESULTS: 131 respondents (31.2%) [95% CI: 26.7-35.6] stated that they purchased medication via the Internet after Covid-19 was classed as a pandemic. It was found that those respondents most likely to have purchased medication via the Internet were male, single, and older and with a high school education. CONCLUSION: More research should be conducted to investigate and compare the self-medication and associated risk factors between online pharmacies and community pharmacies. Moreover, regulatory bodies need to make and implement changes to the regulations that govern the sale and use of medications during COVID-19.