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Background: Non-adherence to cardiovascular medications is a global problem with clinical, economic, and humanistic consequences. Investigation of this problem may open the road for proper management of cardiovascular diseases., Objective: Our objectives were to assess the level of adherence to, and to examine factors influencing adherence to, cardiovascular medications in subjects visiting a heart center in Sudan., Methods: We have conducted a cross-sectional study that assessed adherence to cardiovascular medications among subjects visiting outpatient cardiac clinics in a heart center-Khartoum State, Sudan. The validated Adherence to Refills and Medication Scale (ARMS) tool was used to assess the level of medication adherence. A score of >16 was used as a cut-off point to categorize surveyed patients into non-adherent (e.g., 17-48) and adherent (e.g., 12-16) in ARMS. Descriptive statistics (frequencies and percentages) and inferential tests such as One-Way ANOVA and Binary regression were used for data analysis., Results: A total of 255 subjects were enrolled in this study. Slightly more than half the respondents were males (54.5%) and their ages ranged between (51-60 years), and have no insurance coverage (58%). Most of the subjects were married (60.4%), were from Khartoum-State (67.8%), and were unemployed (77.6%). About 39.6% had primary education while 34.5% had secondary (34.5%) education. Diabetes (56.1%) and hypertension (45.5%) were common among the study population. The results showed a high non-adherence prevalence rate (97.6%). The cited reasons for non-adherence include forgetfulness and the costs of refilling medications. Education and age were associated with the level of adherence. Those with high non-adherence behaviors were the more educated, younger and old patients, those not employed, and those having comorbid diseases., Conclusion: The results generally showed a high level of non-adherence to cardiovascular medications, necessitating interventions to support patients' adherence., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 A. Mahmoud et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Access to accurate and relevant patient health information is crucial for community pharmacists to deliver high-quality care. The use of electronic patient medication records (e-PMR) in the United Arab Emirates (UAE) is currently limited to hospital settings, and community pharmacists do not have access to patient records., Objective: To evaluate the perceptions of community pharmacists regarding the potential benefits, barriers, and concerns associated with the implementation of the e-PMR system in community pharmacies in the UAE., Method: A validated questionnaire was administered to a sample of licensed community pharmacists using proportionate random sampling. The survey was structured and consisted of 40 questions in four sections: characteristics of community pharmacists and pharmacies; perceived usefulness of e-PMR; perceived barriers; and concerns about the use of e-PMR., Results: In total, 552 pharmacists filled out the questionnaire (82.1% response rate). The majority of participants somewhat or strongly agreed that e-PMR would reduce drug abuse (71.6%), dispensing errors (64.4%) and prescribing errors (69.0%), and believed that e-PMR would enhance pharmacists' ability to perform medication reviews (76.0%). Pharmacists in charge (adjusted odds ratio (AOR) = 2.5; 95% confidence interval (CI): 1.6-3.6), facing difficulty tracking the medical history of patients (AOR = 3.2; 95% CI: 2.8-3.9) and working in pharmacies providing telepharmacy services (AOR = 3.4; 95% CI: 2.7-3.8) were more likely to consider e-PMR useful., Implications: The implementation of the e-PMR system in community pharmacies has potential benefits for patient safety and medication therapy management in the UAE., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Epilepsy, a prevalent chronic neurological disorder, is associated with misconceptions, negative attitudes, and stigma because of poor public knowledge and awareness. Therefore, the purpose of the current study was to assess the knowledge, awareness, and attitudes toward epilepsy and its associated factors among the Lebanese general population., Methods: A cross-sectional study was conducted on Lebanese adults between October 2021 and June 2022 using an electronic structured self-administered questionnaire that was circulated online using the different social media platforms. Data related to participants' demographic characteristics, knowledge, awareness, and attitude about epilepsy were measured. Eight items were included in the knowledge score that ranged between "0 and 16", five items were included in the awareness score and ranged between 0 and 10. Likewise, the attitude score was calculated from 14 items and the score ranged between "0 and 28". Data was analyzed using descriptive statistics, and logistic regression was employed to identify factors associated with knowledge and awareness of epilepsy., Results: A total of 301 participants filled the questionnaire with a mean age of 28.68 and majority (66%) were females. The analyzed scores revealed that most of the participants (87.4%) had a good knowledge regarding epilepsy as a disease with mean of 10.2 (± 2.14), 70.1% had good awareness about epilepsy with mean of 6.3 (± 1.4), and 88% had good attitude toward patients with epilepsy with mean of 21.5 (± 6.2). Attending lecture about epilepsy was significantly associated with higher knowledge (OR 5.756, CI 95% 4.652-11.676, p  < 0.001), better awareness (OR 4.936, CI 95% 3.062-10.566, p  < 0.001) and attitude (OR 5.187, CI 95% 1.687-9.761, p  < 0.014) toward the disease., Conclusion: The findings of this study reflected an adequate knowledge and awareness, as well a positive attitude toward patients with epilepsy in Lebanon. However, there is a need for raising societal awareness and understanding of epilepsy to minimize the public misconceptions and reduce the stigma and discriminatory attitudes toward epileptic patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Younes, Chahine, Hanna, Mourad, Al Souheil, Al Mazrouei, Rahal and Malaeb.)

