Abduelmula R. Abduelkarem

The role of pharmacists in developing countries: The current scenario in the United Arab Emirates

Pharmacy practice has passed several rounds of advancements over the past few years. It had changed the traditional positioning criteria of pharmacists as business people into patient-centered healthcare professionals. This worldwide shift is increasingly accumulating pressure on UAE pharmacists to turn up into better level of service providing accompanied with higher demand of inter-personal skills and intellectual capabilities. This can be accomplished through stressing the significance of continuing pharmacy education in basic sciences as well as social and administrative pharmacy techniques and its collaboration in elevating the quality of pharmacy practice in the UAE.

Social Pharmacy Courses Are Often Neglected in the Developing World

To the Editor. Contemporary pharmacy professionals are one of the major contributors to health care systems in developed countries. Increasing demands for pharmacy trained professionals in response to the rapid growth of the health care and pharmacy industry are reminders of the beneficial roles of pharmacists in health and health care issues. This is probably due to the fact that in these countries, the role of the pharmacist has transformed from being merely a medicine compounder and dispenser to one having importance in many other areas. Besides providing manufacturers with technical information on drug composition, counseling health professionals, ie, physicians and nurses, on how to select and use drugs, pharmacists’ responsibilities in the developed world include patient wellness, health promotion and education, disease prevention, and family planning. This ability to assume a pivotal role in the health care sphere and act as a watchdog over the well-being of people requires appropriate skills. In fact, in recent years, there have been exciting changes in pharmacy education in developed countries. Difficulties in meeting health care needs and inadequacies in patient services among others have led to the redirection of pharmacy education from a product to a patient orientation. Also, continuously innovating and incorporating components of pharmaceutical sociology as advocated by the Nuffield Foundation1 has played an important role in the progression of academic and practice orientation in developed countries. Over the last 30 years, pharmacy institutions and pharmacy training in the developed world have increasingly involved commitments in upgrading education through modernizing facilities, well-trained senior staff members, emphasizing subjects including hospital pharmacy, clinical pharmacy, biopharmaceutics and toxicology, and pharmacy practice. This provided opportunities for active and continuous interaction and collaboration between industries and academic institutions. Pharmacy curricula also have been changed by incorporating pharmaceutical sociology components, ie, social pharmacy, to provide pharmacy undergraduates with more opportunities and exercises that promote constant interaction with communities. Pharmacy practice continues to move from a focus on products to a focus on patients in the developed world and in countries such as the United Kingdom, the system for pharmacy education is predicted to continue evolving over the coming years to meet and anticipate changing roles for pharmacists within the health care system.2 In contrast to the developed world, an substantial proportion of the population of developing countries has a higher level of unmet health needs.3 Factors associated with this situation include some specific challenges, ie, societal factors, health care deficiencies and more importantly a shortage of health care professionals. The World Health Organization (WHO) has long believed that pharmacists could make a greater contribution to the provision of health care.4 To this end, this institution has launched many strategies for developing countries. Addressing the strategies by which primary health cares can be improved, the World Health Organization has argued, since the last decade, for the need to focus on strategies towards using pharmacists as active health professionals.5 It also has been suggested for the need to increase the participation of pharmacists in all levels of the public health system, which is fundamental to achieving substantial improvement in the health status of populations as well as to achieving full preparedness to respond to any type of mass casualty event. There is a close relationship between the training received and the type of pharmacy practice. Indeed a pharmacy student trained with more health care dispositions will tend to play an important role in the health care system than a student trained with less emphasis on health care management. In an effort to address strategies on which to base the preparation of future pharmacists, WHO has suggested the need for graduate level education followed by one year of practical training before one is capable of effectively performing the role of a pharmacist. In another attempt to promote the production of future pharmacists with social responsibilities, WHO pinpointed seven roles to which education and professional development of pharmacists should aspire; these are care-giver, decision-maker, communicator, leader, manager, life-long learner and teacher 6. Overview on the recent literature on pharmacy education has shown that while in the developed world ideal frontline pharmacists of the future (or 7 star pharmacists) are increasing in number, efforts to incorporate social pharmacy in pharmacy training are just in the curtain-raiser in many developing countries. The notion of social pharmacy, the key course that has rendered pharmacists of the developing countries to become active health care managers, is still unknown in most parts of the developing world. A common characteristic of these countries is that health care systems are generally deficient and the number of health care professionals is insufficient to meet increasing health needs. One way to overcome this impediment would be the provision of health care by pharmacists trained with more social and behavioral aspects of illness and health as well as opportunities of constant interactions with communities; this is mandatory to the incorporation of more pharmaceutical sociology components in current pharmacy curricula. Omar Saad Saleh Abrikaa, BSc, PhD Candidate, Mohamed Azmi Ahmad Hassalia, BPharm, MPharm, PhD, Abduelmula R. Abduelkaremb, BSc, MPhil, PhD aUniversiti Sains Malaysia, Penang, Malaysia bAjman University, United Arab Emirates

