Costs saved and avoided from pharmacist interventions to address drug-related problems identified from outpatient clinics in Jordan.

BACKGROUND: The pharmacist plays an essential role in identifying and managing drug-related problems. The aim of this research was to assess the costs avoided by clinical pharmacist interventions to resolve drug-related problems. RESEARCH DESIGN AND METHODS: Clinical pharmacists identified drug-related problems and interventions to address them in consecutive outpatients visiting internal medicine clinics at major teaching and public hospitals in Jordan from September 2012 to December 2013. The costs avoided by each intervention to address drug-related problems were collected from the literature. The collected data were used to calculate the overall cost saved and avoided by the interventions implemented to address the identified drug-related problems, adopting a Jordanian healthcare system perspective. RESULTS: A total of 2747 patients were enrolled in the study. Diagnostic interventions, such as the need for additional diagnostic testing, were employed in 95.07% of the 13935 intervention to address the drug-related problem "Miscellaneous" which was the most frequent drug-related problems. Other common drug-related problems categories included inappropriate knowledge (n = 6972), inappropriate adherence (4447), efficacy-related drug-related problem (3395) and unnecessary drug therapy (1082). The total cost avoided over the research period was JOD 1418720 per month and total cost saved over the study period was JOD 17250.204. Drug-related problems were associated the number of prescription medications (odds ratio = 1.105; 95% confidence interval = 1.069-1.142), prescribed gastrointestinal drugs (3.485; 2.86-4.247), prescribed antimicrobials (3.326; 1.084-10.205), and prescribed musculoskeletal drugs (1.385; 1.011-1.852). CONCLUSIONS: The study revealed that pharmacists have provided cognitive input to rationalize and optimize the medication use and prevent errors, that led to the reported projected avoided and saved expenditures via various interventions to address drug-related problems. This highlights the added economic impact to the clinical impact of drug-related problems on patients and the healthcare system. The high prevalence and cost of drug-related problems offer strong rationale for pharmacists to provide more vigilant intervention to improve patient outcomes while maintaining cost effectiveness.

Determinants of Health-Related Quality of Life in Outpatients with Myocardial Infarction.

Background: The health-related quality of life (HRQOL) of patients with myocardial infarction (MI) is suboptimal because of the disease's life-threatening nature, the requirement for long-term lifestyle modifications, and the treatment regimens following MI. This study aimed to evaluate HRQOL and its associated factors in MI patients. Material and Methods: This study was conducted on patients with MI who attended the outpatient cardiology clinic at a major teaching hospital in Jordan. The EQ-5D-3L questionnaire was used to assess HRQOL of the study participants. Quantile regression analysis was conducted to identify the variables associated with HRQOL. Results: The study included 333 patients with a history of MI, with a median age of 58 (57-60). The median of the total EQ-5D score was 0.65 (0.216-0.805). Regression results revealed that male patients (Coefficient= 0.110, 95%Cl (0.022-0.197), P=0.014) and not being diagnosed with diabetes (Coefficient= 0.154, 95%Cl (0.042-0.266), P=0.007) were associated with increased HRQOL. On the other hand, low income (Coefficient= -0.115, 95%Cl (-0.203 - -0.026), P=0.011), not receiving DPP-4 (Dipeptidyl Peptidase -4) inhibitors (Coefficient= -0.321 95%Cl (-0.462 - -0.180), P<0.001), and having low (Coefficient= -0.271, 95%Cl (-0.395 - -0.147), P<0.001) or moderate (Coefficient= -0.123, 95%Cl (-0.202 - -0.044), P=0.002) medication adherence was associated with decreased HRQOL. Conclusion: The current study demonstrated diminished HRQOL among patients with MI, highlighting the necessity of tailoring interventions to tackle medication adherence barriers in this population. Personalized interventions such as educational programs, counseling, and reminders that consider each patient's needs and circumstances can greatly enhance medication adherence and, thus, the HRQOL of MI patients. Individuals with lower income levels, female patients, and those with diabetes should be the specific targets of these interventions.

Hospital pharmacists' knowledge, attitudes and practice of pharmaceutical care and the barriers for its implementation at the hospital setting.

