Impact of pharmacist-led interventions on medication-related problems among patients treated for cancer: A systematic review and meta-analysis of randomized control trials.

BACKGROUND: Medication-related problems (MRPs) continue to impose a voluminous health impact, particularly among patients on anti-cancer therapy, due to the nature and complexity of the care. Pharmacists have a pivotal role in ensuring the safe, effective, and rational use of medicines in this group of patients. OBJECTIVES: To examine the impact of pharmacist-led interventions in resolving MRPs among patients treated for cancer. METHODS: This systematic review and meta-analysis was conducted and reported following the PRISMA protocol and registered in PROSPERO (Registration number: CRD42022311535). Four database searches, PubMed, EMBASE, Cochrane, and International Pharmaceuticals Abstracts, were systematically searched from August 2022 to January 2023. Only randomized control trials (RCTs) were included. The Cochrane risk of bias assessment tool was used to check the quality of the included studies. The outcome measures were overall MRPs, adherence, medication errors, and adverse drug events (ADEs). Data for meta-analysis were analyzed used using STATA version 17 and standardized mean difference effect sizes were calculated for continuous outcomes and odds ratio for categorical outcomes. RESULTS: Out of the 90 studies screened for eligibility, 20 RCT studies were included for the systematic review and 15 for the meta-analysis. Close to two-thirds of the studies were from Europe (n = 7) and Asia (n = 6). A combination of educational and behavioral intervention strategies were used for a period ranged from 8 days to 12 months. The pharmacist-led intervention improved adherence to treatment by 4.79 times (AOR = 4.79; 95%CI = 2.64, 8.68; p-value<0.0001), reduced the occurrence of ADEs by 1.28 (SMD = -1.28; 95%CI = -0.04-2.52; p-value = 0.04) and decreased the overall MRPs by 0.53 (SMD = -0.53; 95%CI = -0.79, -0.28; p-value<0.0001) compared to control groups. CONCLUSION: This study found out that pharmacist-led interventions can significantly lower MRPs among patients treated for cancer. Hence, a global concerted effort has to be made to integrate pharmacists in a multidisciplinary direct cancer care.

Pharmacy professionals' knowledge, attitude and practice towards doping in sports: A Cross-sectional study in Ethiopia.

Background: Doping is appearing as a major problem in Ethiopia, a country decorated with medium and long-distance runners. To protect athletes from doping, pharmacists can be the first port of call for advising athletes on drug treatment. Hence, to fuel the anti-doping movement, it is crucial to explore the knowledge, attitude, and practice of community pharmacy professionals. Therefore, this study aimed to assess the community pharmacy professionals' knowledge, attitude, and practices towards doping in sports in Addis Ababa, Ethiopia. Materials and methods: A cross-sectional survey, involving 336 study participants, was conducted in selected community pharmacies of Addis Ababa, Ethiopia from April to May 2018. Results: Of 336 study participants, most of them knew the word "doping" and out of these, 51.9 % of them wrote the definition of doping correctly. Most respondents classified narcotics, hormone modulators, growth factors, and ß-2 agonists correctly. Almost one-third of the professionals agreed that they have adequate information about doping and that doping is a public health problem. Among the participants, only 33.4 % were confronted with "suspicious of doping substance" without a prescription over the last 12 months. Conclusions: Although most pharmacy professionals lack doping-specific knowledge and adequate training required to be operative in doping prevention, most of them perceive doping as a public health problem although the curriculum does not have good coverage about doping.

National Continuing Professional Development (CPD) training needs of pharmacists in Ethiopia.

BACKGROUND: Continuing Professional Development (CPD) in pharmacy is a lifelong learning approach whereby individual pharmacists are responsible for updating and broadening their knowledge, skills, and attitudes. This is vital to ensure the delivery of high-quality patient care services. However, there is a lack of available data revealing the CPD needs of Ethiopian pharmacists. Thus, the objective of this study was to identify CPD training needs of pharmacists practicing in Ethiopia. METHODS: An institution-based cross-sectional study design with a quantitative approach was employed in this study. This assessment involved 640 pharmacists representing various sectors of the profession. Data were collected through a combination of an online platform and a face-to-face questionnaire administered in person. RESULT: A total of 634 participants completed and returned the questionnaires, resulting in an impressive response rate of 99.1%. A significant majority (74.1%) of the participants possessed bachelor's degree in pharmacy (B. Pharm). Pharmaceutical Logistics and Pharmacy administration was preferentially selected as a prior CPD course by 36% of participants, of them while Pharmacotherapy (17%), Leadership/Governance (13%), Community Pharmacy (12%), Research and Development (11%) were also the subsequent top choices by participants. Off-site face-to-face lectures (59.2%), Hybrid (face-to-face + e-learning) (54.8%), and on-site on-the-job training (45.5%) were the most convenient means of CPD course delivery. On the other hand, the participants least favored print-based or correspondence programs for CPD course delivery. CONCLUSIONS: CPD holds great importance in the professional lives of pharmacists. It is critical for pharmacists, CPD providers, and those responsible for accrediting CPD programs to recognize the specific CPD requirements, preferred methods of delivery, and obstacles involved. This understanding is vital for establishing priorities and effectively planning CPD activities. In light of this, our study identified the most preferred CPD training courses and convenient delivery methods for pharmacists in Ethiopia. We recommend that CPD providers and accrediting bodies in Ethiopia refer to our findings when approving CPD courses.