Background: Drug-related problems (DRPs) significantly threaten the safety of the elderly. In order to improve pharmacists' ability to minimize these events, novel educational interventions that consider the current challenges in clinical practice are crucial., Objectives: The primary objective is to assess the impact of two unique educational interventions on pharmacists' ability to identify DRPs., Method: A total of 127 community pharmacies in the United Arab Emirates (UAE) were recruited and randomly allocated to one of three arms using a 1:1:1 allocation ratio. While a series of clinical case scenarios (N = 24) related to elderly care were established and validated and sent to pharmacists in Active Group A over a 3-month period, lengthy research articles focused on medication safety in elderly were emailed to pharmacists in Active Group B. The control group pharmacist received no intervention. Then, pharmacists self-reported the number, categories, and severity of DRPs and pharmacist recommendations., Results: The incidence of DRPs identified by pharmacists was 10.8% in Active Group A, 2.0% in the Control Group (p = 0.011), and 3.8% in Active Group B (p = 0.014). A significant difference was observed in the proportion of DRP types between Active Group A and the Control Group. The most common DRPs in Active Group A were avoidable medication (14.7%) and untreated disease (9.2%). Pharmacists in Active Group A (37.2%) and Active Group B (32.3%) most commonly intervened by recommending the cessation of medication, while the most common intervention in the Control Group was recommending a decrease in dose (29.8%). The mean cost reduction per patient was highest in Active Group A (31.3 ±11.8 $), followed by Active Group B (20.8 ±8.6 $) and the Control Group (19.6 ±9.5 $). The mean time needed to resolve a DRP was shortest in Active Group A (7.3 ±3.5 minutes), followed by Active Group B (9.8 ±4.2 minutes) and the Control Group (9.8 ±5.7 minutes)., Conclusion: Using WhatsApp to deliver clinical scenarios was effective in improving pharmacists' ability to identify and address DRPs in elderly patients, resulting in faster resolution and higher cost savings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mohamed Ibrahim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: The study aimed to evaluate the potential benefits of luteolin treatment in Huntington's disease (HD), an inherited progressive neurodegenerative disorder., Methods: HD N171-82Q transgenic and WT mice received luteolin or vehicle for treatment at 6 weeks of age. The mice's body weight changes and survival rates were monitored throughout the study, and a series of motor functional tests were conducted. Serum level of the marker NfL was also determined. Immunohistochemical staining and western blotting were utilized to assess the expression of huntingtin aggregates., Results: Luteolin treatment enhanced survival and prevented weight loss in HD mice compared to the vehicle-treated HD group. Furthermore, the luteolin-treated HD mice exhibited enhanced motor coordination and balance and significantly reduced motor dysfunction. Also, luteolin decreased serum NfL levels in HD mice. Notably, the accumulation of huntingtin aggregates was significantly reduced in the brain's cortex, hippocampus, and striatum of luteolin-treated HD mice compared to the vehicle-treated HD group., Conclusion: Luteolin holds promise as a therapeutic agent for improving survival outcomes, managing motor dysfunction, and reducing huntingtin aggregates in HD. The findings are of significance as currently, there are no approved therapeutic interventions that reverse HD pathology or slow down its progression., (© 2024 The Author(s). CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)

Objectives : Schizophrenia, unipolar depression, bipolar disorder, bipolar mania, and bipolar depression are a few of the severe psychiatric diseases that affect millions of individuals and their overall life quality. This study aimed to look at differences in TGA, TC, HDL, LDL, and FPG levels in people who were going through acute episodes of listed diseases. Materials and methods : A cross-sectional prospective study was carried out in Jordan between January and November of 2023, involving all patients with the aforementioned diseases who attended three psychiatric clinics. This study encompassed results from 1187 patients (women N = 675, 56.87%) who were classified into the following ranges: <25, 25-45, 45-65, and >65. Results : The average level of LDL was the highest in bipolar depression (112.442 ± 36.178 mg/dL) and the lowest in bipolar mania (111.25 ± 33.14 mg/dL). The average level of HDL was the highest in schizophrenia (58.755 ± 16.198 mg/dL) and the lowest in bipolar depression (45.584 ± 12.128 mg/dL). Both average levels of TC and TGA were the highest in patients with bipolar depression (188.403 ± 37.396 mg/dL and 149.685 ± 96.951 mg/dL, respectively) and the lowest in bipolar mania (164.790 ± 40.488 mg/dL and 100.679 ± 54.337 mg/dL, respectively). The average level of FPG was the highest in unipolar depression (94.00 ± 21.453 mg/dL) and the lowest in bipolar mania (89.492 ± 14.700 mg/dL). Conclusions : The results confirmed that lipid and glucose abnormalities were more common in people with schizophrenia and mood disorders (unipolar and bipolar).