Objective: To assess hospital pharmacists' understanding of pharmaceutical care and their attitudes regarding the adoption of the patient-centered model, as well as investigate Jordan's current state of pharmaceutical care implementation and the associated barriers. Methods: A validated survey was distributed to hospital pharmacists in different major tertiary hospitals in Jordan. The study questionnaire contained five sections to assess sociodemographic characteristics, pharmacists' understanding of pharmaceutical care, attitudes towards pharmaceutical care, potential barriers that may limit the delivery of pharmaceutical care, and the extent of pharmaceutical care implementation in the hospital setting. Results: The survey was completed by 152 hospital pharmacists. Participants in this study demonstrated adequate levels of knowledge about pharmaceutical care (Mean = 9.36 out of 11, SD = 1.23) and expressed favorable perceptions of pharmaceutical care (mean = 3.77 out of 5; SD = 0.7). Although more than one-third of the pharmacists practiced pharmaceutical care, the study revealed a number of impediments to the delivery of pharmacological care services. Regression analysis revealed that age (P < 0.05) and years of experience (P < 0.05) were significant predictors of knowledge, while age (P < 0.05), gender (P < 0.05), the graduation university (governmental vs. private) (P < 0.05), and years of experience (P < 0.05) were significant predictors of attitude. Furthermore, Doctor of Pharmacy degree holders had fewer barriers to pharmaceutical care implementation but were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.01 and P < 0.05 respectively). Pharmacists with a Master's degree or higher in pharmacy were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.05). Pharmacists working in the Ministry of Health and the Royal Medical Services experienced more barriers than those working in teaching hospitals (P < 0.05). Conclusions: Although the current study indicated high knowledge and perceptions regarding pharmaceutical care among hospital pharmacists, the provision of pharmaceutical care is not widely practiced in Jordan. Moreover, several barriers to the practice of pharmaceutical care were identified, highlighting the need for effective strategies to be put in place to overcome these obstacles. These strategies should include increasing the number of pharmacy staff, resolving timing issues, providing adequate financial initiatives, improving communication skills, changing the layout of pharmacies to include a private counseling room, developing specific policies that support the role of the pharmacist in patient care, and providing effective training and continuing professional education programs.

Prevalence of Medication Associated with QTc Prolongation Used Among Critically Ill Patients.

Background: Acquired prolonged corrected QT (QTc) interval can lead to life-threatening Torsade de Pointes (TdP) arrhythmia. Multiple risk factors including medications, comorbidities, and electrolyte imbalances contribute significantly to acquired manifestations of the QTc prolongation. Critically ill patients are particularly more vulnerable to TdP due to complex medical conditions, aging, and polypharmacy. Objective: This study aimed to assess the prevalence of TdP-associated medication prescribing, identify risk factors for QTc prolongation and TdP, and determine primary predictors of high TdP medication usage in critically ill patients in Jordan. Methods: We conducted a retrospective cross-sectional analysis of electronic medical records for patients from King Abdullah University Hospital who were admitted to Intensive Care Unit (ICU) between (July 2012-July 2022). We collected data on patients' demographics, clinical characteristics, comorbidities, laboratory results, and prescribed medications. Medications were categorized into three TdP risk levels according to CredibleMeds® assessment tool. Data were analyzed using descriptive statistics and a binary logistic regression model. Results: Of the 13,300 patients (58.2% male, median age 62 years). Prescribing prevalence for medications with known TdP risk was 19%, possible risk (24.7%), conditional risk (21.6%), and confirmed conditional risk (8.3%). Common comorbidities included hypertension (40.9%), diabetes (33.3%), and cancer (15.4%). Drugs with known TdP risk included citalopram, amiodarone, clarithromycin, and ciprofloxacin. A binary regression model revealed that as age increased, the odds of TdP associated medication prescribing decreased (OR = 0.989, p < 0.001), while patients on more than five medications had higher odds (OR = 4.281, p < 0.001). Conclusion: The study identified a notable prevalence of prescribing for medications with QTc prolongation/TdP risk in critically ill patients. Healthcare providers in the ICU should exercise caution to minimize the inadvertent prescription of TdP associated medications especially among older patients and those with polypharmacy.

Public knowledge of antibiotics, self-medication, and household disposal practices in Jordan.

