RESUMO
OBJECTIVES: Parenteral nutrition (PN) can be associated with several treatment-related problems (TRPs) and complications in neonatal settings. Thus, understanding the extent and type of these problems and related factors is pivotal to prevent negative consequences of these preparations. Thus, the aim of this study is to assess factors affecting TRPs in neonatal patients receiving PN. METHODS: This was a retrospective chart review of neonates receiving PN in NICU and other wards. We collected their demographics, and laboratory workup. TRPs related to PN preparations as well as their pharmacotherapy were the primary outcomes. RESULTS: Medical charts of 96 neonate were reviewed. The most encountered TRPs related to patients' pharmacotherapy were the lack of frequent monitoring (34.2%) and low dose (17.5%). For PN-related TPRs, a mismatch between patients' nutritional needs and PN composition was observed in third of the patients. Statistically significant positive correlations between number of medications during hospital stay and number of reported TRPs [(r = 0.275, p < 0.01) and (r = 0.532, p < 0.001)] were observed. CONCLUSION: In neonates who receive parenteral nutrition (PN), TRPs are often observed. These problems primarily arise from issues in patients' pharmacotherapy, namely monitoring and dosing. Identifying the risk factors for these TRPs emphasizes the full and effective integration of clinical pharmacists into the healthcare team, which can serve as a potential preventive strategy to lower the occurrence of TRPs.
Assuntos
Nutrição Parenteral , Recém-Nascido , Humanos , Estudos Retrospectivos , Nutrição Parenteral/efeitos adversos , Fatores de RiscoRESUMO
BACKGROUND: Medication errors are preventable incidents resulting from improper use of drugs that may cause harm to patients. They thus endanger patient safety and offer a challenge to the efficiency and efficacy of the healthcare system. Both healthcare professionals and patients may commit medication errors. METHODS AND OBJECTIVES: A cross-sectional, observational study was designed using a self-developed, self-administered online questionnaire. A sample was collected using convenience sampling followed by snowball sampling. Adult participants from the general population were recruited regardless of age, gender, area of residence, medical history, or educational background in order to explore their practice, experience, knowledge, and fear of medication error, and their understanding of this drug-related problem. RESULTS: Of the 764 participants who agreed to complete the questionnaire, 511 (66.9%) were females and 295 (38.6%) had a medical background. One-fifth of participants had experienced medication errors, with 37.7% of this segment reporting these medication errors. More than half of all medication errors (84, 57.5%) were minor and thus did not require any intervention. The average anxiety score for all attributes was 21.2 (The highest possible mean was 36, and the lowest possible was 0). The highest level of anxiety was seen regarding the risk of experiencing drug-drug interactions and the lowest levels were around drug costs and shortages. Being female, having no medical background, and having experience with medication errors were the main predictors of high anxiety scores. Most participants (between 67% and 92%) were able to recognise medication errors committed by doctors or pharmacists. However, only 21.2 to 27.5% of participants could recognise medication errors committed by patients. Having a medical background was the strongest predictor of knowledge in this study (P < 0.001). CONCLUSION: The study revealed that the prevalence of self-reported medication errors was significantly high in Jordan, some of which resulted in serious outcomes such as lasting impairment, though most were minor. Raising awareness about medication errors and implementing preventive measures is thus critical, and further collaboration between healthcare providers and policymakers is essential to educate patients and establish effective safety protocols.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Erros de Medicação , Humanos , Erros de Medicação/estatística & dados numéricos , Estudos Transversais , Feminino , Masculino , Jordânia , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , IdosoRESUMO
Objective: The present study was conducted to assess the perceptions and readiness of pharmacists toward implementing "Telepharmacy" in Jordan. Methods: This was a cross-sectional study that was conducted between April and May 2023. Any licensed community pharmacists practicing in Jordan were considered to be eligible to be included in this study. Pharmacists were approached at their pharmacy store using a convenience sampling method. Logistic regression analysis was utilized to identify predictors affecting pharmacists readiness to implement telepharmacy services. Results: Two hundred eighteen community pharmacists volunteered to participate in this study. Roughly around 42% of the pharmacists (n = 91) reported that they have previously used telepharmacy. More than 70% of the pharmacists believed that telepharmacy decreases the patient's visits to hospitals, private clinics, or pharmacies (n = 165, 75.7%). In addition, more than 65% of the pharmacists expressed their concerns that telepharmacy service may increase pharmacists' workload and commitment (n = 150, 68.8%), and it has a higher error rate for medication dispensing and filling (n = 147, 67.4%). Nearly 70% of the pharmacists (n = 153) expressed their readiness to implement telepharmacy. Regression analysis showed that pharmacists who had previous experience in using telepharmacy service and those who showed more positive perception toward telepharmacy showed significantly higher readiness to implement telepharmacy service (p < 0.001 for both). Conclusions: The utilization of telepharmacy by community pharmacists in Jordan is still limited. The adaption of telepharmacy faces many challenges, including a negative attitude from the pharmacist, financial reimbursement, training, regulations, and competency in and access to efficient technology.
