International pharmacy students' perceptions towards artificial intelligence in medicine-A multinational, multicentre cross-sectional study.

AIMS: To explore international undergraduate pharmacy students' views on integrating artificial intelligence (AI) into pharmacy education and practice. METHODS: This cross-sectional institutional review board-approved multinational, multicentre study comprised an anonymous online survey of 14 multiple-choice items to assess pharmacy students' preferences for AI events in the pharmacy curriculum, the current state of AI education, and students' AI knowledge and attitudes towards using AI in the pharmacy profession, supplemented by 8 demographic queries. Subgroup analyses were performed considering sex, study year, tech-savviness, and prior AI knowledge and AI events in the curriculum using the Mann-Whitney U-test. Variances were reported for responses in Likert scale format. RESULTS: The survey gathered 387 pharmacy student opinions across 16 faculties and 12 countries. Students showed predominantly positive attitudes towards AI in medicine (58%, n = 225) and expressed a strong desire for more AI education (72%, n = 276). However, they reported limited general knowledge of AI (63%, n = 242) and felt inadequately prepared to use AI in their future careers (51%, n = 197). Male students showed more positive attitudes towards increasing efficiency through AI (P = .011), while tech-savvy and advanced-year students expressed heightened concerns about potential legal and ethical issues related to AI (P < .001/P = .025, respectively). Students who had AI courses as part of their studies reported better AI knowledge (P < .001) and felt more prepared to apply it professionally (P < .001). CONCLUSIONS: Our findings underline the generally positive attitude of international pharmacy students towards AI application in medicine and highlight the necessity for a greater emphasis on AI education within pharmacy curricula.

Living with bronchial asthma: A qualitative study among patients in a hill village in Nepal.

INTRODUCTION: Bronchial asthma continues to be a problem in the Himalayan country of Nepal. This study explored the impact of bronchial asthma on patients' lives in a hill village in Syangja district, Nepal, and obtained information about the perceived impact of the illness, knowledge of the disease, self-care behaviors and treatment among patients. MATERIAL AND METHODS: The study site is the village of Jyamire (located at an elevation between 900 to 1200 m) Syangja district. Individuals suffering from asthma residing in the village aged 18 years or above were included. Semi-structured interviews were conducted face-to-face with the respondents at their homes using an interview guide. The interviews were audio recorded, transcribed in the Nepali language, and then translated into English for further analysis. RESULTS: Most participants were female, between 18 to 60 years of age, and housewives. Most houses were built of mud and poorly ventilated. Gas was used for cooking though firewood was also used. Most used to get an average of three serious attacks a year both during winter and summer. The themes that emerged were the number and seasonal variation in attacks, the perceived effect of asthma on their lives and social interactions, the knowledge of the interviewee about the disease, the impact of asthma on their socioeconomic status, and treatment and self-care behaviors. Residing in a hill village required them to walk up and down several times a day and the disease seriously impacted their lives. The smoke produced during different ceremonies and during cooking also worsened their asthma. CONCLUSION: Findings suggest, the existence of multiple factors, a few unique to Nepal contributing to poor asthma control. Though the recent socioeconomic improvement has led to improved prevention and treatment options, asthma seriously affected the patients.

A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education.

OBJECTIVE: To implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students' abilities to manage patients with low HL. METHODS: Students virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman's rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. RESULTS: A total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the "gathering information" domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the "patient management" domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. CONCLUSION: An HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.

A national survey of knowledge, attitude, practice, and barriers towards pharmacovigilance and adverse drug reaction reporting among hospital pharmacy practitioners in the United Arab Emirates.

