Knowledge, attitude and practice among pharmacy students and faculty members towards artificial intelligence in pharmacy practice: A multinational cross-sectional study.

BACKGROUND: Modern patient care depends on the continuous improvement of community and clinical pharmacy services, and artificial intelligence (AI) has the potential to play a key role in this evolution. Although AI has been increasingly implemented in various fields of pharmacy, little is known about the knowledge, attitudes, and practices (KAP) of pharmacy students and faculty members towards this technology. OBJECTIVES: The primary objective of this study was to investigate the KAP of pharmacy students and faculty members regarding AI in six countries in the Middle East as well as to identify the predictive factors behind the understanding of the principles and practical applications of AI in healthcare processes. MATERIAL AND METHODS: This study was a descriptive cross-sectional survey. A total of 875 pharmacy students and faculty members in the faculty of pharmacy in Jordan, Palestine, Lebanon, Egypt, Saudi Arabia, and Libya participated in the study. Data was collected through an online electronic questionnaire. The data collected included information about socio-demographics, understanding of AI basic principles, participants' attitudes toward AI, the participants' AI practices. RESULTS: Most participants (92.6%) reported having heard of AI technology in their practice, but only a small proportion (39.5%) had a good understanding of its concepts. The overall level of knowledge about AI among the study participants was moderate, with the mean knowledge score being 42.3 ± 21.8 out of 100 and students having a significantly higher knowledge score than faculty members. The attitude towards AI among pharmacy students and faculty members was positive, but there were still concerns about the impact of AI on job security and patient safety. Pharmacy students and faculty members had limited experience using AI tools in their practice. The majority of respondents (96.2%) believed that AI could improve patient care and pharmacy services. However, only a minority (18.6%) reported having received education or training on AI technology. High income, a strong educational level and background, and previous experience with technologies were predictors of KAP toward using AI in pharmacy practice. Finally, there was a positive correlation between knowledge about AI and attitudes towards AI as well as a significant positive correlation between AI knowledge and overall KAP scores. CONCLUSION: The findings suggest that while there is a growing awareness of AI technology among pharmacy professionals in the Middle East and North Africa (MENA) region, there are still significant gaps in understanding and adopting AI in pharmacy Practice.

Studying Microbial Ecology of Diabetic Foot Infections: Significance of PCR Analysis for Prudent Antimicrobial Stewardship.

This study presents a comprehensive investigation into the microbial ecology of diabetic foot infections (DFIs), using molecular-polymerase chain reaction (PCR) analysis to accurately identify the causative agents. One hundred DFI patients were recruited and classified using the Depth Extent Phase and Associated Etiology (DEPA) score according to their severity. Results revealed polymicrobial infections in 75% of cases, predominantly featuring Staphylococcus epidermidis (83%) and Staphylococcus aureus (63%). Importantly, 20% of samples exhibited facultative anaerobes Bacteroides fragilis or Clostridium perfringens, exclusively in high DEPA score ulcers. Candida albicans coinfection was identified in 19.2% of cases, underscoring the need for mycological evaluation. Empirical antimicrobial therapy regimens were tailored to DEPA severity, yet our findings highlighted a potential gap in methicillin-resistant Staphylococcus aureus (MRSA) coverage. Despite an 88% prevalence of methicillin-resistant Staphylococci, vancomycin usage was suboptimal. This raises concerns about the underestimation of MRSA risk and the need for tailored antibiotic guidelines. Our study demonstrates the efficacy of molecular-PCR analysis in identifying diverse microbial communities in DFIs, influencing targeted antibiotic choices. The results advocate for refined antimicrobial guidelines, considering regional variations in microbial patterns and judiciously addressing multidrug-resistant strains. This research contributes crucial insights for optimizing DFIs management and helps the physicians to have a fast decision in selection the suitable antibiotic for each patient and to decrease the risk of bacterial resistance from the improper use of broad-spectrum empirical therapies.