Background: Huntington's disease is an inherited progressive neurodegenerative disorder caused by an expansion of the polyglutamine tract leading to malformation and aggregation of the mutant huntingtin protein in the cell cytoplasm and nucleus of affected brain regions. The development of neuroprotective agents from plants has received considerable research attention., Objective: Our study aims to investigate the neuroprotective effects of luteolin and the mechanisms that underline its potential mediated protection in the mutant htt neuroblastoma cells., Methods: The mutant htt neuroblastoma cells were transfected with 160Q, and the control wild-type neuroblastoma cells were transfected with 20Q htt for 24 h and later treated with luteolin. Cell viability was determined by MTT and PI staining in both groups, while western blotting was used to evaluate caspase 3 protein expression. Aggregation formation was assessed via immunofluorescence microscopy. Also, western blotting was utilized to measure the protein expression of mutant htt aggregated and soluble protein, Nrf2 and HO-1. The impact of Nrf2 on luteolin-treated neuroblastoma cells was assessed using small interfering RNAs., Results: Our study reports that luteolin can protect cultured cells from mutant huntingtin cytotoxicity, evidenced by increased viability and decreased apoptosis. Also, luteolin reduced the accumulation of soluble and insoluble mutant huntingtin aggregates in mutant htt neuroblastoma cells transfected with 160Q compared to the control wild-type. The mutant htt aggregate reduction mediated by luteolin appeared to be independent of the Nrf2 -HO-1 antioxidant pathway., Conclusion: Luteolin presents a new potential therapeutic and protective agent for the treatment and decreasing the cytotoxicity in neurodegenerative diseases such as Huntington's disease., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier B.V. on behalf of King Saud University.)

Introduction: Remote pharmacist interventions have achieved much more attention during the coronavirus disease 2019 (COVID-19) outbreak, since they reduce the risk of transmission and can potentially increase the access of vulnerable populations, such as patients with COVID-19, to pharmaceutical care. This study aimed to examine differences in rates and types of pharmacist interventions related to COVID-19 and medication dispensing errors (MDEs) across community pharmacies with and without telepharmacy services., Methods: This was a prospective, disguised, observational study conducted over four months (from March 2020 to July 2020) in 52 community pharmacies (26 with and 26 without telepharmacy) across all seven states of the United Arab Emirates using proportionate random sampling. A standardised data-collection form was developed to include information about patient status, pharmacist interventions and MDEs., Results: The test (telepharmacy) group pharmacies provided pharmaceutical care to 19,974 patients, of whom 6371 (31.90%) and 1213 (6.07%) were probable and confirmed cases of COVID-19, respectively. The control group pharmacies provided care to 9151 patients, of whom 1074 (11.74%) and 33 (0.36%) were probable and confirmed cases of COVID-19, respectively. Rates of MDEs and their subcategories, prescription-related errors and pharmacist counselling errors across pharmacies with telepharmacy versus those without remote services were 15.81% versus 19.43% ( p  < 0.05), 5.38% versus 10.08% ( p  < 0.05) and 10.42% versus 9.35% ( p  > 0.05), respectively., Discussion: This is one of the first studies to provide high-quality evidence of the impact of telepharmacy on COVID-19 patients' access to pharmaceutical care and on medication dispensing safety.