BACKGROUND: This study aimed to assess public understanding of antibiotics, self-medication, and drug disposal practices. METHODS: A cross-sectional self-administered online survey was undertaken in Jordan. RESULTS: The study was completed by 1,105 participants. When asked about their knowledge of antibiotics, rational antibiotic use, and disposal practices, 16% percent believed they should discontinue antibiotics once they felt better, and 12% agreed to take the same antibiotics prescribed to others for the same illness. Self-medication with antibiotics was practiced by 44% of the participants. Prior experience, healthcare costs, and pharmacy location were all major determinants of self-medication. Only 6.4% of unneeded antibiotics were returned to the pharmacy, 60% were kept at home, and 26.6% were disposed of at home. Almost half of those who kept the antibiotics said they would use them again, and one-third said they would give them to friends and family. Respondents who had used antibiotics within the previous 6 months (p = 0.052) and relied on medication leaflets (p = 0.031) and physician recommendations (p = 0.001) were less likely to self-medicate with antibiotics. CONCLUSIONS: The study highlighted areas of inappropriate use of antibiotics, self-medication and the improper antibiotic disposal that can inform antimicrobial stewardship.

The era of E-learning from the perspectives of Jordanian medical students: A cross-sectional study.

Introduction: Online learning is becoming a crucial part of the educational process worldwide, especially after the recent COVID-19 pandemic. This study was designed to assess medical students' perception toward online learning and their perceived preparedness and barriers during the COVID-19 pandemic. Methods: An electronic-based, cross-sectional survey was used to recruit eligible students in Pharmacy, Doctor of Pharmacy, Medicine, Nursing, Dentistry, and Veterinary Medicine programs at various Jordanian universities (public and private). Descriptive and linear regression analysis were conducted using S.P.S.S. software. The perception score was calculated based on a 5-point Likert scale. Results: A total of 939 students agreed to participate in this study. The prominent category was females (n = 691, 73.6%), the median age of students was 22.0 years (IQR = 2.0), and around 56% of the students study in private universities (n = 520, 55.6%). More than half of the students reported that their experiences were unsatisfactory or very unsatisfactory (n = 510, 54.3%). The majority of students preferred face-to-face communication with their professors and colleagues and considered it more effective (n = 682, 72.6%). The median of the mean perception score was 2.4 (IQR = 1.1). Regarding challenges and barriers, more than 70% reported weak internet connection, E-learning boredom, and lack of motivation (n = 723, 77.0%). Conclusion: This study reported inadequate satisfaction and perception towards the current experience in E-learning during the COVID-19 pandemic. It also discussed the barriers and challenges hindering this transition, such as weak internet connection and the lack of motivation, indicating a need for implementing new pedagogies to enhance students' experiences regarding online education.

The role of clinical pharmacist in enhancing hemodialysis patients' adherence and clinical outcomes: a randomized-controlled study.

BACKGROUND: Adherence to treatment recommendations is challenging in hemodialysis (HD) patients, yet it has been found to be extremely crucial in obtaining positive clinical and health outcomes. AIM: To evaluate the influence of implementing an educational process provided by the clinical pharmacist on HD patients' adherence to treatment recommendations and clinical outcomes. METHOD: A randomized controlled trial was conducted in which patients from three HD units in Jordan were randomly allocated to either an intervention (n = 60) or a control group (n = 60). During a three-month period, the intervention group received a monthly educational approach from a clinical pharmacist with recommendations for improving medication, nutrition, and fluid adherence, whereas the control received standard medical care. The primary outcome was patient adherence to HD-related recommendations. Quality of life (QOL), disease awareness, hospitalization, and changes in biochemicals were secondary outcomes. RESULTS: The final analysis included 114 patients (n = 57/group). In the intervention group, there was a significant improvement in total adherence score versus control (1170.6 ± 44.1 vs. 665.8 ± 220.7, p < 0.001), and adherence to various aspects including episodes/duration of shortening HD, dietary guidelines, fluid restriction, and prescription medications. The clinical pharmacist intervention enhanced patients' QOL and improved awareness and perspective of the disease. Following the intervention, laboratory values for urea, creatinine, phosphorus, and hemoglobin were considerably improved. Additionally, the intervention group had fewer hospitalizations than the control group (0.54 ± 0.07 vs. 0.78 ± 0.26, p < 0.001). CONCLUSION: Providing clinical pharmacy education to HD patients improved adherence behavior and clinical outcomes. This illustrates the importance of clinical pharmacists as interdisciplinary team members in dialysis care. Trial registration This trial has been registered in ISRCTN Register (ISRCTN75517095). https://clinicaltrials.gov/ct2/show/ISRCTN75517095.

Community pharmacists' attitudes toward practice-based research and their perceived utilization of scientific evidence.