Assuntos
Serviços Comunitários de Farmácia , Farmacêuticos , Humanos , Estudos Transversais , Jordânia , PercepçãoRESUMO
This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.
RESUMO
This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. It explores potential interventions such as educational programs for healthcare professionals and patients to promote appropriate medication use. Furthermore, it discusses policy implications that could enhance deprescribing efforts and improve patient safety. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.
RESUMO
BACKGROUND: Knowledge of diabetes by the graduate physicians had been reported to be deficient in many aspects of diagnosis and management of type 1 diabetes (T1D). This will reflect on patient care and quality of health services especially in limited-resources countries. Our aim was to assess knowledge of basic management of T1D in new medical graduates in Jordan. METHODS: A questionnaire was developed to collect information concerning demographics and knowledge and was distributed in paper form and online using google forms. The knowledge was assessed using 28 questions on different aspects of the disease. RESULTS: A total of 358 new medicine graduates responded to the survey and female respondents were significantly higher than male respondents. Average number of lectures concerning diabetes during the medical school years was 3.92 ± 1.37. High knowledge scores were on pathophysiology of T1D, hypoglycemia, and certain aspects of diabetic ketoacidosis. Female gender, higher number of persons with T1D the participant had encountered during medical school, and good or excellent expected degree of self-knowledge of diabetes were associated with high knowledge score, p values = 0.01, 0.009, and < 0.001, respectively. Female gender and good or excellent expected degree of knowledge of diabetes predicted high knowledge score, p value = 0.008, and < 0.001, respectively. CONCLUSION: Gaps in knowledge of new medical graduates in certain T1D subjects exist. This can be corrected by many strategies including changes in curricula, elective courses, more clinical exposure, and interprofessional education. These measures must be evaluated for their short and long-term benefits.
Assuntos
Diabetes Mellitus Tipo 1 , Hipoglicemia , Humanos , Masculino , Criança , Feminino , Adolescente , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Países em Desenvolvimento , Inquéritos e Questionários , Faculdades de MedicinaRESUMO
OBJECTIVES: This study aimed to examine the extent of community pharmacists' awareness of Chat Generative Pretraining Transformer (ChatGPT), their willingness to embark on this new development of artificial intelligence (AI) development, and barriers that face the incorporation of this nonconventional source of information into pharmacy practice. METHODS: A cross-sectional study was conducted among community pharmacists in Jordanian cities between April 26, 2023, and May 10, 2023. Convenience and snowball sampling techniques were used to select study participants owing to resource and time constraints. The questionnaire was distributed by research assistants through popular social media platforms. Logistic regression analysis was used to assess predictors affecting their willingness to use this service in the future. RESULTS: A total of 221 community pharmacists participated in the current study (response rate was not calculated because opt-in recruitment strategies were used). Remarkably, nearly half of the pharmacists (n = 107, 48.4%) indicated a willingness to incorporate the ChatGPT into their pharmacy practice. Nearly half of the pharmacists (n = 105, 47.5%) demonstrated a high perceived benefit score for ChatGPT, whereas approximately 37% of pharmacists (n = 81) expressed a high concern score about ChatGPT. More than 70% of pharmacists believed that ChatGPT lacked the ability to use human judgment and make complicated ethical judgments in its responses (n = 168). Finally, logistics regression analysis showed that pharmacists who had previous experience in using ChatGPT were more willing to integrate ChatGPT in their pharmacy practice than those with no previous experience in using ChatGPT (odds ratio 2.312, P = 0.035). CONCLUSION: Although pharmacists show a willingness to incorporate ChatGPT into their practice, especially those with previous experience, there are major concerns. These mainly revolve around the tool's ability to make human-like judgments and ethical decisions. These findings are crucial for the future development and integration of AI tools in pharmacy practice.