Antidiarrheal and Antisecretory Effect of 80% Hydromethanolic Leaf Extract of Moringa stenopetala Baker f. in Mice.

INTRODUCTION: In Ethiopia, different medicinal plants have been claimed and used to treat diarrheal diseases. However, these claimed effects for most medicinal plants have not been scientifically verified. One of such plants in Ethiopian folkloric medicine is Moringa stenopetala, which is usually consumed as a vegetable in southern Ethiopia. Thus, this study aimed to evaluate the antidiarrheal and antisecretory effects of 80% methanolic leaf extract of Moringa stenopetala in different mice models. METHOD: Using Swiss albino mice, castor oil-induced diarrhea, charcoal meal-based gastrointestinal motility, and castor oil-induced secretion models were employed to assess antidiarrheal activity. In all of the test models, animals were randomly assigned into five groups consisting of six animals in each group. Group I received 0.5 ml of the vehicle (2% tween-80), while group II was treated with standard drug (3 mg/kg loperamide) in the respective models, whereas groups III to V received 150, 300, and 450 mg/kg of the methanolic leaf extracts of Moringa stenopetala. Onset, frequency, consistency, and weight of stool (diarrhea) were recorded, and different parameters and percentage proportions were calculated. Data were analyzed using one-way ANOVA followed by Tukey's test, and p < 0.05 was considered statistically significant at 95% confidence of interval. RESULT: In the castor oil-induced diarrheal model, the percentage inhibition of diarrhea was 48.5, 58.6, and 60% for the respective doses of 150, 300, and 450 mg/kg of the extract. And, the extract showed a 36.8, 54.4, and 55.9% reduction of peristalsis in charcoal meal-based gastrointestinal motility test compared to the negative control group. Moreover, in the antisecretory assay, the 150, 300, and 450 mg/kg doses of MEMS inhibited fluid contents of the stool by 11.5, 54.54, and 61.82%, respectively, relative to the vehicle-treated group. CONCLUSION: The findings revealed that the 80% methanolic leaf extract of Moringa stenopetala extract has shown antidiarrheal activity.

Wound Healing Activity of 80% Methanol Leaf Extract of Zehneria scabra (L.f) Sond (Cucurbitaceae) in Mice.

BACKGROUND: Zehneria scabra is one of the folklore plants of Ethiopia frequently used for external wound treatment in humans. Nevertheless, pharmacological investigations have not been performed to substantiate activity of the plant extract in wound healing. Hence, this study attempted to explore the activity of leaf extract of Z. scabra in wound healing using a mice model. MATERIALS AND METHODS: The air-dried leaf from Z. scabra was pulverized and extracted with 80% methanol and prepared with 5% and 10% extract ointments. An acute dermal toxicity study of the extract was conducted in female mice by observing the signs of toxicity. Then 5% and 10% (w/w) ointments of the extract were applied topically to investigate their wound healing activity in incision and excision wound models. Parameters such as wound contraction, period of epithelialization, and tensile strength were determined. RESULTS: Upon the application of 10% w/w extract ointment, no signs of dermal toxicity were observed in mice. Both 5% and 10% (w/w) extract ointment formulations increased percentage wound contraction and tensile strength, and shortened the epithelialization period. CONCLUSION: The findings of this study collectively showed that the leaf extract of Z. scabra possessed significant wound healing activity, upholding the folkloric use of the experimental plant.

Indole: The After Next Scaffold of Antiplasmodial Agents?

Malaria remains a global public health problem due to the uphill fight against the causative Plasmodium parasites that are relentless in developing resistance. Indole-based antiplasmodial compounds are endowed with multiple modes of action, of which inhibition of hemozoin formation is the major mechanism of action reported for compounds such as cryptolepine, flinderoles, and isosungucine. Indole-based compounds exert their potent activity against chloroquine-resistant Plasmodium strains by inhibiting hemozoin formation in a mode of action different from that of chloroquine or through a novel mechanism of action. For example, dysregulating the sodium and osmotic homeostasis of Plasmodium through inhibition of PfATP4 is the novel mechanism of cipargamin. The potential of developing multi-targeted compounds through molecular hybridization ensures the existence of indole-based compounds in the antimalarial pipeline.

Hospitalization and Predictors of Inpatient Mortality among HIV-Infected Patients in Jimma University Specialized Hospital, Jimma, Ethiopia: Prospective Observational Study.