BACKGROUND: Enhancing the contribution of practicing pharmacists into scientific evidence via practice-based research (PBR) is crucial in maintaining high-quality clinical practice and healthcare delivery. Involving community pharmacists in PBR can potentially can also help break barriers to the utilization of the current best evidence in everyday pharmacy practice. The impact of pharmacists' attitude towards PBR on their utilization of current best evidence in pharmacy practice is understudied. OBJECTIVES: The aim of the study was to investigate the impact of community pharmacists' attitudes toward PBR on their utilization of current best evidence, barriers for conducting PBR in clinical practice were also investigated. METHODS: In this cross-sectional study, 169 community pharmacists working across Jordan filled a questionnaire to assess their attitudes towards PBR, barriers to PBR, and their utilization of the current best evidence in clinical practice. RESULTS: Pharmacists in this study showed a positive attitude toward PBR (attitude mean score >3.5). A positive attitude towards PBR was associated with high utilization of the best current scientific evidence. We also investigated several barriers to PBR and their association with utilization those included; the lack of perceived benefits, lack of institutional support, and lack of self-engagements of community pharmacists to PBR. The lack of perceived benefit was found to be negatively associated with pharmacists' utilization of the current best scientific evidence. CONCLUSION: In this study, pharmacists' utilization of current best evidence was found to be significantly impacted by their attitude toward PBR. The current study findings highlight the importance of supporting, promoting, and facilitating PBR among community pharmacists which can potentially enhance their utilization of the current best evidence in their everyday pharmacy practice.

The impact of health literacy on self-medication: a cross-sectional outpatient study.

Although health literacy practices have been increasingly recommended in public health literature, there is a lack of studies that examine the relationships between health literacy and self-medication. BACKGROUND: This research project aims to measure and evaluate the impact of health literacy on self-medication and to achieve a better understating of patients' behaviors. METHODS: A cross-sectional approach was conducted and participants were recruited outpatient clinics through convenience sampling. Health literacy was measured by Single Item Literacy Screener. RESULTS: A total of 194 participants agreed to participate (63.9% were females). The results showed that more than half (57.2%) had adequate health literacy. Almost 30% of the participants were over the age of 50. The prevalence of self-medication was 74.2%. Nearly, two-thirds of the total participants reported self-administration of antibiotics. There was a significant relationship between the overall health literacy level and practice of self-medication. CONCLUSIONS: Improving the health literacy level of the public can reduce inappropriate self-medication, especially the self-medication with antibiotics, which represented a high prevalence situation in our sample. Appropriate reading skills are important for accessing health information, using health care services, and achieving desirable health outcomes.

Online learning for undergraduate health professional education during COVID-19: Jordanian medical students' attitudes and perceptions.

BACKGROUND: The popularity of online learning has increased tremendously in response to the needs of students amid outbreaks of emerging infectious diseases. Few studies have concentrated on the learner's perspectives involved with the transition from traditional to online learning. The aim of this study was to assess students' attitudes towards online learning as well as the perceived preparedness and barriers. METHODS: A descriptive, cross-sectional, correlational web-based survey design was used to recruit eligible participants from five Jordanian government universities. A Facebook-based campaign and snowball sampling approach were used to recruit potential survey participants. RESULTS: The results show that 1,210 medical college students decided to take part in this online survey. Students' attitudes and perceived preparedness for online learning were moderate, while perceived barriers were high. This study revealed a connection between students' attitudes toward online learning and their gender, major, living area, college level, and prior experience. The main obstacles to online learning were an unstable Internet connection, a lack of motivation, and a lack of instructions. CONCLUSION: The majority of students had mixed feelings about online learning and were largely supportive of conventional classroom learning. Students were pessimistic about their chances of learning professional skills and core competencies online. More research is required to determine whether students are ready and able to make greater use of online education in order to access high-quality learning opportunities.

Public Health Literacy, Knowledge, and Awareness Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study.