BACKGROUND: Pharmacovigilance (PV) is an essential component of patient safety and pharmacists are expected to be aware of the PV processes and willing to report ADRs. This study assessed the hospital pharmacists' knowledge, attitude, and practice toward PV, barriers faced by them in ADR reporting, and factors influencing ADR reporting. METHOD: A cross-sectional nationwide questionnaire survey was conducted among randomly chosen hospital pharmacists across UAE from March to July 2022. The filled questionnaires were assessed both descriptively [median (IQR scores), maximum 5 for Likert type and 1 for knowledge questions] and inferentially using the Mann-Whitney U test (for dichotomous variables) and the Kruskal-Wallis test (for variables with more than two responses) at alpha value = 0.05. Post hoc analyses and correlations were performed wherever applicable. RESULTS: Of the 342 respondents, the majority were knowledgeable about the concepts of PV (93.3%; n = 319) and ADRs (86.8%; n = 297). The overall median (IQR) knowledge score was 5 (3-7)/9. Knowledge levels within 'qualification groups' varied significantly (p-value < 0.001) and participants 'between 10 and 14 years of experience' had more knowledge than those 'with < 5 years of experience' (p-value < 0.001, Bonferroni test). The overall median (IQR) attitude score was 22 (20-24)/30. Most respondents (90.6%; n = 311) were willing to spare time to review patients' ADR reports. The overall median (IQR) practice score was 17.5 (11-21)/24. Although 71.1% (n = 243) noticed ADRs during the previous year, only 53.2% (n = 182) reported an ADR, the reasons for underreporting being mainly due to a lack of proper training [median IQR score 4(4-5)/5]. The 'clinical pharmacists' engaged themselves more in pharmacovigilance than 'pharmacists' (p-value = < 0.001), and 'inpatient pharmacists' reported more ADRs than 'pharmacists' (p-value = 0.018); Bonferroni test. The overall median (IQR) barrier score was 26 (23-29)/40 and the common barrier was 'lack of awareness about the national ADR reporting system 4 (4-5)'. The pharmacists in this study suggested incentives for reporting ADRs (69.3%; n = 237). CONCLUSION: The authors concluded professional training courses for practicing pharmacists and educational curriculums related to PV and ADR reporting processes are to be considered for future pharmacists in order to inculcate ADR reporting culture and practices.

Pharmacy students’ readiness and preparedness to contribute during disasters: a cross-sectional two institutional study from the UAE

Background: Pharmacists involvement in disaster management has been acknowledged in the literature for their involvement in various clinical and non-clinical services. Future pharmacists are expected to be skill full in handling medicine disasters. This study aimed at investigating the knowledge, attitude, and readiness of pharmacy students to contribute to disasters in the United Arab Emirates (UAE). Methods: A quantitative, descriptive, cross-sectional study was conducted in two pharmacy colleges in the UAE using a pre-validated electronic questionnaire. Data were collected using simple random sampling from February 2021 to November 2021. The questionnaire consisted of five sections: demographic information, knowledge, attitude, and readiness to practice with perceived barriers. The Likert data were not normally distributed (Shapiro-Wilk test, p<0.05) and hence analyzed using the Mann-Whitney U test and Kruskal Wallis test at alpha=0.05. Results: A total of 258 pharmacy students were surveyed. The majority were fourth-year students (51.2%, n = 132) with a mean (SD) age of 20.46 [2.35] years. The average score for total knowledge was 155.3 (60.2%), with no statistical differences between groups. The median interquartile range (IQR) scores for total attitude, total readiness to practice, and barriers to disaster medicine were 4. Conclusions: Students exhibited varying levels of knowledge and expressed a positive attitude and willingness to practice disaster medicine. Inclusion of various educational modules in pharmacy curricula could help to better prepare students for the practice of disaster medicine. (AU)

Pattern of drug therapy related problems encountered by clinical pharmacists in a critical care setting in Nepal

Background: Most hospitalized patients experience Drug Therapy-Related Problems (DTRPs) resulting in morbidity, mortality, and an increase in the cost of treatment. DTRPs are an important issue and a serious yet preventable problem. Objective: To identify DTRPs in the department of critical care medicine of a tertiary care center in Nepal. Methods: This was a cross-sectional study carried out at the department of critical care medicine in a tertiary care hospital in Kathmandu, Nepal from August to November 2021. All the patients admitted to ICU/ high care unit (HCU) for more than 48 hours during the study period were recruited in this study. Two clinical pharmacists visited the ICU/ HCU daily to identify any drug therapy-related problems. The Pharmaceutical Care Network Europe (PCNE) Classification system version 9.1 was referred for the classification of identified DTRPs. Descriptive statistics were applied for demographic variables. The Chi-square test was used for categorical variables. Pearson correlation was used to study the relationship between patient variables and the number and types of DTRPs. Results: DTRPs were identified in 74.2% (n=89) of patients. More than one DTRP was identified in 38.5% of patients. The identified DTRPs were primarily classified into two sections: Problems and Causes. A total of 106 problems were identified among which unnecessary drug treatment (40.5%, n=43) was the most common problem. For the causes: total of 137 were identified, out of which the drug and dose selection accounted for 44.5 and 16.8%, respectively. The average DTRP per patient was 1.5± 0.7. Antibiotics 30 (22%) and multivitamins, 10 (7%) were the maximal involved in DTRPs. More DTRPs were observed in male patients (n=60, 80%). The association between dose selection and gender was significant. Drug selection issues were observed more in patients prescribed multiple drugs and with a shorter hospital stay. (AU)