A qualitative study exploring physicians' perceptions on the role of community pharmacists in Dubai

Objective: The aim of this study is to explore the perceptions of physicians operating within the boundaries of Dubai on the role of community pharmacists. Methods: Semi-structured interviews were done with 12 physicians working within the boundaries of Dubai Health Authority. Interviews mainly focused on understanding the perceptions of physicians on the role of community pharmacists in addition to willingness to integrating pharmacists in patient care process. Results: Key findings show that all interviewees agree that community pharmacists are important healthcare professionals. However, 7 physicians restrict the role of pharmacists to dispensing medicines. Physicians in Dubai are willing to collaborate with pharmacists, but more than half of them (7) think that pharmacists might interfere with their jobs. Conclusion: The study concludes that all informants agree that collaboration between community pharmacists and physicians definitely enhances patients’ drug therapy outcomes.

Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates

The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.

Use of Over-the-Counter Medication among Pregnant Women in Sharjah, United Arab Emirates

Background Over-the-counter medications are widely available in pharmacies Their safety profile, however, does not extend to pregnant women. Accordingly, there should be educational programs developed for pregnant women to protect them from the harms of the side effects. Aim This study was planned and designed with the aim of exploring the awareness and assessing the usage of OTC medications among pregnant women in Sharjah, UAE. Method A cross-sectional survey using a self-administered questionnaire. Results More than three-quarters (75.7%) reported that they are familiar with the term “over-the-counter drugs.” Interestingly, 40% of the respondents reported that they took OTC drugs during pregnancy, and the majority (94.2%) agreed with the survey statement “not all OTC medications are safe to be taken during pregnancy.” Constipation was the most frequent side effect that most of the participants reported during the study period. Folic acid (36%), calcium (28.6%), and iron (35.1%) were the most common supplements used by the pregnant women responding. Conclusion The reported 40% usage of OTC medications among pregnant women in this study is worrisome and calls for the need to educate, counsel, and increase awareness among pregnant women regarding the dangers of OTC drugs usage while pregnant in Sharjah, UAE.

Evaluation of breast cancer awareness among female university students in University of Sharjah, UAE

V are one of the greatest achievements in public health. However, critical evaluation and continuous process improvement areneeded to ensure that vaccines are stored, handled and administeredproperlyto avoid compromising the vaccine. Failure to do so will result in vaccine wastage with resultant cost implications, and may potentiallyexpose people to disease and erode confidence in vaccination. A panel of the United States immunization experts from national immunization policy organizations; state and local immunization programs; healthcare practitioners; and, members of the vaccine industry convened to identify and evaluate challenges to vaccine delivery from storage and handling through vaccine preparation and administration. A report of the first meeting identifying issues was recently published1. The group’s primary observation was that the unrecognized complexity of vaccine delivery posed a major challenge to appropriate delivery of vaccines. Proper training, storage, cold chain maintenance, handling, preparation, administration, and documentation were areas where continuous process improvement would benefit the immunization process.N pain induced by a commonly used chemotherapy-drug paclitaxel (taxol) is a major toxicity responsible in clinics that force patients to discontinue this otherwise life-saving treatment. Glycogen synthase kinase 3β (GSK3β) is a powerful regulator of neuroinflammation in many neurologic diseases. In this study, the role of GSK3β in the development and maintenance of taxol-induced neuropathic pain in a rat model induced by i.p. injection of taxol (2 mg/kg) on 4 alternative days (accumulated doses 8 mg/kg) was investigated. Ten days post the first taxol injection, using western blots, we found that expression of phosphorylated GSK3β (the inactive form of GSK3β) in the spinal dorsal horn was reduced while total GSK3β protein expression remained unchanged, indicating an increased activity of GSK3β. This was concomitantly associated by downregulation of glial glutamate transporter 1 (GLT-1) protein expression, activation of astrocytes (increased expression of GFAP) in the same region, and mechanical allodynia in the rats. Next, we treated the rats with the GSK3β inhibitor, lithium chloride (LiCl, 2 mg/kg/day, s.c. injection, starting immediately prior to the first taxol injection and then daily for 10 days). This treatment prevented the development of mechanical allodynia induced by taxol and suppressed GSK3β activities (an increased expression of phosphorylated GSK3β) in the spinal dorsal horn. At the same time, the taxol-induced downregulation of GLT-1 protein expression and activation of astrocytes were also significantly ameliorated. Finally, we determined if LiCl can reverse the taxol-induced allodynia. Ten days after the first taxol injection, LiCl (2 mg/kg/day, s.c.) was applied to rats with allodynia for another 10 days. This treatment attenuated the existing allodynia. Meanwhile, in the spinal dorsal horn, the taxol induced increased GSK3β activities and GFAP protein expressions were suppressed; GLT-1 protein expression was improved. Together, our data indicate that an increase of GSK3β activities is a key event related to the down-regulation of glial glutamate transporter expression in the spinal dorsal horn, and the development and maintenance of neuropathic pain induced by taxol. Further, inhibition of GSK3β activity with lithium is an effective approach to prevent and attenuate paclitaxel-induced neuropathic pain.