Multi-drug-resistant (MDR) organisms pose a global threat to modern medicine, which has grown as a result of irrational antibiotic use and misuse. This study aimed to assess general public knowledge in Jordan and awareness of antibiotics and antibiotic resistance during the COVID-19 pandemic. A cross-sectional study was carried out utilizing the WHO multicountry public awareness survey. The study population was composed mainly of social media users, and a total of 1213 participants completed the online survey. According to the findings, more than half of the participants were well versed in antibiotic use and resistance. Those with adequate health literacy were found to better understand antibiotics (OR = 1.37, p = 0.017) and antibiotic resistance (OR = 1.46, p = 0.003). The vast majority (88.5%) recognized at least one antibiotic resistance term; however, 53.2% believed that antibiotic resistance is a problem in other nations. The participants in this study reported using antibiotics incorrectly, believing that they were treating sore throats, colds, and flu. The participants were well aware of antibiotic resistance solutions and their consequences on health. Age, education, health literacy, and antibiotic knowledge were found to be substantially (p < 0.05) associated with greater awareness of antibiotic resistance. The findings highlight the need for antimicrobial resistance education campaigns, health literacy, and antibiotic stewardship initiatives.

Prescribers' Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan.

More research is needed on the drivers of irrational antibiotic prescribing among healthcare professionals and to ensure effective prescribing and an adequate understanding of the issue of antibiotic resistance. This study aimed at evaluating prescribers' knowledge, attitudes and behaviors about antibiotic use and antibiotic resistance. A cross-sectional study was conducted utilizing an online questionnaire and included physicians and dentists from all sectors in Jordan. A total of 613 prescribers were included (physicians n = 409, dentists n = 204). Respondents' knowledge on effective use, unnecessary use or associated side effects of antibiotics was high (>90%), compared with their knowledge on the spread of antibiotic resistance (62.2%). For ease of access to the required guidelines on managing infections, and to materials that advise on prudent antibiotic use and antibiotic resistance, prescribers agreed in 62% and 46.1% of cases, respectively. 28.4% of respondents had prescribed antibiotics when they would have preferred not to do so more than once a day or more than once a week. Among respondents who prescribed antibiotics, 63.4% would never or rarely give out resources on prudent use of antibiotics for infections. The findings are of importance to inform antibiotic stewardships about relevant interventions aimed at changing prescribers' behaviors and improving antibiotic prescribing practices.

Physicians' Knowledge and Attitudes Regarding Point-of-Care Pharmacogenetic Testing: A Hospital-Based Cross-Sectional Study.

INTRODUCTION: Pharmacogenetic testing (PGx) is a diagnostic technique used by physicians to determine the possible reactions of patients to drug treatment on the basis of their genetic makeup. The aim of this study was to determine the impact of physicians' awareness, attitudes, and sociodemographics on the adoption of point-of-care (POC) PGx testing as a diagnostic method, as well as the impact of their knowledge, attitudes, and sociodemographics on its adoption. METHODS: A cross-sectional survey of 200 physicians and medical trainees working at the Clinics of King Abdullah University Hospital in Jordan was performed. Data on sociodemographics, knowledge and attitudes concerning PGx testing, genetic information sources, and barriers to POC-PGx testing adoption were gathered. RESULTS: Participants' perceived knowledge of the role of PGx testing in therapeutic decision-making was rated as "Excellent" (1.9%), "Very Good" (19.4%), "Good" (34.4%), "Fair" (32.5%), and "Poor" (11.9%). Physicians' actual knowledge of PGx testing was adequate (mean=3.56 out of 7, SD=1.2), but their attitudes were generally favorable (mean=3.64 out of 5.00, SD=0.52). According to Rogers' theory, many variables (eg, perceived need, relative advantage, compatibility) had a significant impact on physicians' willingness to endorse POC-PGx testing. DISCUSSION: The majority of physicians stated that they were unaware of PGx testing. Physicians' perceived knowledge of POC-PGx testing, however, was higher than those who participated in other studies. Participants were optimistic about the future benefits of PGx testing in prescribing effective medications and reducing potential side effects, which were consistent with previous studies. Physicians' willingness to accept and implement POC-PGx testing was hampered by a lack of PGx expertise, as well as concerns about patient confidentiality, employability, and insurability. More training and genetic courses are needed, according to the majority of participants.

Depression symptoms and quality of life in patients receiving renal replacement therapy in Jordan: A cross-sectional study.