Readiness for Interprofessional Education Among Health Profession Students in a University in the United Arab Emirates.

Introduction: Inter-Professional Education (IPE) is an educational engagement between students from two or more professions possibly leading to better collaboration among them in the future workplace. Several organizations have advocated, developed, and updated guidelines for IPE. Objective: This study was aimed at assessing the medical, dental, and pharmacy students' readiness toward interprofessional education (IPE), and to identify the association between readiness and the demographic profile of students in a university in the United Arab Emirates (UAE). Methods: A cross-sectional questionnaire-based exploratory study involving 215 medical, dental, and pharmacy students at Ajman University, UAE, using convenience sampling. The survey questionnaire (Readiness for Interprofessional Learning Scale, RIPLS) had a total of 19 statements. The first 9 items were related to "teamwork and collaboration", items 10-16 were related to "professional identity", and the remaining three (items 17-19) were related to "roles and responsibilities". The individual statements' median (IQR) scores were calculated and the total scores were compared with the demographic characteristics of the respondents with suitable non-parametric tests at alpha=0.05. Results: Altogether, 215 undergraduate students (medical (n= 35)), pharmacy (n=105), and dental (n=75) responded to the survey. The median (IQR) score for the 19 individual statements was '5 (4-5)' for 12 of the statements. The total scores and domain-specific scores (teamwork and collaboration, professional identity, and roles and responsibilities) according to respondents' demography showed significant differences only in the case of the educational stream with professional identity score (p=<0.001), and the total RIPLS score (p=0.024). Further, post hoc pairwise comparison showed a significant difference between medicine-pharmacy (p<0.001), and dentistry-medicine (p=0.009), for professional identity, and medicine-pharmacy (p=0.020) for the total RIPLS score. Conclusion: A high readiness score among students offers the possibility of conducting IPE modules. A favorable attitude can be considered by curriculum planners while initiating IPE sessions.

Materiovigilance in Perspective: Understanding Its Concept and Practice in the Global Healthcare System.

Materiovigilance (Mv) has the same purpose and approach in ensuring patient safety as pharmacovigilance but deals with medical devices associated with adverse events (MDAEs) and their monitoring. Mv has been instrumental in recalling many defective or malfunctioning devices based on their safety data. All MDAEs, such as critical or non-critical, known, or unknown, those with inadequate or incomplete specifications, and frequent or rare events should be reported and evaluated. Mv helps to improve medical devices' design and efficiency profile and avoid device-related complications and associated failures. It alerts consumers and health professionals regarding counterfeit or substandard devices. Common events reported through Mv are device breakage and malfunction, entry- and exit-site infections, organ perforations or injuries, need for surgery and even death, and life cycle assessment of devices. Health authorities globally have developed reporting frameworks with timeframes for MDAEs, such as MedWatch in the USA, MedSafe in New Zealand, and others. Health professionals and consumers need to be made aware of the significance of Mv in ensuring the safe use of medical devices and getting familiar with the reporting procedures and action plans in case of a device-induced adverse event.

Knowledge, attitude, and readiness towards disaster management: A nationwide survey among healthcare practitioners in United Arab Emirates.