Assuntos
Serviços Comunitários de Farmácia , Farmácia , Humanos , Farmacêuticos , Jordânia , Estudos Transversais , Inteligência Artificial , Atitude do Pessoal de Saúde , Papel ProfissionalRESUMO
Identifying risk factors for suboptimal glycemic control during the first year after diagnosis with type 1 diabetes (T1D) may provide early appropriate and individualized management. Our aim was to study possible predictors of early glycemic control during the first year after diagnosis with T1D in children and adolescents in Jordan. This is a retrospective study conducted through a review of medical records at Jordan University Hospital and the National Centre for Diabetes, Endocrinology and Genetics. Children and adolescents diagnosed with T1D at age younger than 16 years and with diabetes duration of at least 2 years were included. Demographic, clinical and socioeconomic factors were collected, in addition to glycosylated hemoglobin (HbA1c) values during the first year after diagnosis. Average age at diagnosis of the 337 patients who were enrolled in the study was 7.7 ± 3.8 years. HbA1c at diagnosis was 10.9 ± 1.9% (95.64 ± 20.76 mmol/mol). Factors such as the involvement of children's mothers in deciding insulin doses, higher mother's educational level and higher family monthly income were associated with better early glycemic control. HbA1c at 6 months after diagnosis, parental marital status and compliance to counting carbohydrates were significant predictors of glycemic control at 12 months after diagnosis. Many clinical and socioeconomic factors were associated with early glycemic control at 12 months after diagnosis. Modifiable risk factors must be addressed as early as possible to decrease future complications. Children with nonmodifiable risk factors should be identified early for closer observation and providing individualized diabetes care plan.
Assuntos
Diabetes Mellitus Tipo 1 , Controle Glicêmico , Adolescente , Glicemia , Criança , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/terapia , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/efeitos adversos , Insulina/uso terapêutico , Estudos RetrospectivosRESUMO
BACKGROUND: Medication errors remained among the top 10 leading causes of death worldwide. Furthermore, a high percentage of medication errors are classified as medication discrepancies. This study aimed to identify and quantify the different types of unintentional medication discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional medication discrepancies among this cohort of patients. METHODS: This was a prospective observational study undertaken in a large teaching hospital. A convenience sample of adult patients, taking ≥4 regular medications, with a prior history of treated hypertension admitted to a medical or surgical ward were recruited. The best possible medication histories were obtained by hospital pharmacists using at least two information sources. These histories were compared to the admission medication orders to identify any possible unintentional discrepancies. These discrepancies were classified based on their severity. Finally, the different predictors affecting unintentional discrepancies occurrence were recognized. RESULTS: A high rate of unintentional medication discrepancies has been found, with approximately 46.7% of the patients had at least one unintentional discrepancy. Regression analysis showed that for every one year of increased age, the number of unintentional discrepancies per patient increased by 0.172 (P = 0.007), and for every additional medication taken prior to hospital admission, the number of discrepancies increased by 0.258 (P= 0.003). While for every additional medication at hospital admission, the number of discrepancies decreased by 0.288 (P < 0.001). Cardiovascular medications, such as diuretics and beta-blockers, were associated with the highest rates of unintentional discrepancies in our study. Medication omission was the most common type of the identified discrepancies, with approximately 46.1% of the identified discrepancies were related to omission. Regarding the clinical significance of the identified discrepancies, around two-third of them were of moderate to high significance (n= 124, 64.2%), which had the potential to cause moderate or severe worsening of the patient´s medical condition. CONCLUSIONS: Unintentional medication discrepancies are highly prevalent among hypertensive patients. Medication omission was the most commonly encountered discrepancy type. Health institutions should implement appropriate and effective tools and strategies to reduce these medication discrepancies and enhance patient safety at different care transitions. Further studies are needed to assess whether such discrepancies might affect blood pressure control in hypertensive patients.