Willingness to pay for community pharmacies-based medication review service: perspectives of private health insurance firms

Background: The medication review service (MRS) is a valuable community pharmacies-based health service to patients, ensuring optimal medication use and reducing medication errors. Nevertheless, it remains limited in scope and empowerment without remuneration for providing the service. Objective: This study aimed to assess private health insurance (PHI) and third-party administration (TPA) firms' perspectives regarding the MRS offered by community pharmacies in Jordan and the extent of their willingness to pay for this service. Method: The research was an observational, cross-sectional study conducted using a constructed and validated Arabic questionnaire that was distributed electronically to the key health insurance decision-makers (general managers, operational managers, medical network managers, directors, and supervisors) among all the (22) PHI and TPA active firms that are members of the Jordan Insurance Federation (JIF) and licensed under the insurance administration in the Ministry of Industry and Trade. Participants provided their consent electronically before filling out the questionnaire. Results: 50 health insurance decision-makers agreed to participate in this study. 48% partially (42%) or completely (6%) heard about the medication review service. Most respondents (n=35, 70%) believed the medication review service is expected to reduce the cost of medications. Furthermore, they believed the service is expected to reduce the cost of the medical bill by ensuring the medication is not repeated within a short time unless advised by the doctor, checking the exact dosage regimen of each drug, and using alternative medicines at lower cost (74%, 64%, and 60%) of respondents respectively. Half of the respondents were eager to remunerate for the medication review service, with the majority willing to pay less than 10 Jordanian Dinars (JODs) per patient (AU)

The Impact of the COVID-19 Pandemic on Loneliness Among University Students: A Cross-Sectional Study in Jordan.

INTRODUCTION: Loneliness is characterized by a sense of melancholy, emptiness, and despair, as well as a higher risk of both psychological and physical problems. Numerous post-coronavirus disease 2019 (COVID-19) sequela, both physically and mentally, have been caused by the global COVID-19 pandemic that has affected many people. Memory issues and loneliness were found to be uniquely correlated. The purpose of this study was to evaluate how the COVID-19 epidemic affected the levels of loneliness among Jordanian university students. METHODS: This is a cross-sectional questionnaire-based study. Google Forms were used for data collection, utilizing a three-item loneliness scale developed by the University of California, Los Angeles (UCLA), United States, which accounts for the following items: (1) how often does the participant feel about lacking companionship, (2) how often does the participant feel being left out, and (3) how often does the participant feel isolated from others. Each item was marked for three frequency levels of experience: (1) hardly ever, (2) some of the time, and (3) often. Responses to the three loneliness questions were graded on a scale of 3-9, with scores between 3 and 5 indicating "not lonely" and scores between 6 and 9 indicating "lonely." RESULTS: The study included 802 participating students. Specifically, 75.4% of the participants were females, 58% were aged 20-25, and 39% were 17-19. In addition, 37% were from the capital city, while 28% lived in the middle area. Seventy nine percent were from public universities, and 74% were studying in their second year. According to UCLA's three-item loneliness scale, 411 (51.2%) participants were lonely, while 391 (48.8%) participants were not feeling lonely. According to direct question answers, 576 (71.8%) participants were lonely, and 226 (28.2%) were not lonely. CONCLUSION: The study concluded that the frequency of loneliness was high among Jordanian university students. However, both genders experienced equal levels of loneliness, while younger participants felt more lonely than older ones.

Assessment of Jordanian pharmacists' knowledge and perception regarding sexual and reproductive health and their practice in providing sexual counseling to patients.