Health professionals are expected to be knowledgeable on disaster medicine and prepared to deal with medicine disasters. This study aimed to assess the level of knowledge, attitude, and readiness to practice disaster medicine among health care workers in the United Arab Emirates (UAE) and determine the influence of sociodemographic factors on the practice of disaster medicine. A cross-sectional survey conducted among various healthcare professionals in different healthcare facilities in the UAE. An electronic questionnaire was used and randomly distributed throughout the country. Data were collected from March to July 2021. The questionnaire consisted of 53 questions distributed among four sections: demographic information, knowledge, attitude and readiness to practice. The questionnaire distribution involved a 5-item of demographic information, a 21-item of knowledge, a 16-item of attitude and an 11-item of practice. A total of 307 (participation rate ~80.0%, n = 383) health professionals practicing in the UAE responded. Of these, 191 (62.2%) were pharmacists, 52 (15.9%) were physicians, 17 (5.5%) were dentists, 32 (10.4%) were nurses, and 15 (4.9%) were others. The mean experience was 10.9 years [SD ±7.6] (median 10, IQR 4-15). The median (IQR) overall knowledge level was 12 (8-16) and the maximum knowledge level was 21. The overall knowledge level differed significantly between the age groups of the participants (p = 0.002). The median (IQR) of overall attitude was (57, 50-64) for pharmacists, (55, 48-64) for physicians, (64, 44-68) for dentists, (64, 58-67) for nurses, and (60, 48-69) for others. The total attitude score differed significantly between the different professional groups (p = 0.034), gender (p = 0.008) and workplace (p = 0.011). In terms of readiness to practice, respondents' scores were high and not significantly related to age (p = 0.14), gender (p = 0.064), professional groups (p = 0.0.762), and workplace (p = 0.149). This study showed that health professionals in the UAE have moderate levels of knowledge, positive attitudes, and high readiness to engage in disaster management. Gender and place of work can be considered as influencing factors. Professional training courses and educational curriculums related to disaster medicine can be beneficial to further reduce the knowledge-attitude gap.

A nationwide exploratory survey assessing perception, practice, and barriers toward pharmaceutical care provision among hospital pharmacists in Nepal.

Pharmaceutical care (PC) services reduce medication errors, improve the use of medicines, and optimize the cost of treatment. It can detect medication-related problems and improve patient medication adherence. However, PC services are not commonly provided in hospital pharmacies in Nepal. Therefore, the present study was done to determine the situation of PC in hospital pharmacies and explore the perception, practice, and barriers (and their determinants) encountered by hospital pharmacists while providing PC. A descriptive online cross-sectional study was conducted from 25th March to 25th October 2021 among pharmacists with a bachelor's degree and above working in hospital pharmacies using non-probability quota sampling. The questionnaire in English addressed perception and practice regarding PC, and barriers encountered and were validated by experts and pre-tested among 23 pharmacists. Descriptive statistics were used to describe the data. Kendall's correlation was used to explore the correlations among various perception and practice constructs. The scores were also compared among subgroups of respondents using the Mann-Whitney test for subgroups with two categories and Kruskal-Wallis test for greater than two categories. A total of 144 pharmacists participated in the study. Majority of the participants were male, between 22 and 31 years of age, and had work experience between 10 and 20 years. Over 50% had received no training in PC. The perception scores were higher among those with more work experience and the practice scores among those who had received PC training. Participants agreed that there were significant barriers to providing PC, including lack of support from other professionals, lack of demand from patients, absence of guidelines, inadequate training, lack of skills in communication, lack of compensation, problems with access to the patient medical record, lack of remuneration, and problems with accessing objective medicine information sources. A correlation was noted between certain perceptions and practice-related constructs. Hospital pharmacists who participated had a positive perception and practice providing PC. However, PC was not commonly practised in hospital pharmacies. Significant barriers were identified in providing PC. Further studies, especially in the eastern and western provinces, are required. Similar studies may be considered in community pharmacies.

Undergraduate Medical Students' and Interns' Knowledge and Perception of Artificial Intelligence in Medicine.