Background: The current therapy of Rheumatoid Arthritis (RA) is confronted with many challenges such as inadequate response, infection, and treatment failure., Aim and Objective: The main objective was to assess the efficacy and safety of tocilizumab (TCZ) in subjects with RA using the available evidence from published randomized controlled trials., Methods: The current systematic review was performed on nine randomized controlled trials from 2002 to 2016 for TCZ in subjects with rheumatoid arthritis. The primary outcomes were the clinical improvement in American College Rheumatology 20% (ACR20) or Disease Activity Score remission (DAS28), in addition to other outcomes such as ACR50 and ACR70 in the intention-to-treat population., Results: We have conducted a systematic review on nine randomized controlled trials, with 4129 [100%] enrolled, of which 3248 [78.7%] were on the intention-to-treat. 2147 (66.1%) were treated with TCZ and 1101 (33.9%) have had received placebo or methotrexate or other conventional Disease- Modifying Anti-rheumatic Drugs (cDMARD) or biologic Disease-Modifying Anti-rheumatic Drugs (bDMARDs). In subjects taking TCZ with or without concomitant methotrexate, compared to placebo, subjects treated with TCZ 4 or 8 mg/kg were substantially and statistically significantly more likely than placebo or methotrexate to achieve the ACR20 and/or DAS28. There were no statistically significant differences in serious adverse events such as serious infection; however, subjects on TCZ were more likely to have increased lipid profiles., Conclusion: TCZ mono-therapy or in combination with methotrexate is valuable in diminishing rheumatoid arthritis disease activity and improving disability. Treatment with TCZ was associated with a significant surge in cholesterol levels but no serious adverse effects. Randomized clinical trials with safety as the primary outcome are warranted to report these safety issues., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Although telemedicine services have been adopted on a large scale in the United Arab Emirates (UAE) during the coronavirus disease 2019 (COVID-19) pandemic, a little is known about the public experience., Objectives: This study aimed to investigate consumers' patterns, nature, and predictors of telemedicine utilization and consumers' attitude toward this technology., Methods: A quantitative, self-administered questionnaire was developed, validated, and delivered randomly to adults living across the United Arab Emirates (UAE) between January 2021 and January 2022. The questionnaire included questions about categories of telemedicine used, purpose of use, challenges encountered during the use of telemedicine, and reasons for not using telemedicine technology. We adopted a proportionate random sampling technique to recruit participants by 3 ways: social media, phone calls, and face to face., Results: The final dataset included 1584 participants, of which 496 (31.3%) used telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. The most common reasons for not using telemedicine during COVID-19 was having no idea that telemedicine exists (38.3%, 417 of 1088) or having no idea how to use it (33.5%, 365 of 1088). Telemedicine users reported that that telepharmacy (89.7%), teleconsultation (78.2%), and telediagnosis (23.0%) were the most frequently used telemedicine services during the COVID-19 crisis. Of the 496 telemedicine users, 469 (94.6%) reported using telemedicine for seeking a pharmacist advice about medication instructions, 422 (85.1%) for ordering nonprescription drugs, and 401 (80.8%) for seeking a physician advice. Those with high activity on social media were less likely to be associated with telemedicine users versus nonusers., Discussion: Although telepharmacy has been increasingly used by consumers, more attention is needed to fix its limitations and improve patient safety., Conclusion: This study shows a positive attitude and a general acceptance of telemedicine services among the UAE population. Some sociodemographic and clinical characteristics were significantly associated with the use of telemedicine during the pandemic., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: Because COVID-19 patients are vulnerable to prescribing errors (PEs) and adverse drug events, designing and implementing a new approach to prevent prescribing errors (PEs) involving COVID-19 patients has become a priority in pharmacotherapy research. Objectives: To investigate whether using WhatsApp to deliver prescribing error (PE)-related clinical scenarios to community pharmacists could enhance their ability to detect PEs and conduct successful pharmaceutical interventions (PIs). Methods: In this study, 110 community pharmacies were recruited from different regions across Jordan and equally allocated to 2 groups. Over the course of 4 weeks, WhatsApp was used to send PEs-related clinical case scenarios to the active group. The second group was controlled with no clinical scenarios. After completion of the 4-week phase, pharmacists