Objective: In this quantitative study, we intended to explore sexual/ reproductive counseling between Jordanian pharmacists by addressing pharmacists' knowledge regarding sexual/ reproductive health and their perception and practice in providing counseling to patients. Method: This study adopted a survey methodology using a self-completed validated and administered unnamed survey. Participants were asked to fill-out the electronic survey after providing their electronic consent. Social media was utilized to extend the survey to facilitate contact multiple parts of pharmacists' community. Results: In this study, 200 pharmacists agreed to participate in this study. Most of the pharmacists knew that depression (n= 182, 91%) and alcohol (n=171, 85.5%) were among the main factors that my decrease sexual performance. Also, only 38.5% of the pharmacists (n= 77) agreed that discussing sexual issues is the responsibility pf pharmacists, and only 55% of them (n= 110) felt comfortable discussing patients' sexual matters as any medical issue. Moreover, more than two-third of the pharmacist (n= 146, 73%) reported that if they were consulted about sexual problem, they may explore patients' problem. On the other side, only half of pharmacists (n= 102, 51%) revealed that they may discuss the side effects of prescribed drug if it might affect sexual performance. Conclusion: Education on sexuality/ reproduction is the key to help Jordanian pharmacists to advance patients' sexual/ reproductive health. In general, research on sexual/ reproductive health in conservative societies is limited. Therefore, additional surveys that include the perspectives of both patients and pharmacists on sexuality/ reproduction to augment this normally ignored aspect of health are necessary.

Assessment of Jordanian Pharmacists’ Knowledge and Perception Regarding Sexual and Reproductive Health and their Practice in Providing Sexual Counseling to Patients

Objective: In this quantitative study, we intended to explore sexual/ reproductive counseling between Jordanian pharmacists by addressing pharmacists’ knowledge regarding sexual/ reproductive health and their perception and practice in providing counseling to patients. Method: This study adopted a survey methodology using a self-completed validated and administered unnamed survey. Participants were asked to fill-out the electronic survey after providing their electronic consent. Social media was utilized to extend the survey to facilitate contact multiple parts of pharmacists’ community. Results: In this study, 200 pharmacists agreed to participate in this study. Most of the pharmacists knew that depression (n= 182, 91%) and alcohol (n=171, 85.5%) were among the main factors that my decrease sexual performance. Also, only 38.5% of the pharmacists (n= 77) agreed that discussing sexual issues is the responsibility pf pharmacists, and only 55% of them (n= 110) felt comfortable discussing patients’ sexual matters as any medical issue. Moreover, more than two-third of the pharmacist (n= 146, 73%) reported that if they were consulted about sexual problem, they may explore patients’ problem. On the other side, only half of pharmacists (n= 102, 51%) revealed that they may discuss the side effects of prescribed drug if it might affect sexual performance. Conclusion: Education on sexuality/ reproduction is the key to help Jordanian pharmacists to advance patients’ sexual/ reproductive health. In general, research on sexual/ reproductive health in conservative societies is limited. Therefore, additional surveys that include the perspectives of both patients and pharmacists on sexuality/ reproduction to augment this normally ignored aspect of health are necessary. (AU)

Synchrotron-Radiation-Based Fourier Transform Infrared Microspectroscopy as a Tool for the Differentiation between Staphylococcal Small Colony Variants.

Small colony variants (SCVs) are clinically significant and linked to persistent infections. In this study, synchrotron-radiation-based Fourier transform infrared (SR-FTIR) is used to investigate the microspectroscopic differences between the SCVs of Staphylococcus aureus (S. aureus) and diabetic foot Staphylococcus epidermidis (S. epidermidis) in two main IR spectral regions: (3050-2800 cm-1), corresponding to the distribution of lipids, and (1855-1500 cm-1), corresponding to the distribution of protein amide I and amide II and carbonyl vibrations. SR-FTIR successfully discriminated between the two staphylococcal species and between the SCV and the non-SCV strains within the two IR spectral regions. Combined S. aureus SCVs (SCVhMu) showed a higher protein content relative to the non-SCV wild type. Complemented S. aureus SCV showed distinguishable differences from the SCVhMu and the wild type, including a higher content of unsaturated fatty acids. An increase in the CH2/CH3 ratio was detected in S. epidermidis SCV samples compared to the standard control. Protein secondary structure in standard S. epidermidis and SCVs consisted mainly of an α-helix; however, a new shoulder at 1635 cm-1, assigned to ß-sheets, was evident in the SCV. In conclusion, SR-FTIR is a powerful method that can discriminate between staphylococci species and to differentiate between SCVs and their corresponding natural strains.

Prevalence and predictive factors for infertility-related stress among infertile couples: A cross-sectional study from Jordan and the occupied Palestinian territories.