Despite the number of patients enrolled in ART is increased, HIV/AIDS continues to constitute a significant proportion of medical admissions and risk of mortality in low- and middle-income countries. As one of these countries, the case in Ethiopia is not different. The aim of this study was thus to assess reasons for hospitalization, discharge outcomes, and predictors of inpatient mortality among people living with HIV (PLWH) in Jimma University Specialized Hospital (JUSH), Jimma, Southwest Ethiopia. Prospective observational study was conducted in medical wards of JUSH from February 17th to August 17th, 2017. In this study, 101 PLWH admitted during the study period were included. To identify the predictors of mortality, multiple logistic regression analysis was employed. Of the 101 hospitalized PLWH, 62 (61.4%) of them were females and most of them (52.5%) were between 25 and 34 years of age. A majority (79.2%) of the study participants were known HIV patients, before their admission. Tuberculosis (24.8%), infections of the nervous system (18.8%), and pneumonia (9.9%) comprised more than half of the reasons for hospitalization. Moreover, drug-related toxicity was a reason for hospitalization of 6 (5.9%) patients. Outcomes of hospitalization indicated that the overall inpatient mortality was 18 (17.8%). The median CD4 cell counts for survivors and deceased patients were 202 cells/µL (IQR, 121-295 cells/µL) and 70 cells/µL (IQR, 42-100 cells/µL), respectively. Neurologic complications (AOR = 13.97; 95% CI: 2.32-84.17, P = 0.004), CD4 count ≤ 100 cells/µl (AOR = 16.40; 95% CI: 2.88-93.42, P = 0.002), and short hospital stay (AOR = 12.98, 95% CI: 2.13-78.97, P = 0.005) were found to be significant predictors of inpatient mortality. In conclusion, opportunistic infections are the main reason of hospitalization in PLWH.

In Vitro Anthelmintic Activity of Crude Extracts of Artemisia herba-alba and Punica granatum against Haemonchus contortus.

Gastrointestinal nematodes (GINs) are the major limiting factor for the successfulness of livestock production throughout the world. Emergence of resistance strains as well as scarcity and high cost of the currently available drugs has led to the evaluation of other alternative helminth control options, mainly from plants. The current study is aimed at investigating the in vitro anthelmintic efficacy of crude methanolic extracts of two traditionally important medicinal plants, Artemisia herba-alba and Punica granatum, against Haemonchus contortus using adult motility assay (AMA) and egg hatch inhibition assay (EHIA). Four graded concentrations of the extracts were tested for both the AMA (10, 5, 2.5, and 1.25 mg/mg) and EHIA (0.1, 0.25, 0.5, and 1 mg/mL) in replicates. Albendazole and phosphate-buffered saline (AMA) or distilled water (EHIA) were used as the positive and negative controls, respectively. The crude extracts of A. herba-alba and P. granatum exhibited a potential anthelmintic activity at all dose levels in a concentration- and time-dependent fashion. The highest concentration (10 mg/mL) of all the extracts caused a significantly (p < 0.05) superior nematocidal activity compared to the negative control. Moreover, significant and concentration-dependent egg hatching inhibition effect was observed from both plant extracts. Maximal (98.67%) egg hatching inhibition effect was exhibited by the flower extract of A. herba-alba at 1 mg/mL concentration. The relative egg hatch inhibition efficacy indicated that both plants caused a significantly (p < 0.05) greater egg hatch inhibition within 48 hr of exposure. The current study validated the traditional use of both plants as a natural anthelmintic against H. contortus justifying a need to undertake detail pharmacological and toxicological investigation on both plants.

Emergency Contraceptives: Knowledge and Practice towards Its Use among Ethiopian Female College Graduating Students.

INTRODUCTION: Ethiopia has a high incidence of unwanted pregnancies and incomplete and unsafe abortions, particularly among adolescents. This can be avoided by using different contraceptive methods including emergency contraceptives (EC). This study aimed to assess the knowledge and practice of EC among female college graduating students in Harar, Eastern Ethiopia. METHODS: Institution based cross-sectional study was conducted on 214 female students selected from two randomly selected colleges. Data was collected using a self-administered questionnaire and analyzed using SPSS for Windows version 20.1. Level of significance was taken at P <0.05. RESULTS: The mean (±SD) age of the participants was 21.06 (±2.14) years. Of the 200 (93.5%) study participants who had ever heard of ECs, 140 (70.0%) had good knowledge. Among the 214 graduating female students, 66 (33.0%) had ever used EC. Being above the age of 20 years old, father's and mother's literacy were found to be determinants of knowledge of EC. Moreover, knowledge was the only determinant factor of practice of EC. CONCLUSION: Most of the respondents had relatively good knowledge of EC. The study revealed that female students of older age and higher educational status of parents had higher knowledge and practice of EC.