Assuntos
Hipertensão , Reconciliação de Medicamentos , Adulto , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Admissão do Paciente , Prevalência , Fatores de RiscoRESUMO
OBJECTIVE: To investigate the frequency of changes in antiepileptic drugs (AEDs) use, as well as concomitant changes in the degree of seizure control in pediatric patients, who are receiving 2 or more AEDs. METHODS: A prospective follow-up study at Jordan University Hospital`s pediatric neurology clinics was conducted on epileptic pediatric patients receiving at least 2 AEDs between December 2013 and April 2014. Patients were followed for 12 months. RESULTS: A total of 82 patients were included, with a mean age of 7.2+/- 4.7 years. The mean number of AEDs received by patients at enrollment was 2.4+/-0.6, and 2.5+/-0.7 after follow-up. Most patients (63.4%) experienced no change in seizure control, and the majority reported at least one adverse drug reaction. Most patients received lower doses than recommended, both at the beginning and end of the study. During the year, only 3 patients (4%) were eligible for dose tapering, which would then be converted to monotherapy. Follow-up appointments average was 4.2+/-2.9 visits/patients in one year. The frequency of medication changes and dose adjustment was very low, about one-third (29.3%) of patients requiring no change in AEDs during any follow-up visits. CONCLUSION: During the one year follow-up study, most patients on polytherapy maintained their level of response to the AEDs, with minimal changes in their regimen despite frequent follow-up visits. Only a small percent could be converted to AEDs monotherapy.
Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Adolescente , Criança , Pré-Escolar , Quimioterapia Combinada/métodos , Feminino , Humanos , Jordânia , Masculino , Resultado do TratamentoRESUMO
Aim: Medical literature revealed that there is a lack of information about the opinions of medical interns and residents about curricula provided to them during their undergraduate programs, either in a group of detached subjects or an incorporated and efficacious topic (ie, pathology). Purpose: To assess and compare the interns' and residents' perspectives towards Pathology as a subject. To recognize their opinions toward the relevance and application of Pathology while practicing clinically. Methods: This study was a cross-sectional online, self-administered questionnaire targeting interns and residents. The questionnaire consisted of 30 questions, enquiring about the demographic data, subject strength, teaching duration, interest in the subject, and usefulness of Pathology as a subject in clinical practice. Results: Overall, 103 participants completed the survey. The female and male percentage was 59.2% and 40.8% respectively. 86.4% of participants were interns, while 13.6% were residents. 87% of participants agreed that applying pathology during clinical practice is a skill that should be strengthened in the early stages of preclinical education of Medicine. A modest percentage believed that a practitioner could efficiently treat the majority of patients with no need to know the specifics of the pathological mechanisms involved. Most of the participants believed that pathology courses helped them in making a differential diagnosis, analysis of normal and pathological constituents, and dissection and identification of structures. Conclusion: This study highlights the positive perceptions of Jordanian interns and residents toward pathology courses. It also demonstrates that participants prefer an active and dynamic educational model with an emphasis on better integration of pathology courses and clinical experiences that fit their needs in clinical practice. Thus, we recommend future studies to compare the competencies of interns and residents enrolled in the courses with integrated medical curricula, of pathology versus those who studied the conventional medical curricula of pathology, as well as to evaluate their perceptions of medical education.