OBJECTIVES: To assess the level of infertility-related stress, associated socio-economic, and demographic factors among infertile couples living in Jordan and those living under the chronic Israeli-Palestinian conflict in the occupied Palestinian territories. METHODS: A cross-sectional study was carried out in a number of fertility and reproductive clinics in Jordan and occupied Palestinian territories over a period of 6 months. Trained clinical pharmacists interviewed the identified couples. RESULTS: A total of 443 participants were interviewed. Three variables were significantly and independently associated with global stress scores. The need of parenthood appears higher in women than men among infertile couples in Jordan and Palestine (p=0.005). The country of origin (p<0.001) made the greatest contribution of unique variance followed by family type (p=0.035). Additionally, a significant contribution to the model was carried out by the number of clinicians who followed up on the case (p=0.013). The average total cost of treatment since the problem had been diagnosed was 2936±4529 Jordanian dinar, which may be of concern to both Jordanians and Palestinians given the limited resources available in developing nations. CONCLUSION: This study shows a significant degree of stress among infertile couples. The place of origin, family structure, and presence of medical insurance had a significant impact on the infertility global stress score. This study emphasizes the necessity for specific psychological therapies that are currently lacking in public healthcare practices in both Jordan and Palestine.

Prevalence and Predictive Factors of Masked Depression and Anxiety among Jordanian and Palestinian Couples: A Cross-Sectional Study.

Although anxiety and depression are among the most prevalent mental disorders worldwide, they continue to gain less attention than their physical counterparts in terms of health care provision and population mentalisation. This cross-sectional study explores and compares the national prevalence of depression and anxiety signs/symptoms and well as identifying associated socio-demographic factors among Jordanian and Palestinian fertile couples. Four-hundred and sixty-nine participants were eligible for inclusion and agreed to participate in the study. The mean score for HAM-A and BDI-II were 12.3 ± 8.2 and 15.30 ± 10.0, respectively. According to the grading of HAM-A and BDI-II, the majority of the participants have graded themselves to be mildly anxious (N = 323, 68.9%) and around one third of participants (N = 148, 31.6%) moderately to severe depressed. The suicidal intent was remarkable and of concern where around 18.6% of participants had suicidal thoughts and wishes. There was a significant correlation between both HAM-score and BDI-II score and age [p = 0.01, p = 0.011, respectively], body weight [p = 0.01, p = 0.006, respectively], and total monthly income [p < 0.001, p < 0.001, respectively]. Our findings ought to alert healthcare professionals and other interested parties that there is a high burden of anxiety and depression symptoms among Jordanian and Palestinian couples. To support Jordanian and Palestinian couples' mental health, healthcare professionals, researchers, and educators favoured to concentrate on creating efficient and culturally relevant education, preventive, and intervention procedures utilising evidence-based guidelines.

The COVID-19 Pandemic and Patient Safety Culture: A Cross-Sectional Study among Community Pharmacies in Jordan.

The COVID-19 pandemic has dramatically imposed stressful conditions that may impact the ability of healthcare staff to provide safe and effective care. Research on patient safety culture among community pharmacies during the pandemic is limited. This study aimed to assess the patient safety culture among community pharmacies in Jordan during the COVID-19 pandemic. Pharmacists and pharmacy assistants from 450 community pharmacies were approached through online means, with 378 answering the questionnaire written in Arabic that had been adapted from the Community Pharmacy Survey on Patient Safety Culture (PSOPSC). This study showed that various patient safety standards were addressed to a high degree during the COVID-19 pandemic, as represented by the high positive response rate (PRR) measures that were mainly observed in the dimensions "Teamwork" (90.1%), "Patient Counseling" (85.2%), and "Staff Training and Skills" (82.7%). Furthermore, significantly higher PRR scores for the "Teamwork", "Staffing, Work Pressure, and Pace", "Response to Mistakes", "Organizational Learning-Continuous Improvement", and "Overall Perceptions of Patient Safety" dimensions were observed among participants who worked in independent pharmacies than those who worked in chain pharmacies. Despite an overall positive patient safety culture in the current context of community pharmacies in Jordan during the COVID-19 pandemic, pitfalls were observed in the "Staffing, Work Pressure, and Pace" dimension.