Purpose: Artificial intelligence (AI) is playing an increasingly important role in healthcare and health professions education. This study explored medical students' and interns' knowledge of artificial intelligence (AI), perceptions of the role of AI in medicine, and preferences around the teaching of AI competencies. Methods: In this cross-sectional study, the authors used a previously validated Canadian questionnaire and gathered responses from students and interns at KIST Medical College, Nepal. Face validity and reliability of the tool were assessed by administering the questionnaire to 20 alumni as a pilot sample (Cronbach alpha = 0.6). Survey results were analyzed quantitatively (p-value = 0.05). Results: In total 216 students (37% response rate) participated. The median AI knowledge score was 11 (interquartile range 4), and the maximum possible score was 25. The score was higher among final year students (p = 0.006) and among those with additional training in AI (p = 0.040). Over 49% strongly agreed or agreed that AI will reduce the number of jobs for doctors. Many expect AI to impact their specialty choice, felt the Nepalese health-care system is ill-equipped to deal with the challenges of AI, and opined every student of medicine should receive training on AI competencies. Conclusion: The lack of coverage of AI and machine learning in Nepalese medical schools has resulted in students being unaware of AI's impact on individual patients and the healthcare system. A high perceived willingness among respondents to learn about AI is a positive sign and a strong indicator of futuristic successful curricula changes. Systematic implementation of AI in the Nepalese healthcare system can be a potential tool in addressing health-care challenges related to resource and manpower constraints. Incorporating topics related to AI and machine learning in medical curricula can be a useful first step.

Gap analysis in manufacturing, innovation and marketing of medical devices in the Asia-Pacific region.

INTRODUCTION: Although similar in many aspects of manufacturing and regulatory provisions to medicines, medical devices have their provisions and attract considerable investments in manufacturing and innovation. While the U.S. holds the leading global position in the devices market, Asia Pacific (APAC) countries like China, Japan, Singapore, and South Korea have proved tremendous market potential holding top ten positions. Still, many APAC countries are import-reliant due to hurdles in technological innovation and regulatory provisions. AREAS COVERED: The review aimed to explore those predictors or hurdles and analyzed these to enhance the region's export capacity gradually. EXPERT OPINION: Policymakers in APAC countries with no device manufacturing and health technology assessment capacities would be benefited from the review. The findings showed the presence of a gap in manufacturing, innovation, and marketing of devices within the APAC region and between APAC and western countries. Stringent regulatory measures and quality indicators are still lacking in many APAC nations, and there is an urgent need to harmonize regulatory standards. Being a region constituting over one-third of the global population, a considerable investment in innovation, manufacturing, and establishing quality standards is urgently needed among APAC countries to ensure an adequate supply of quality medical devices.

Safety profile of COVID-19 vaccines, preventive strategies, and patient management.

INTRODUCTION: Fast-track approval has led to serious concerns on the perception of COVID-19 vaccines' safety among the public. Common adverse drug reactions (ADRs) of COVID-19 vaccines are minor localized reactions, while systemic ADRs have been reported rarely. The serious ADRs include anaphylaxis, vaccine-induced immune thrombotic thrombocytopenia syndrome (VITTS), and reactions related to the pharmaceutical excipients present in the vaccine. A comprehensive review on the safety of COVID-19 vaccines would help in early identification and better management of ADRs. This literature review was conducted using PubMed, Google Scholar, COVID-19 Vaccine package inserts, and UpToDate. AREAS COVERED: This article provides various aspects of COVID-19 vaccine safety and offers strategies to prevent and clinically manage suspected ADRs related to COVID-19 vaccines. EXPERT OPINION: A careful consideration of contraindications and patient education on early identification of serious ADRs are the cornerstones in tackling safety concerns associated with COVID-19 vaccines. Most of the mild ADR cases are manageable with over-the-counter medications, while the serious ones may require physician oversight and hospitalization. It is also mandatory to report all ADRs to the local pharmacovigilance centers, with a higher priority given to the moe significant ones, in order to improve vaccine safety data.

Readiness for Interprofessional Learning Among First Year Medical and Dental Students in Nepal.

Introduction: Health professional education curricula in Nepal do not include interprofessional education (IPE). Though a previous study conducted in Nepal identified positive attitudes among medical and nursing students, so far there are no studies assessing the health professional students' readiness toward IPE. The aim of the study was to assess the readiness for IPE among medical and dental students. Methods: The present cross-sectional study explored the readiness of conveniently selected first-year medical and dental students towards IPE and compared readiness among subgroups of respondents. The readiness was assessed through an online survey using the standard Readiness for Interprofessional Learning Scale (RIPLS) during June 2021. The nineteen questions in RIPLS were categorized under four domains: teamwork and collaboration (items 1-9), negative professional identity (items 10-12), positive professional identity (items 13-16), and roles and responsibilities (items 17-19). The individual statements were scored and assessed as per the study objectives. The scores were not normally distributed, so non-parametric tests (Mann-Whitney U-test and Kruskal Wallis test) were used. Results: A total of 83 students (69 medical and 14 dental) students responded. The median total score was 75, IQR 6 with the maximum score being 95. The median (IQR) scores for the domains teamwork and collaboration were 38 (IQR 3), negative professional identity 11 (IQR 2), positive professional identity 16 (IQR 3), roles and responsibilities 10 (3). The scores were different between students aged 20 years and below = 37, and above 20 years = 38; (p =< 0.001) in the negative professional identity domain and the total score (p = 0.001). The scores were also different among those with and without previous learning exposure with other discipline students in the same class (p = 0.046). A high median score of 5 was achieved for 8 out of 19 statements in the questionnaire. Conclusion: The findings showed a high level of readiness for IPE among student respondents. Study findings can be considered as a positive factor for implementing IPE sessions.