RESUMO
Background: Antibiotics have significantly reduced mortality and improved outcomes across various medical fields; however, the rise of antibiotic resistance poses a major challenge, causing millions of deaths annually. Deprescribing, a process that involves discontinuing unnecessary antibiotics, is crucial for combating this threat. This study was designed to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. Methods: A cross-sectional survey was conducted between January-February 2024 to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. An electronic questionnaire served as the data collection tool. Descriptive analysis was performed using SPSS software version 26. Additionally, logistic regression analysis was carried out to identify independent factors associated with physicians' willingness to deprescribe antibiotics. Results: The study involved 252 physicians, primarily male (n = 168, 67.7%), with a median age of 33 years. Regarding antibiotics deprescribing, 21.8% (n = 55) expressed willingness to deprescribe inappropriate antibiotics.High awareness of deprescribing was evident, with 92.9% (n = 234) familiar with the concept, 94% (n = 237) knowledgeable about appropriate situations, and 96.8% (n = 244) recognising its potential benefits. Furthermore, 81.8% (n = 205) reported having received formal training in antibiotics deprescribing, and 85.3% (n = 215) were informed about the availability of deprescribing tools.Physicians highlighted challenges including insufficient time (44.4%, n = 112) and resistance from patients (41.3%, n = 104) and colleagues (42.1%, n = 106). Despite challenges, a significant proportion regularly assessed antibiotic necessity (46.9%, n = 117) and educated patients about antibiotic-related harms (40.5%, n = 102). Logistic regression analysis revealed no significant demographic factors influencing physicians' willingness to deprescribe antibiotics (p > 0.05). Conclusion: Physicians in Jordan exhibit high awareness of antibiotics deprescribing and recognise its benefits. Challenges such as time constraints and communication barriers need to be addressed to facilitate effective deprescribing practices. Comprehensive guidelines and interdisciplinary collaboration are essential for promoting judicious antibiotic use and combating antimicrobial resistance.
RESUMO
OBJECTIVES: To investigate the prevalence of thyroid autoimmunity and related thyroid disorders among children and adolescents with type 1 diabetes in Jordan. METHODS: In a retrospective study, thyroid stimulating hormone and thyroid hormone (Free T4) levels were measured in 684 children with type 1 diabetes who presented to Jordan University Hospital between January 2012 and February 2021. Anti-thyroid peroxidase (TPOAb) and anti-thyroglobulin (TGAb) antibodies were measured in 526 and 438 subjects with type 1 diabetes, respectively. RESULTS: 681 children were included in the study (52.4â¯% females, average current age 14.3 years, average age at diagnosis 8.0 years, and average diabetes duration 6.2 years). Of the whole group, 18 children (2.6â¯%) were diagnosed with subclinical hypothyroidism and 31 children (4.4â¯%) had overt hypothyroidism. Of those who were tested for TPOAb and TGAb, 22.6 and 23.1â¯% were positive respectively. Predictors for developing hypothyroidism were female sex and positive antibodies to glutamic acid decarboxylase. CONCLUSIONS: Screening for associated thyroid autoimmunity in children and adolescents with type one diabetes from Jordan is advised with a special focus on females and those with positive antibodies to glutamic acid decarboxylase.
RESUMO
Nanotechnology is an advanced field that has remarkable nutraceutical and food applications. Phyto-bioactive compounds (PBCs) play critical roles in promoting health and disease treatment. However, PBCs generally encounter several limitations that delay their widespread application. For example, most PBCs have low aqueous solubility, poor biostability, poor bioavailability, and a lack of target specificity. Moreover, the high concentrations of effective PBC doses also limit their application. As a result, encapsulating PBCs into an appropriate nanocarrier may increase their solubility and biostability and protect them from premature degradation. Moreover, nanoencapsulation could improve absorption and prolong circulation with a high opportunity for targeted delivery that may decrease unwanted toxicity. This review addresses the main parameters, variables, and barriers that control and affect oral PBC delivery. Moreover, this review discusses the potential role of biocompatible and biodegradable nanocarriers in improving the water solubility, chemical stability, bioavailability, and specificity/selectivity of PBCs.
Assuntos
Nanopartículas , Nanotecnologia , Suplementos Nutricionais , Solubilidade , Disponibilidade Biológica , Nanopartículas/química , Sistemas de Liberação de MedicamentosRESUMO
Accurate detection and monitoring of therapeutic drug levels are vital for effective patient care and treatment management. Aptamers, composed of single-stranded DNA or RNA molecules, are integral components of biosensors designed for both qualitative and quantitative detection of biological samples. Aptasensors play crucial roles in target identification, validation, detection of drug-target interactions and screening potential of drug candidates. This review focuses on the pivotal role of aptasensors in early disease detection, particularly in identifying biomarkers associated with various diseases such as cancer, infectious diseases and cardiovascular disorders. Aptasensors have demonstrated exceptional potential in enhancing disease diagnostics and monitoring therapeutic drug levels. Aptamer-based biosensors represent a transformative technology in the field of healthcare, enabling precise diagnostics, drug monitoring and disease detection.