Feasibility of using simulated patients for onsite structured practice feedback in Jordanian community pharmacy settings.

Simulated patient (SP) visits followed with structured feedback is useful to outline training needs as well as preference for continuing professional education in community pharmacy settings. This study aimed to investigate community pharmacists' management of an over-the-counter (OTC) product request and feasibility of immediate SP feedback in Jordan. Four trained SP visited a sample of pharmacies in three main urban cities in Jordan requesting an antacid. Information request and professional behavior as well as content of information were evaluated. The SP provided structured immediate feedback. The pharmacy staff views on the visit and usefulness of the feedback were collected. A total of 57 visits were conducted. The average duration of SP visits was 1.55 min. The average score (±SD) for information seeking behavior was 16% (±7) and for professional behavior was 56% (±15). The average score for information provision provided spontaneously was 17.1% (±12). Upon demand by the SP; the average score for information improved to 47.6 (±18). Non-pharmacological advice was not offered often; only 6 (10.5%) visits. Written information was provided in 10 (17.5%) visits. Immediate feedback was accepted by all visited pharmacies. Participants expressed positive views about the SP visit and usefulness of the feedback. Community pharmacists supplied OTC drug without carful screening of symptoms and essential information. The SP approach with immediate feedback was shown feasible and well accepted. Further potential for use of SP with feedback formally in practice and professional development should be explored in future studies.

Assessing content and factors influencing responses to information requests in community pharmacies in Jordan: A simulated patients study.

OBJECTIVES: To assess the management of requests for information about a prescription only medicine (simvastatin for treatment of dyslipidemia) by pharmacy staff in community settings and explore the factors influencing the information content. METHODS: A cross sectional study conducted using the stimulated patient (SP) method between November 2018 and May 2019. The SP conveyed the request at the beginning of the encounter in a standardized way based on predetermined plots and was instructed to ask the pharmacy staff directly if information was not discussed spontaneously. After the visit, the SP provided written feedback including information about the scenario and a copy of individualized feedback. The study was reported according to the checklist for reporting research using simulated patient methodology (CRiSP). Factors influencing information content with or without information demand were investigated. RESULTS: A total of 55 visits were analyzed. The average content score for the information discussed spontaneously was 16.2% with the standard deviation (SD) equal to15.6. The score improved significantly after information was demanded by the SP; the average total information content score became 34.4% (SD = 16) with p < 0.001. The score of information discussed spontaneously was higher for male pharmacy staff, older age, more experience, and a Pharm D degree. When the SP prompted or demanded for information, older pharmacy staff with more experience and with a college degree scored higher. Independent pharmacies, longer visit durations, and less distraction were associated significantly with higher information scores Pharmacy staff aged 35-39 and those with 6-10 years of experience were significant contributors to spontaneous discussion of information with p values = 0.003 and 0.013, respectively. After the SP demanded information, pharmacy staff with less than 5 years of experience and greater confidence as well as longer visits were positively predicting higher information scores with p values of 0.049, 0.04, and 0.04, respectively. CONCLUSIONS: Information provided by community pharmacists responding to information requests about prescription only medications was found to be suboptimal. Patient requests for information were found to be a positive driver for better information content. Further research of mixed methodologies is required to clarify the factors and motivators enabling information exchange in community settings and to outline true training needs.

Factors Influencing Public Willingness to Reuse the Unused Stored Medications in Jordan: A Cross-Sectional Study.