from both groups were asked to document PEs in COVID-19 patients and their interventions using a data-collection form. Results: The incidence of PEs in COVID-19 patients documented in the active group (18.54%) was higher than that reported in the control group (3.09%) ( P  = .001). Of the 6598 and 968 PIs conducted by participants working in the active and control group pharmacies, 6013 (91.13%) and 651 (67.25%) were accepted, respectively. The proportions of wrong drug (contraindication), wrong drug (unnecessary drug prescribed/no proof of its benefits), and omission of a drug between the active and control groups were 15.30% versus 7.21% ( P  = .001), 11.85% versus 6.29% ( P  = .03), and 17.78% versus 10.50% (0.01), respectively. Additionally, the proportions of lethal, serious, and significant errors were 0.74% versus 0.35% ( P  = .04), 10.52% versus 2.57% (0.002), and 47.88% versus 9.57% (0.001), respectively. Addition of drug therapy interventions (AOR = 0.62; 95% CI, 0.21-0.84) and errors with significant clinical seriousness (AOR = 0.32; 95% CI, 0.16-0.64). Conclusions PEs involving COVID-19 patients in community settings are common and clinically significant. The intervention assessed in this study could be promising for designing a feasible and time-efficient interventional tool to encourage pharmacists' involvement in identifying and correcting PEs in light of COVID-19., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: While the role of pharmacists in the current pandemic control has been recognized worldwide, their coaching efforts to improve public's behaviors that could prevent COVID-19 transmission has been rarely investigated. Objectives: To assess whether pharmacist-based virtual health coaching sessions could increase the proportion of people who practised healthy social behaviors, to test whether this model can increase the public acceptance of COVID-19 vaccines, and to measure whether these behaviors could actually prevent contracting COVID-19. Method: In this randomized controlled trial, adults who matched specific criteria were randomly allocated into 2 arms. The active arm received 12 pharmacist-based virtual coaching sessions delivered via Zoom ® over a month. Participants allocated to the control arm received no coaching. At the end of the last coaching session, both groups were asked to complete a structured questionnaire for outcome assessment. Participants in the active group were followed up to 2 weeks after the end of the last coaching session to check if they contracted COVID-19 or not. The SPSS software version 26.0 (IBM Corp., Chicago, IL) was used for statistical analysis. Results: Of the 300 participants who gave consent for participation, 295 completed the study (147 from the active arm and 148 from the control arm). The proportion of those using face masks, avoiding crowds, and willing to be isolated if infected in the active arm was increased from 51.70%, 53.74%, and 59.86% at baseline to 91.83%, 80.27%, and 96.59% at the end of coaching, respectively (all with P  < .05). In addition, the proportion of behaviors, such as disinfecting surfaces, not touching the T-zone, and avoid sharing personal belongings with colleagues at work was increased from 36.05%, 27.89%, and 46.93% at baseline to 63.94%, 52.38%, and 87.75% at the end of coaching, respectively (all with P  < .05). Avoid touching the T-zone (OR = 0.43; 95% CI, 0.24-0.89) and using disposable tissues (OR = 0.30; 95% CI, 0.18-0.77), each versus using face masks appropriately were more likely to get COVID-19. Conclusion: Pharmacist-based virtual health coaching could be a potential strategy to increase the proportion of behaviors that could curtail the spread of COVID-19., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Purpose: Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine., Methods: After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group. Pharmacists-physicians collaborative coaching intervention was delivered to active group subjects over two months through Facebook live sessions. The outcome measures were assessed in both groups before coaching, directly after coaching, and a month after coaching., Results: The proportions of hesitancy and resistance for a COVID-19 vaccine among subjects in the active group were significantly reduced from 64.3% and 35.7% before coaching to 20.1% and 7.8% directly after coaching, respectively. These proportions were further reduced to 11.1% and 3.3% a month after coaching, respectively. Furthermore, the mean scores for knowledge on, and attitude towards COVID-19 vaccine were significantly increased from 4.6 ± 1.8 and 4.1 ± 1.7 before coaching to 7.5 ± 3.1 and 8.9 ± 3.8 directly after coaching, respectively. However, the change in mean score of beliefs about COVID-19 vaccines among active group subjects was not significant., Conclusion: High rates of hesitancy and resistance for a COVID-19 vaccine were found in Jordan. These rates can be significantly reduced through online pharmacists-physicians collaborative