Patients with chronic illnesses, such as those with chronic kidney disease (CKD) that are undergoing renal replacement therapy (RRT), face significant psychological changes. This descriptive cross-sectional research was carried out to investigate the factors that influence depressive symptoms and quality of life (QoL) in patients with end-stage renal disease. Data were collected from 70 participants undergoing RRT using a self-reported questionnaire that included sociodemographic information, depressive symptoms, disease status, and QoL. The Beck Depression Inventory-II (BDI-II) screening scale was used to measure depressive symptoms and the SF-36 (Medical Outcome Survey-Short Form 36) was used to assess QoL. Participants in the study rated their depressive symptoms as 'minimum (44.3%), 'mild' (20%), 'moderate' (21.4%), and 'severe (14.3%). Furthermore, a shorter duration of dialysis and comorbid conditions were significantly associated with the development of depressive symptoms. Patients on RRT for a longer period of time had lower physical activity scores than patients on dialysis for a shorter period of time. Male participants have a higher mental QoL than female participants, suggesting that the mental aspect of renal disease is less impaired than the physical aspect. The findings of this study are expected to increase awareness of RRT therapy targets and enhance patient outcomes.

Pharmacists self-perceived role competence in prevention and containment of COVID-19: A cross-sectional study.

INTRODUCTION: The increased need for prioritized infection prevention and control (IPC) activities for the prevention and containment of COVID-19 is pivotal and timely in preventing harm caused by the COVID-19 pandemic. Little is known about pharmacists' infection IPC activities and their role competence during disease outbreaks. This study aimed to assess pharmacists' perceived role competence to perform frontline roles during the COVID-19 pandemic. METHOD: A cross-sectional survey was conducted using online social media to recruit eligible participants. A validated questionnaire contained 41 items on sociodemographic characteristics, preventative behaviors, and competencies. RESULTS: A total of 486 participants completed the survey. Participants reported several IPC activities that could potentially prevent COVID-19 spread. The majority expressed high attitudes towards their capabilities to fulfill their healthcare roles (M = 4.43, SD = 0.46, out of 5). The vast majority of participants (97.1%) were willing to demonstrate the effective way of cleaning hands and using facemasks. Pharmacists (89.1%) showed their willingness to timely refer patients in response to their emerging needs. Gender, age groups, years of experience, monthly incomes, area of work, ability to make a referral, source of information, and self-isolation discontinuation criteria were significantly associated with pharmacists' self-perceived role competence. CONCLUSION: Pharmacists are well-positioned as access points to care and can potentially play a significant role in the containment of the COVID-19 outbreak by delivering advanced clinical and public health services. Future research efforts need to be comprehensively directed towards the advanced role of pharmacists in implementing point-of-care testing for infectious diseases.

Knowledge of pediatric palliative care among medical students in Jordan: A cross-sectional study.

PURPOSE: The aim of this study was to examine the medical student knowledge regarding pediatric palliative care (PPC) and determine the predictors of knowledge among them toward PPC. METHODS: A cross-sectional engaging study was directed with 326 medical students studying in Jordanian universities. A campaign utilizing online social media and Web-based software were executed to promote, enlist, overview undergraduate medical students, and gather information for this study. The authors employed four techniques to select undergraduate medical students on paid-promoted Facebook, personal messages, and postings in clinical forums. RESULTS: The results of this study showed that medical students have inadequate knowledge about pediatric palliative care in Jordan. The only factors that predict the knowledge toward PPC is gender. CONCLUSION: it should build the medical students' information on pediatric palliative care. The pointer was not significant in the multivariate studies, and that vicariate studies indicated no distinction in the overall scores on either test among the nonmedical students, Training projects ought to be established and delivered to pediatric medical students to improve their knowledge about pediatric palliative/palliative consideration.

Pharmacists' experience, competence and perception of telepharmacy technology in response to COVID-19.

BACKGROUND: In the telepharmacy model, the pharmacist can play a pivotal role in delivering pharmaceutical services for patients. However, evidence of pharmacists' impact on improving patient outcomes through disease outbreak through telepharmacy is sparse. OBJECTIVES: This study aims to examine pharmacists' attitudes towards clinical benefits and identify challenges regarding the use of telepharmacy during the COVID-19 pandemic in Jordan. METHOD: A cross-sectional survey design was used to recruit eligible participants from both hospital and community pharmacies. RESULTS: A total of 364 pharmacists agreed to participate in the study. The majority of the participants (70.6%) expressed favourable attitudes towards telepharmacy to accurately capture and report signs and symptoms of COVID-19. Almost 91% agreed that patients can receive immediate medical feedback while using telepharmacy services. Pharmacists (87%) emphasised their role in the monitoring of physiological parameters when entered by patients using telepharmacy technology. However, more than half of the participants reported that lack of reimbursement and evidence-based studies might hinder the use of telemedicine technology to deliver remote clinical services. CONCLUSION: The need for implementing telepharmacy technology has been further boosted because of its noticeable benefits in promoting convenient healthcare services remotely in emergency situations.