The reissuing, redispensing, redistributing, or even recycling of the returned unused stored medicines is referred to as medicine reuse. A few studies have examined people's willingness to reuse unused stored medicines. This study aims primarily to explore the public's willingness to reuse unused stored medicines in the future and the factors affecting their decisions, and to assess the pharmacological types and formulations of the unused stored medicines by the public. A cross-sectional study was conducted using a convenient sampling technique over three weeks (February-March 2022) among Jordanian populations. Data were collected from 681 participants who agreed to fill out a questionnaire, which was distributed online. Participants showed a positive perception of reusing any of the unused stored medicines in the future; of those, 79.6% (n = 400) believed that reusing "unused medicines" has economic benefits and 50% (n = 251) believe there are environmental benefits. Moreover, more than half of the participants believed that reusing "unused medicines" is safe (n = 256, 51%), but provided that a pharmacist or a doctor evaluates their quality or that the unused medicines are stored well. Results from this study show that the public positively endorses the idea of reusing unused stored medicines if the quality and safety are assured. However, future studies are needed to evaluate the Jordanian healthcare professionals' perceptions towards medicine reuse and pharmaceutical companies' willingness to be a part or facilitator of medicine reuse.

Effect of Diluted Dakin's Solution Versus Standard Care on Diabetic Foot Ulcer Management: A Randomized Controlled Trial.

BACKGROUND: Diabetic foot ulcers (DFUs) are the main cause of hospitalizations and amputations in diabetic patients. Failure of standard foot care is the most important cause of impaired DFU healing. Dakin's solution (DS) is a promising broad-spectrum bactericidal antiseptic for management of DFUs. Studies investigating the efficacy of using DS on the healing process of DFUs are scarce. Accordingly, this is the first evidence-based, randomized, controlled trial conducted to evaluate the effect of using diluted DS compared with the standard care in the management of infected DFUs. METHODS: A randomized controlled trial was conducted to assess the efficacy of DS in the management of infected DFUs. Patients were distributed randomly to the control group (DFUs irrigated with normal saline) or the intervention group (DFUs irrigated with 0.1% DS). Patients were followed for at least 24 weeks for healing, reinfection, or amputations. In vitro antimicrobial testing on DS was performed, including determination of its minimum inhibitory concentration, minimum bactericidal concentration, minimum biofilm inhibitory concentration, minimum biofilm eradication concentration, and suspension test. RESULTS: Replacing normal saline irrigation in DFU standard care with 0.1% DS followed by soaking the ulcer with commercial sodium hypochlorite (0.08%) after patient discharge significantly improved ulcer healing (P < .001) and decreased the number of amputations and hospitalizations (P < .001). The endpoint of death from any cause (risk ratio, 0.13; P = .029) and the amputation rate (risk ratio, 0.27; P < .001) were also significantly reduced. The effect on ulcer closure (OR, 11.9; P < .001) was significantly enhanced in comparison with the control group. Moreover, DS irrigation for inpatients significantly decreased bacterial load (P < .001). The highest values for the in-vitro analysis of DS were as follows: minimum inhibitory concentration (MIC), 1.44%; minimum bactericidal concentration (MBC), 1.44%; minimum biofilm inhibitory concentration (MBIC), 2.16%; and minimum biofilm eradication concentration (MBEC), 2.87%. CONCLUSIONS: Compared with standard care, diluted DS (0.1%) was more effective in the management of infected DFUs. Dakin's solution (0.1%) irrigation with debridement followed by standard care is a promising method in the management of infected DFUs.

Pharmacists' Perception of the Coronavirus Pandemic (COVID-19) in Jordan: A Cross-Sectional Study.