Opportunities for extended community pharmacy services in United Arab Emirates: perception, practice, perceived barriers and willingness among community pharmacists.

BACKGROUND: Community pharmacies are widely distributed in the United Arab Emirates where community pharmacists' (CPs') perspectives on provision of extended community pharmacy services (ECPS) is not known. This study assessed CPs perception, practices, perceived barriers and willingness to provide ECPS. METHODS: A descriptive cross-sectional survey using a self-administered Likert-type questionnaire (Cronbach alpha = 0.976) was conducted among 195 community CPs in Northern emirates, selected through multistage sampling technique. The filled questionnaires were assessed for CPs' perception, practice, perceived barriers and willingness to perform ECPS. Mann-Whitney and Kruskal-Wallis tests examined the association between demography and outcome variables (alpha value of 0.05) with further analysis using Dunn' post hoc test. RESULTS: Of the respondents, 71.8% (n = 140) 'strongly agreed' that every CP must provide ECPs and 39% (n = 76) 'strongly agreed' in supporting ECPS with another 44.1% (n = 86) 'agreed' on the same. The major barriers felt by CPs in practicing ECPS were lack of incentive for employee pharmacists [3 (2-3)], lack of documentation [3 (2-3)], insufficient time [3 (2-3)] and lack of patients' demand [(2-3)]; maximum score (5-5). CPs also responded 'completely' willing to provide services such as blood pressure measurement, pregnancy testing and BMI measurement. Pharmacy location influenced practice score (p = 0.008) and access to the internet had a significant effect on barriers score (p = 0.000). Availability of drug information sources impacted perception (p = 0.038), practice (p = 0.000) and willingness scores (p = 0.011). CONCLUSIONS: CPs' perception on providing ECPS was positive and they are currently offering ECPS within their available resources and facilities. Less demand from patients and lack of time were reportedly the major barriers in offering ECPS. Proper utilization of CPs in providing ECPS can complement the healthcare system with additional cost and time savings for the patients.

An exploratory survey on community pharmacists' service provision for pregnant and lactating women in Sharjah, United Arab Emirates.

Over-the-counter (OTC) medications are generally deemed safe to be used during pregnancy and lactation. However, some products can be harmful to the mother, fetus or breast-fed child, which presents a challenge to health professionals and consumers. This study was aimed at assessing the practice of OTC medication dispensing and counseling services provided to pregnant and lactating by community pharmacists (CPs). A cross-sectional descriptive questionnaire-based survey was answered during February-November 2020, by licensed CPs practicing in Sharjah, United Arab Emirates. The determination of the significant factors associated with the CPs' views and OTC medication dispensing during pregnancy and breastfeeding was carried out using logistic regression. Among 256 respondents, dispensing medicines and referral to a physician were the predominant services provided to pregnant and lactating women. Respondents dispensed medications mostly to treat headache (74.2%), fever (62.5%) in pregnant women, and headache (81.3%) and fever (65.2%) in lactating mothers. Referral to a physician was common in pregnant women in the following cases: varicose veins (72.7%), swelling of the feet and legs (71.9%), and vaginal itching (53.9%). In breastfeeding women, the referrals were commonly for varicose veins (79.7%), swelling of the feet and legs (73.0%) and mastitis (70.3%). Most participants came to an agreement that CPs are capable of counselling and providing pregnant and lactating women the best OTC treatment. Around 35% of the respondents stated that OTC medicines are not safe to be used during pregnancy. One in five respondents stated that OTC medicines are not safe for breastfeeding women. CPs were confident to counsel and provide advice to pregnant and breastfeeding women to address medication and health problems. Proper utilization of CPs can contribute largely to the healthcare system in managing common minor ailments in pregnant and lactating women, reducing the need to visit the physician and enhancing patient safety.