Assuntos
Aptâmeros de Nucleotídeos , Técnicas Biossensoriais , Neoplasias , Humanos , Sondas Moleculares , Monitoramento de Medicamentos , BiomarcadoresRESUMO
Disulfiram and hydralazine have recently been reported to have anti-cancer action, and repositioned to be used as adjuvant in cancer therapy. Chemotherapy combined with other medications, such as those that affect the immune system or epigenetic cell profile, can overcome resistance with fewer adverse effects compared to chemotherapy alone. In the present study, a combination of doxorubicin (DOX) with hydrazine (Hyd) and disulfiram (Dis), as a triple treatment, was evaluated against wild-type and DOX-resistant MCF-7 breast cancer cell line. Both wild-type MCF-7 cell line (MCF-7_WT) and DOX-resistant MCF-7 cell line (MCF-7_DoxR) were treated with different combination ratios of DOX, Dis, and Hyd followed by measuring the cell viability using the MTT assay. Synergism was determined using a combination index, isobologram analysis, and dose-reducing index. The anti-proliferation activity and mechanism of the triple combination were investigated by apoptosis analysis. The results showed a reduction in the IC50 values of DOX in MCF-7_WT cells (from 0.24 µM to 0.012 µM) and MCF-7_DoxR cells (from 1.13 µM to 0.44 µM) when treated with Dis (0.03µM), and Hyd (20µM) combination. Moreover, The triple combination DOX/Hyd/Dis induced significant apoptosis in both MCF-7_WT and MCF-7_DoxR cells compared to DOX alone. The triple combination of DOX, Dis, and Hyd showed a synergistic drugs combination to decrease the DOX dose needed to kill both MCF-7_WT and MCF-7_DoxR cancer cells and enhanced chemosensitivity to DOX.
RESUMO
Background: AI platforms are equipped with advanced algorithms that have the potential to offer a wide range of applications in healthcare services. However, information about the accuracy of AI chatbots against conventional drug-drug interaction tools is limited . This study aimed to assess the sensitivity, specificity, and accuracy of ChatGPT-3.5, ChatGPT-4, Bing AI, and Bard in predicting drug-drug interactions. Methods: AI-based chatbots (ie, ChatGPT-3.5, ChatGPT-4, Microsoft Bing AI, and Google Bard) were compared for their abilities to detect clinically relevant DDIs for 255 drug pairs. Descriptive statistics, such as specificity, sensitivity, accuracy, negative predictive value (NPV), and positive predictive value (PPV), were calculated for each tool. Results: When a subscription tool was used as a reference, the specificity ranged from a low of 0.372 (ChatGPT-3.5) to a high of 0.769 (Microsoft Bing AI). Also, Microsoft Bing AI had the highest performance with an accuracy score of 0.788, with ChatGPT-3.5 having the lowest accuracy rate of 0.469. There was an overall improvement in performance for all the programs when the reference tool switched to a free DDI source, but still, ChatGPT-3.5 had the lowest specificity (0.392) and accuracy (0.525), and Microsoft Bing AI demonstrated the highest specificity (0.892) and accuracy (0.890). When assessing the consistency of accuracy across two different drug classes, ChatGPT-3.5 and ChatGPT-4 showed the highest variability in accuracy. In addition, ChatGPT-3.5, ChatGPT-4, and Bard exhibited the highest fluctuations in specificity when analyzing two medications belonging to the same drug class. Conclusion: Bing AI had the highest accuracy and specificity, outperforming Google's Bard, ChatGPT-3.5, and ChatGPT-4. The findings highlight the significant potential these AI tools hold in transforming patient care. While the current AI platforms evaluated are not without limitations, their ability to quickly analyze potentially significant interactions with good sensitivity suggests a promising step towards improved patient safety.