coaching, which can also improve knowledge of and attitude towards COVID-19 vaccines., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Background: Community pharmacists have the responsibilities of identifying and resolving medication-related problems (MRPs), thereby improving patient safety., Objectives: To deliver a series of clinical case scenarios using WhatsApp and assess the impact of this method on the ability of pharmacists to identify MRPs., Methods: This study was conducted in 104 community pharmacies in the United Arab Emirates (UAE) over a period of six months. Recruited pharmacies were randomly allocated to either intervention or control groups using a 1:1 allocation ratio. Senior experts in clinical pharmacy created a series of clinical case scenarios based on their clinical practice and based on previous published studies related to MRPs. WhatsApp®, a well-known messenger application, which has been proven to be an efficient platform to improve communication between learners and educators, was used to deliver clinical scenarios-based educational interventions to pharmacists. Then, pharmacists from both groups filled a standardized data reporting form. The clinical importance of pharmacist recommendations was assessed by a multidisciplinary expert panel., Results: The total number of patients with MRPs across the intervention and control groups was 492 versus 194 (p = 0.01). While the number of MRPs identified, the mean time needed to resolve MRPs for patients with major polypharmacy, and physicians' acceptance of pharmacist recommendations across the intervention and control groups were 492 versus 194, 1589 versus 255, 6.82 (±3.86) versus 10.78 (±6.38), and 1065/1284 (82.94%) versus 125/201 (62.18%), respectively, all with p < 0.05. Efficacy-related problems (27.56%) and safety-related problems (28.44%) were the most commonly identified MRPs by pharmacists in the intervention group. Clinically significance of pharmacist recommendations was a significant predictive factor for physicians' acceptance of pharmacist recommendations., Conclusion: Clinical case scenarios delivered by WhatsApp may be useful for improving the ability of pharmacists to identify MRPs and for shortening the mean time needed to resolve MRPs., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Although community pharmacists have been actively engaged in patient care, their role in deprescribing is still restricted., Objectives: This study aimed to assess the effectiveness of a new educational approach designed to catalyze deprescribing in community pharmacies., Methods: In this 4-month, randomized, controlled trial, 108 community pharmacies in Egypt were randomly and equally distributed to either the active or the control groups. Participants from the active group pharmacies received 31 deprescribing-related clinical case scenarios, designed according to the available deprescribing guideline and clinical experiences of an expert panel members, and delivered through WhatsApp. Then participants from both groups reported the incidence of potentially inappropriate medicines (PIMs), the frequency of deprescribing opportunities, and related pharmacist interventions., Results: Pharmacists from the active group reported a considerably higher incidence of PIMs (20.87%) than that reported by pharmacists from the control group (5.03%). In addition, they made 1326 deprescribing-related interventions, of which 1022 (77.07%) were accepted and 641 (48.34%) were significant interventions. The proportions of cessation of drug therapy, reducing the dose, and persuasion of patients to accept deprescribing pharmacist interventions in the active group were 37.85%, 22.09%, and 10.63%, respectively. In contrast, 150 of 268 deprescribing-related interventions (55.97%) in the active group were accepted. The clinical value and type of deprescribing decision were statistically significant determinants for the acceptance of deprescribing decisions. The mean time needed to persuade the patient about deprescribing and the cost saved per patient across the active and the control groups were 5.09 ± 3.54 minutes versus 10.03 ± 6.19 minutes and 17.88 ± 9.60 U.S. dollars versus 4.49 ± 2.44 U.S. dollars, respectively., Conclusion: The intervention proposed improved the frequency and clinical value of deprescribing decisions., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: Clinical pharmacists have a vital role in intercepting prescribing errors (PEs) but their impact within a Jordanian hospital emergency department (ED) has never been studied. Objective: To evaluate the impact of clinical pharmacy services on PEs and assess predictors of physicians' acceptance of clinical pharmacists' interventions. Setting: This study was conducted in the ED of the largest governmental hospital in Jordan. Method: This was a pre-post study conducted in October and November 2019 using a disguised observational method. There were 2 phases: control phase (P0) with no clinical interventions, and active phase (P1) where clinical pharmacists