Perceived Stress and Quality of Life Among Final-Year Pharmacy Students in the United Arab Emirates During COVID-19 Pandemic Lockdown.

BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic has caused huge disruptions worldwide affecting most people including university students. The impact of the pandemic lockdown on pharmacy students' stress levels and quality of life (QoL) is not well studied. This study assessed the impact of COVID-19 lockdown on perceived stress levels and QoL among final-year undergraduate pharmacy students at Ajman University, United Arab Emirates (UAE). METHODS: A cross-sectional electronic survey was conducted among final-year Bachelor of Pharmacy students at Ajman University during the COVID-19 lockdown period. The perceived stress scale and World Health Organization Quality of Life Instrument (WHOQOL-BREF) were administered through Google Forms. The filled responses were exported to IBM SPSS statistics, Version 26, scored as per the standard scoring procedures, and analyzed to answer the study objectives. Since the data were not distributed normally (p=0.000, Kolmogorov-Smirnov test), non-parametric tests (Mann-Whitney test and Kruskal-Wallis test) were performed to compare the median (IQR) scores with demographic parameters at an alpha value of 0.05. RESULTS: Of the eligible 94 students, 81 (male=16, 19.8%, female = 65, 80.2%) responded. The perceived stress level due to COVID-19 among the participants of a score of 24 suggests that the students suffered a "moderate" level of stress with no statistical significance between genders regardless of the place of residence in the seven Emirates (p=0.371) of the UAE. During the previous month of conducting the survey, 40.7% (n=33) of the respondents "very often" felt nervous and 22% (n=18) "fairly often" felt nervous with a median (IQR) score 3 (2-4); 3 denotes 'sometimes'. Of the respondents, 6.2% (n=14) "very often" and 21% (n=17) "fairly often" felt that things were going their own way. Regarding the QoL statements, a median (IQR) score of 3 (3-4) was obtained for the question on "How much do you enjoy life?", and the median scores were "4 (very much)" for more than half of the statements overall denoting a better QoL. The study reported females to have more physical pain, which may prevent them from carrying out their daily activities, than males (p=0.001) reflecting a better QoL among males over females during the lockdown. It also reflects a higher need for medications among females compared to males (p=0.014). All participants showed negative feelings, which is more apparent among male participants (4, 3-4.5) when compared to female participants (3, 2-3) (P = 0.001). CONCLUSION: The impact of COVID-19 lockdown on perceived stress and self-reported QoL is minimum. Age, gender and other demographic factors had little or no effect on stress levels, but gender influenced "experience of physical pain" and "requirement for medications", with more likelihood in females. Student friendly educational approaches and proper implementation of educational reforms can help minimizing student stress and improving QoL during vulnerable times like lockdowns.

Community Pharmacists' Awareness toward Their Roles in Healthcare and Interaction with General Practitioners: A Cross-Sectional Study.

INTRODUCTION: There is a paucity of data on the extended role of community pharmacists (CP) in Malaysia. This study is aimed to evaluate CPs awareness toward their roles in healthcare and interaction with general practitioners (GPs). MATERIALS AND METHODS: A cross-sectional design using a validated questionnaire was conducted nationwide among randomly selected Malaysian CPs. The questionnaire consisted of consisted of 32 questions with three sections. The Cronbach's alpha measure for the scale on awareness was 0.494 and 0.724 for the interaction between CPs and GPs. Descriptive statistics were reported. The Chi-square test, Mann-Whitney test, Kruskal-Wallis test, and post hoc analyses were applied at the alpha level of 0.05. RESULTS: Of the 127 CPs who filled out the responses, 57.5% (n = 73) mentioned that they rarely or never interacted with GPs. Many CPs (n = 106, 83.5%) were aware of their role in providing patient education, and 109 (85.8%) indicated that they could suggest nonprescription medicines to patients, whereas 88 respondents (69.3%) were aware that they could suggest alternative medicines. A total of 117 respondents (92.1%) indicated their willingness to perform selected screening tests and identify and prevent prescription errors. A considerable number of CPs (n = 76, 59.8%) were aware of their ability to design and regulate prescribed regimens, and 89 (70.1%) showed their willingness to monitor these regimens. The total average score of the CPs' awareness toward their roles in providing healthcare for the 16 activities/items and the value of the interaction mean score was 12.00 (±2.92), with a median score of 12.00 (interquartile range: 9.5-14.5). CONCLUSIONS: Malaysian CPs are fully aware of their role in providing healthcare and pharmaceutical care. Though the majority of them were willing to provide extended services, they are often unable to perform these roles due to the lack of interprofessional collaboration, lack of time, and absence of remuneration for their extended services. Training programs, practice guidelines, and professional service fee may encourage CPs to perform more extended services.