RESUMO
Objective: This research aimed to explore how telepharmacy is perceived, whether it would be willingly used by the overall population in Jordan, and the associated socioeconomic disparities that might affect its acceptance. Methods: This is a survey-based cross-sectional study involving the general public of Jordan. The study took place in various Jordanian cities from May 2nd to June 1st, 2023. Using Google forms, the questionnaire was shared through various social media channels (such as Facebook and WhatsApp). Results: The questionnaire received responses from 800 participants. The data showed that a sizable portion of the Jordanian population were unaware of telepharmacy (n= 343, 42.9%), and a majority had never utilized it (n= 131, 16.4%). The participants viewed the main advantage of telepharmacy as minimizing unnecessary trips to pharmacies (n= 668, 83.5%) and reducing travel time and expenses (n= 632, 79.0%). However, the primary concern was the mental effort required to use this service (n= 465, 58.1%). Of the respondents, 61.3% (n= 490) indicated a willingness to adopt telepharmacy services in the future. Regression analysis indicated that men were more likely to use this service compared to women (OR= 1.947, p<0.001), and people living in northern and southern Jordan exhibited a greater willingness compared to those inhabiting the central region (OR= 2.168, p<0.001). Conclusion: The results reveal a positive attitude towards and a significant readiness to embrace telepharmacy among the Jordanian population. However, for broader acceptance and utilization, apprehensions regarding the service need to be addressed. Doing so could improve access to pharmaceutical care, particularly for patients living in far-flung areas of Jordan.
RESUMO
Objective: Data regarding diabetic ketoacidosis (DKA) at diagnosis of type one diabetes (T1D) in developing countries are scarce. The aim of this study was to describe the frequency of DKA at the onset of T1D in children and adolescents in Jordan and to compare the clinical and biochemical characteristics between the group that presented with DKA and the group that did not. Methods: The records of 341 children and adolescents, less than sixteen years of age, who were diagnosed with T1D between 2015 and 2019 were evaluated retrospectively. Results: Of all the children diagnosed with T1D, 108 (31.7%) presented with DKA. The majority had mild or moderate DKA (38% and 33.3% respectively). Higher paternal education levels were associated with a lower probability of presenting with DKA (p=0.043). A family history of T1D had a protective effect on the occurrence of DKA (Odds ratio=2.138; 95% confidence interval=1.167-3.917, p=0.014). Patients with celiac disease and higher HbA1c levels were more likely to experience recurrent episodes of DKA, (p=0.004 and 0.011, respectively). Conclusion: In Jordan, the rate of DKA at presentation of T1D remains high. Prevention campaigns are needed to increase diabetes awareness among the public and healthcare providers.
Assuntos
Diabetes Mellitus Tipo 1 , Cetoacidose Diabética , Criança , Humanos , Adolescente , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Jordânia/epidemiologia , Estudos Retrospectivos , Cetoacidose Diabética/diagnóstico , Cetoacidose Diabética/epidemiologia , Cetoacidose Diabética/complicações , Pessoal de SaúdeRESUMO
Methods: The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and socioeconomic data were collected using electronic clinical charts. Possible predictors of depression were assessed using logistic regression analysis. Results: A total of 108 children were enrolled in the study with mean age of 13.7 ± 2.3 years. Fifty-eight children (53.7%) had a CES depression score less than 15, and 50 children (46.3%) had a depression score of 15 or more. The number of diabetes-related hospital admissions and the frequency of self-monitoring of blood glucose (SMBG) were significantly different between the two groups. In the multivariable analysis, both gender and SMBG frequency were statistically significant. Girls were more likely to have a depression score ≥ 15 (OR = 3.41, p = 0.025) than boys. Patients who were rarely testing blood glucose levels were more likely to have a depression score ≥ 15 compared to those who were testing regularly (OR = 36.57, p = 0.002). Conclusion: The prevalence of depressive symptoms is relatively high in adolescents with T1D, especially in those living in developing countries. Longer diabetes duration, higher glycated hemoglobin level, and less frequent blood glucose monitoring are associated with higher depression scores.