prospectively intervened upon errors. The clinical significance of errors was determined by a multidisciplinary committee. The SPSS software version 24 was used for data analysis. Main Outcome Measure: PEs incidence, type, severity, and predictors for physicians' acceptance. Results: Of 18003 patients, 8732 were included in P0 and 9271 in P1. PEs incidence decreased from 24.6% to 5.4%. Contraindication, drug selection, and dosage form error types were significantly reduced from 32.6%, 9.1%, and 3.7% (P0) to 12.6%, 0.0%, and 0.0% (P1), respectively. Albeit not statistically significant, drug-drug interaction, drug frequency, and allergy error types were reduced from 4.9%, 3.1%, and 0.1% to 4.5%, 2.5%, and 0.0%, respectively. Significant and serious errors were significantly reduced from 68.7% and 3.0% (P0) to 8.9% and 1.8% (P1), respectively. During P1, most errors were minor (89.3%, 1574/1763), and lethal errors ceased. Predictors for physicians' acceptance were: significant errors (OR 3.1; 95% CI 2.6-4.3; P = 0.03) and non-busy physicians (OR 2.1; 95% CI 1.6-2.7; P = 0.04). Conclusion: Clinical pharmacists significantly reduced PEs in the ED by 76%; most of interventions were significant. Policymakers are advised to implement active clinical pharmacy in the ED., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Background: Although pharmacists are trusted and easily accessible by the public, their role in changing health behaviours related to breast cancer has been rarely investigated., Objective: To investigate the effectiveness of pharmacist-based coaching in improving BC-related health behaviors and knowledge in females, and to measure the comfort level toward this program., Methods: This was a randomized controlled study carried out in community pharmacies in Egypt. Pharmacies included were asked to enroll 240 females into a trial, then equally allocate them into either active or control arms, and provide 12 weekly face-to-face coaching sessions to those assigned to the active arm. Pharmacists were also asked to survey females and fill a standardized data collection form at baseline, in the middle of coaching, at the end of coaching, and three months after coaching., Results: The proportions of doing high physical activity, practicing healthy diet, and practicing breast self-exam three months after the end of coaching programme across the active and control arms were 52.17% versus 17.09% (p=0.002), 62.60% versus 28.20% (p=0.003), and 81.73% versus 23.07% (p=0.005), respectively. The mean scores of knowledge on BC symptoms, risk factors, and detection methods three months after coaching across the active and control arms were 4.10±2.47 versus 2.72±1.19 (p=0.038), 4.25±2.20 versus 3.28±1.48 (p=0.020), and .34±1.80 versus 1.72±0.68 (p=0.001) respectively. While most of the females participated in the active arm were comfortable toward the financial 94.78% and social 88.69% sides of the program, more than one-third (34.78%) of the participants were uncomfortable toward the competency of coaches., Conclusion: Despite the need for some modifications, BC-related health behaviors and knowledge can be improved through pharmacist-based health coaching., (Copyright: © Pharmacy Practice.)

Background: Telepharmacy services are expected to have an important role in increasing access of patients to pharmaceutical care and reducing potential dispensing errors in community pharmacies. Objective: To assess the predictors for effective telepharmacy services on increasing access of patients to care and reducing dispensing errors in community pharmacies. Method: This is a prospective study carried out for 4 months in 52 community pharmacies across the United Arab Emirates (UAE) using disguised direct observation. Multivariable logistic regression was used as a tool to predict factors associated with effective telepharmacy services in improving dispensing safety and increasing access of patients to pharmaceutical care. Data were entered and analyzed using the Statistical Package for Social Science (SPSS) software version 26. Results: Pharmacist recommendations related to COVID-19 at pharmacies with telepharmacy (n = 63,714) versus those without remote services (n = 15,539) were significantly more likely to be (1) contact the nearest testing center (adjusted odds ratio [AOR] = 7.93), (2) maintain home quarantine (AOR = 5.64), and (3) take paracetamol for fever (AOR = 3.53), all were significant results (p < 0.05). Rates of medication dispensing errors (MDEs) and its subcategories, prescription-related errors, and pharmacist counseling errors across pharmacies with telepharmacy versus those without remote services were (15.81% vs. 19.43%, p < 0.05), (5.38% vs. 10.08%, p < 0.05), and (10.42% vs. 9.35%, p > 0.05), respectively. However, pharmacies with telepharmacy were more likely to include wrong patient errors (AOR = 5.38, p < 0.05). Conclusions: Telepharmacy can be used as a tool to reduce the burden on the health care system and improve drug dispensing safety in community pharmacies.