Assessment of a Pharmacovigilance Module: An Interventional Study on Knowledge, Attitude, and Practice of Pharmacy Students.

BACKGROUND: The aim of the study was to assess the impact of a pharmacovigilance module on the knowledge, attitude, and practice (KAP) of pharmacy students and elucidate their feedback on the module. METHODOLOGY: Bachelor of pharmacy students at Pokhara University, Nepal, were assessed for their baseline KAP on drug safety and related issues using a KAP questionnaire (Cronbach alpha 0.70) consisting of 25 questions. Students' baseline KAP was assessed and after that, they were grouped into either control (2nd and 4th year) or test (1st and 3rd year) groups. The later received the pharmacovigilance training in three 1-h sessions spread over 6 months at 0, 90, and 180 days; the sessions covered introduction to pharmacovigilance, theoretical aspects of pharmacovigilance, and adverse drug reaction reporting procedures. KAP scores and student feedback were analyzed at 5% significance level. RESULTS: A total of 124 students (control = 56 and test = 68) were studied. The median (interquartile ranges [IQRs]) of the baseline scores prior to grouping the students into control and test groups was 20 (18.25-21.00) for knowledge, 19.5 (18.00-21.00) for attitude/practice, and 39 (37.00-41.00) for the total score. Males (n = 81) had a slightly higher median score of 40 (37-42) than females (n = 43), who had a median score of 38 (36-41). The KAP score for the control group was 40 (38-42) at baseline, 42 (20-44) during first follow-up, 41.5 (40-44) during second follow-up, and 41 (39-44.5) during third follow-up. For the test group, upon intervention, the KAP scores improved from 39 (36.25-40.75) at baseline to 42 (39.50-44.00) at the 1st follow-up, 43 (41-45) at the 2nd follow-up, and 44 (42-45) at the 3rd follow-up (P < 0.001). The median feedback score (IQR) was 86 (81.5-90.0). CONCLUSIONS: Pharmacy students had good attitude/practice scores and relatively poor knowledge scores at baseline, which improved postintervention. Student feedback about the module was positive.

Risk Perception and Hesitancy Toward COVID-19 Vaccination Among Healthcare Workers and Staff at a Medical College in Nepal.

PURPOSE: The study was conducted to explore the perception of healthcare workers and staff towards the risk of COVID-19 vaccination and to study vaccine hesitancy amongst them. METHODS: A total of 266 healthcare workers working in a medical college in Nepal were studied using a questionnaire consisting of three sections: demographics, experiences and perception of COVID-19, and COVID-19 vaccine safety. Data were analyzed using IBM SPSS version 26. The total perception score was calculated by noting respondent's agreement with a set of eleven statements using a Likert-type scale. Non-parametric tests (Mann-Whitney U and Kruskal-Wallis) were used for analysis (p<0.05). RESULTS: Altogether, 13.9% of respondents had been diagnosed COVID-19 positive prior to the survey. Many considered themselves to be at increased risk of contracting COVID-19. Only over one third (38.3%) were willing to be vaccinated. The most common reason for refusal/hesitancy was concern about vaccine safety. The median (interquartile range) total perception score was 36 (4) (maximum possible score=55). The score was significantly higher among those who had been diagnosed COVID positive, those who perceived the pandemic as being moderate or severe and among those willing to be vaccinated. CONCLUSION: Addressing doubts related to vaccine safety and providing more data on the safety of vaccine may be helpful in overcoming hesitancy.