OBJECTIVES: To analyze the role of pharmacists during the COVID-19 pandemic, to measure pharmacists' attitude toward COVID-19 safety measures (wearing masks, wearing gloves, isolation shield, good hygiene, etc.), and explore their perspectives regarding a second wave of the virus. METHODS: This cross-sectional online survey study was conducted in Jordan during the COVID-19 outbreak in July 2020 to discuss Jordanian pharmacists' awareness of safety at their workplace during the COVID-19 outbreak, their sources of information, and their predictions for COVID-19 vaccination. RESULTS: The participants (n = 311) were all pharmacists mostly aged between 23-30 years old (45%) and female (83%). The primary source of information about COVID-19 was social networking (38.9%). Pharmacists were committed to social distancing (86.5%) and wearing masks (76.2%). They expressed levels of agreement to their role in decreasing COVID-19 spread (94.2%) and correcting false information (94.5%); they expressed levels of expectation toward concern about a second COVID-19 wave (83%) that would be more severe than the previous one (43.4%). Pharmacists expected that an influenza vaccine might be helpful in decreasing severity and spread of the COVID-19 pandemic (56.9%). Pharmacists expected COVID-19 vaccine development within 6 months of administering our study survey (84.9%) and that vaccination might be effective in preventing COVID-19 (93%) infection. CONCLUSION: Pharmacists expressed positive roles on COVID-19 spread through exemplary actions, self-commitment to protection measures, and public health awareness. Social media as a source of health information should be cautiously investigated, and pharmacists should always refer to evidence-based sources. The role of pharmacists is particularly important for the upcoming era of COVID-19 vaccination administration and awareness.

Public perceptions about pharmacists' role in prescribing, providing education and delivering medications during COVID-19 pandemic era.

COVID-19 is a pandemic disease with a significant threat to public health. Public knowledge and perception significance in tackling pandemics have been evidenced in the previous research. This study aimed to explore public perceptions about pharmacists' educational and prescribing role, and the medication delivery service provided during COVID-19 outbreak. A cross-sectional study was conducted among the general population of Jordan using a convenient sampling technique for 10 days (15-25 May 2020). Data were collected from 578 participants who agreed to fill the questionnaire, which was distributed online. The questionnaire items were piloted using face validity and reliability. Participants showed a positive perception about the impact of pharmacists and pharmacy services provided during COVID-19 outbreak. More than half of the participants (61.1%) believed that pharmacists could prescribe over-the-counter medications, and only 15.7% believed that pharmacists could prescribe both over-the-counter and prescribed medications. Linear regression was performed to assess the factors that affect the participants' perception of pharmacists' prescribing and educational role and delivering medication during COVID-19. Females have lower perception scores towards medication delivery services compared with males (P value = .008). However, male participants, those aged less than 50 years, those with postgraduate degrees and those from non-medical profession showed a significantly higher perception score towards the impact of pharmacists and pharmacy services provided during COVID-19 outbreak compared with others (P value < .05 for all). This study indicates that the public positively endorsed the impact of the educational role of the pharmacist, medication delivery services and extending pharmacists' prescribing authority during COVID-19 pandemic. Also, findings from this study provide a platform to examine the perception of the public towards pandemic diseases and inform policy decision-makers to react by updating their regulation to allow extending pharmacy services and prescribing role during COVID-19 pandemic.

Impact of pharmacist interventions on drug-related problems in general surgery patients: a randomised controlled trial.

OBJECTIVES: The inappropriate use of medications is harmful and is a common issue in hospitalised patients. Patients hospitalised in general surgery wards are usually at high risk for drug-related problems (DRPs). This randomised controlled trial aimed to explore the value of a pharmaceutical care service conducted in general surgery wards in the identification and reduction of DRPs in comparison with standard medical care. METHODS: This study was conducted in general surgery wards including abdominal, cardiovascular, vascular, endocrine, orthopaedic and oncological surgeries at one of the largest teaching hospitals in Jordan over a period of 6 months. Recruited patients were randomised into intervention or control groups. Clinical pharmacists assessed patients' DRPs and submitted recommendations to resolve the identified DRPs in the intervention group. RESULTS: Patients in the intervention group (n=63) and the control group (n=60) had a mean age of 55±14.4 years, with 52.0% being women. A total of 1062 DRPs were identified, with a mean of 8.6±3.6 per patient (intervention group, 8.65±4.2; control group, 8.62±2.6; p=0.56). The commonly identified DRPs included safety (20.2%) and efficacy (19.0%) issues. The acceptance rate for pharmacists' recommendations by physicians was very high (90%) with a good DRP correction rate of 58.9% during patients' hospital stay. The value of pharmaceutical care was significantly reflected in the achievement of the therapeutic outcomes and prevention of morbidity (resolved/improved or prevented) of 68.2% (24.2%+44%) in the intervention group compared with 19.2% (12.4%+6.8%) in the control group (p<0.001). CONCLUSIONS: This study shows that DRPs are common among general surgery patients in Jordan, especially those related to drug safety and efficacy. Pharmacists' recommendations contributed substantially to resolving most of the identified DRPs and had a significant impact on improving medications used in general surgery patients.