Objectives: This study aimed to investigate the frequency, nature, and clinical significance of pharmacist interventions on over-the-counter (OTC) medicines with abuse potential across community pharmacies with and without virtual care., Methods: In this prospective observational study, a trained research team observed the dispensary teams of 12 community pharmacies in the United Arab Emirates (UAE), 6 of which were operating virtual pharmacy care. A standardized data collection form was used to include information about dispensing of OTC medicines and pharmacist interventions on those with abuse/misuse potential. The clinical significance of the interventions was evaluated by a multidisciplinary committee., Results: The frequency of pharmacist interventions on OTC medicines with abuse potential across pharmacies with and without virtual services was 83.2% versus 91.0%, respectively, whereas the frequency of pharmacist interventions on OTC medicines with misuse potential across pharmacies with and without virtual services was 79.8% versus 41.2%, respectively. The proportions of clinically significant interventions across pharmacies with and without virtual services were 19.7% versus 10.5%, respectively. Cough medicines were dispensed significantly more across pharmacies with virtual care than across pharmacies without virtual care (25.6% vs. 9.7%, respectively; P = 0.04). Asking the patient to seek the advice of an addiction specialist (adjusted odds ratio = 4.11; P = 0.001) versus refusing to sell the drug was more likely to be associated with pharmacies with virtual services than with pharmacies operating traditional pharmacy services., Conclusion: Virtual pharmaceutical care is a potential approach to reduce the abuse/misuse of OTC medicines but needs some improvements regarding detection of these cases. The UAE is the first country in the region to implement and regulate virtual pharmacy practice., (Copyright © 2021 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Objectives: To investigate community pharmacists' knowledge about COVID-19 and their preparedness for the pandemic., Methods: This cross-sectional online survey was conducted (in community pharmacies in the United Arab Emirates) over 3 weeks (24 May 2020 to 14 June 2020). A proportionate random sample of 491 participants was invited to take part. The SPSS version 26 was used for data management and analysis., Key Findings: The majority of participants (n = 400) had good knowledge about COVID-19 and high level of preparedness for the pandemic control. Most pharmacists agreed (212, 53.0%) or strongly agreed (91, 22.8%) that they have a major role in the management of the ongoing crisis. Most participants had good awareness about the most common methods of COVID-19 transmission (359, 89.7%) and symptoms encountered (368, 92.0%). However, approximately a quarter of participants (103, 25.7%) incorrectly thought COVID-19 was caused by a DNA virus. Participants who had 5-10 and >10 years of experience were 3.95 (P = 0.03) and 1.59 (P = 0.01) times, respectively, were more likely to have good knowledge compared to participants with less than 2 years of experience. Those with good knowledge were more likely to have a specific area for customers with suspected COVID-19 symptoms compared to those with poor knowledge (P = 0.031)., Conclusion: This study indicates that years of experience and good knowledge on COVID-19 were significant determinants of pharmacists' preparedness for the pandemic control., (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The public awareness toward the causes and consequences of antibiotic resistance (AR) is crucial to mitigate the inappropriate use of antibiotics (ABs), particularly in the low- and middle-income countries. There was no previous study that assessed the awareness, attitude, and knowledge about antibiotic use and AR among the Jordanian public in affluent and deprived areas., Objective: This study aimed to assess the awareness, attitude, and knowledge about antibiotic use and AR in affluent and deprived areas in Jordan., Setting: The survey was conducted in November 2019 in Amman, the capital of Jordan., Method: A cross-sectional questionnaire was used to survey households in their areas in each of West Amman (affluent region) and East Amman (deprived region), Households were selected using proportionate random sampling method., Results: A total of 620 householders (310 per area) completed the questionnaire. Pharmacists were perceived as strong influencers on householders' decision, as 80.32% (n = 465/580) of those who used antibiotics in the last year follow pharmacists' advice. Our results showed poor understanding of antibiotic usage among the Jordanian public, as only 14.2% (n = 44/310) of the sample in West Amman and 2.9% (n = 9/310) in East Amman disagreed with the statement " Antibiotics work on most coughs and colds ." Householders in West Amman showed much better understanding of AR compared to those in East Amman; 82.3% (n = 255/310) of West Amman respondents agreed with the statement " Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic. " compared to 31.9% (n = 99/310) of East Amman respondents on the same statement ( P   <  .05)., Conclusion: The Jordanian community generally had poor knowledge and awareness toward antibiotics use and AR. Socio-economic factors could influence the public's attitude toward antibiotics use and AR.