Physicians' Knowledge, Perceptions, and Attitudes Related to Patient Confidentiality and Data Sharing.

BACKGROUND: The protection of patient confidentiality is an essential practice for the successful provision of healthcare. This study examines physicians' knowledge and attitudes related to data sharing and patient confidentiality. METHODS: This is a descriptive, questionnaire-based study. Physicians were invited via e-mail to complete the study survey. The survey comprised three sections related to knowledge, attitudes, and demographic characteristics. RESULTS: A total of 221 physicians, with varying levels of experience and from a range of specialty areas, completed the study survey. Ethical dilemmas were encountered annually by physicians specialized in family medicine and daily by physicians in internal medicine wards more often than those in other departments. The mean score for knowledge was 7.34 (out of 14; SD=2.92) and had a positive correlation with attitudes towards the protection of data confidentiality (r2=0.282, p<0.001). Undergraduate courses were the main source of knowledge related to ethical issues (167; 74.9%). Sex (B=-1.47, p=0.001), marriage (B=-1.198, p=0.021), and source of consultation (B=-.248, p=0.02) were all found to predict knowledge scores. Likewise, attitudes were predicted by experience (B= 0.279, p<0.001), sex (B= -2.797, p=0.002), marriage (B=1.91, p=0.02), and number of ethical dilemmas faced (B=1.695, p <0.001). CONCLUSION: Physicians from different departments were found to lack sufficient knowledge about many aspects of patient confidentiality. While some of the physicians' practices complied with the law, other practices were identified as patient confidentiality breaches.

Nursing and PharmD Undergraduate Students' Attitude Toward the "Do Not Resuscitate" Order for Children with Terminally Ill Diseases.

BACKGROUND: Nurses and Doctor of Pharmacy (pharmD) must communicate and properly documented the do not resuscitate orders for terminally ill children and their relatives. They also have to offer excellent care including more family support, assisting the child with terminally ill disease in passing on peacefully, and preventing unnecessary cardiopulmonary resuscitation. This research was aimed to survey attitudes of nursing and pharmD undergraduate students about the "do not resuscitate" order for children with terminally ill diseases. METHODS: A cross-sectional correlational design was used to study the correlation between attitude toward DNR and demographic variables. More than 400 nursing and pharmD students from Jordan University of Science and Technology were recruited in this study. All the participating students were e-mailed information regarding the study, including the web survey link. RESULTS: The results showed that there was a significant difference in perception toward do not resuscitate order between nursing and pharmD students (p ≤ 0.05). The pharmD students had more positive attitude toward do not resuscitate than the nursing students. Approximately, 60% of the nursing and pharmD students would disclose the need for the do not resuscitate order for children with terminally ill diseases Demographic variables were not associated with the perception toward do not resuscitate orders (p ≥ 0.05). CONCLUSION: This study showed that Jordanian nursing and pharmD students are willing to learn more about different aspects of do not resuscitate orders for terminally ill children. Analyzing their responses to many items showed their misconception about do not resuscitate orders for terminally ill children.

Pediatric palliative care from nursing and PharmD perspectives.

BACKGROUND: This research aimed to survey a sample of nursing students and Doctor of Pharmacy (PharmD) students in Jordan about their knowledge of pediatric palliative care (PPC) in the context of treating terminally ill children. METHOD: A descriptive, cross-sectional, correlational design was used to fulfill the goal of this research. A convenience sample of nursing and PharmD students currently studying in Jordan University of Science and Technology in Jordan was recruited to complete a survey that contained 20 statements about issues on and around the subject of PPC. RESULTS: The results showed that there was a significant difference in PPC between nurses and PharmD students. The mother's education (t = 2.158, P = 0.032) and being a nursing or PharmD student (t = 1.969, P = 0.050) were associated with knowledge about PPC. Other listed factors such as gender, working ward, and age were not associated with knowledge of PPC. CONCLUSION: This was the first study in Jordan to survey a sample of nursing students and PharmD students in Jordan about their knowledge of PPC. The current study found that knowledge of nursing and PharmD students regarding PPC was satisfactory, depending on the scale used.