Patients' attitude and willingness to pay for pharmaceutical care: An international message from a developing country.

BACKGROUND: Since patients are essential partners in determining priorities and resource allocation in the healthcare system, considerable efforts have been made to shift the focus of pharmacy profession from drug dispensing to patient-oriented care. Accordingly, the assessment of patient-oriented care has become a prominent method to evaluate the quality of the healthcare services delivered and willingness to pay (WTP) to receive them. OBJECTIVE(S): To determine patients' attitude towards pharmaceutical care services among general population in Jordan and their WTP for this service. METHODS: A cross-sectional study was conducted in a teaching hospital in Jordan over a period of six months. A contingent valuation method was used, with closed-ended questions to elicit participants' attitudes and WTP for pharmaceutical care services. RESULTS: A total of 223 participants were interviewed. Most of the participants showed a positive attitude towards pharmaceutical care services, with an average attitude score of 0.82 (±0.19). Almost 96.0% of participants believed that pharmacists must be committed to more counseling roles than dispensary activities. The majority of participants (194, 87.0%) expressed their interest in pharmacists checking their medications at least once per month. Most of the participants (212, (95.1%) believed that the pharmacist should be reimbursed for providing a pharmaceutical care service that would potentially reduce medication-related problems (MRPs) by 50%. Of these, 208 (93.3%) participants were willing to pay out of their pockets an average maximum amount of $3.95 (±4.23) for the pharmaceutical care services they may receive to reduce 50% of the risk of MRPs. CONCLUSIONS: This study revealed that Jordanian people have a supportive attitude regarding pharmacists' abilities in providing pharmaceutical care services in addition to dispensing. Majority of participants in this study were willing to pay for pharmaceutical care services that would reduce the risk of MRPs.

Proteinases as Biomarkers in Breast Cancer Prognosis and Diagnosis.

BACKGROUND: Breast cancer is the second leading cause of cancer-related deaths among women in the Western World. METHOD: Upon diagnosis and treatment in the preinvasive state, the five years survival rate levitate up to 93%, making early detection crucial for dedicative diagnosis and treatment. Currently, mammography is the most efficacious diagnostic modality. However, this technique does not match the ultimate sensitivity. Other routinely used biomarkers include tumor size, histological type, nuclear and cellular characteristics, mitotic index, vascular invasion, hormonal and axillary lymph node status were not good enough to predict the course of cancer. To date, researchers revealed a change in the level of some proteinases in breast cancer tissue and reported the role of these proteinases in tumor aggressiveness and patient response to therapy. CONCLUSION: This review summarizes the potential role of serine proteinases (including urokinasedependent plasminogen activator and kallikreins) and zinc metalloproteinases (including matrix metalloproteinase and A disintegrin and metalloproteinase) as either a prognostic and/or diagnostic breast cancer biomarkers. These proteinases plus genetic biomarkers could be implemented in the development of multiplex bio sensing platform toward early breast cancer detection, diagnosis, monitor progression and therapeutic success.

Multiple Prescription Drug Abuse and Salt Craving in a Psychotic Patient: A Case Report From a Teaching Hospital in Jordan.

INTRODUCTION: Diuretics and laxative abuse as a means of purging is common in patients with bulimia nervosa and there may be an underestimation of the true prevalence of diuretic abuse, as some are also available without prescription. CASE PRESENTATION: A 28-year-old woman presented with tetany due to hypocalcemia, hypokalemia and hypomagnesemia. She had a history of laxative and diuretic abuse, and salt craving. Psychiatric evaluation revealed a disturbed social history with masked depression that necessitated treatment. CONCLUSIONS: Multiple prescription drug abuse and salt/salty food addiction usually reflects a personality of addiction, which leads to harmful use and dependence.