Pushing health care provider towards public health and evidence-based practice: The impact of clinical knowledge

A innovative first professional year clinical program was developed to meet national pharmacy school accreditation standards relating to experiential programs. The content and assessments were developed in conjunction with the Purdue University Center for Instructional Excellence. The content is taught in a clinically based, on-campus pharmacy. Students serve faculty, staff, retirees and students’ prescription needs and provide patient counseling while meeting course objectives through mentored experiences with instructors, pharmacists and upper classmen. Students gain practical and clinical experience with patient care, commonly used drugs and engage in pharmacy operations. The course is a blended design of active learning and small group discussion. It is a highly structured clinical experience that ensures patient safety and incorporates continuous assessment with feedback. Technology plays a key role in student assessments, which are conducted primarily by upperclassmen. Assessment data on course effectiveness has been compiled and is available for review. Pre and post test results, prescription processing methods, counseling simulations, peer-reviewed video recorded counseling sessions with patients, and the use of multimedia and iPads are discussed. Patti Darbishire, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004P is a complex and challenging task that requires diagnostic skills, knowledge of medicines, communication skills, an understanding of the principles of clinical pharmacology, appreciation of risk and uncertainty, and ideally experience. It is an anomaly that recent medical graduates are often the doctors who prescribe most frequently in modern hospitals. The demands on new prescribers have increased because of several important trends including more licensed medicines available, more indications for drug therapy, greater complexity of treatment regimens leading to ‘polypharmacy’, and more elderly and vulnerable patients. The systems that prescribers work in are often complex and contribute to suboptimal performance. Medication errors and avoidable adverse reactions are common causes of harm to patients and many involve recently qualified doctors. For all of these reasons, there is great interest in ensuring that medical graduates are competent to prescribe and supervise the use of medicines within the health service. This talk will focus on the development of the Prescribing Skills Assessment (PSA) which is designed to assess prescribing-related skills amongst final year medical students. This session will cover (i) the content of the PSA, (ii) the development and quality control of the PSA item bank, (iii) the novel PSA online system used to author and edit items, and deliver assessments to medical schools, and (iv) the experience gained from the PSA piloting undertaken in 2012 and 2013 amongst 5,000 medical graduates. Simon Maxwell, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004Background: It is well recognized that medication errors occur and can affect success in treating patients. Programs in Germany using the teacher-practitioner model and an HIV/AIDS service in the USA are few of the clinical programs developed and assessed. Objectives: In both programs the objective was to 1) determine the incidence medication errors; and 2) describe the nature and cause(s) of errors to guide future programs. Methods: In 1 program 10 student-paired groups were used as extenders on an internal medicine ward in 3 consecutive 4hour long blocks using a paper-based system. In another program a daily antiretroviral utilization report was used to identify adults who were receiving ART, and had been admitted to a tertiary care teaching hospital during 2 consecutive months in 2005. Patients’ charts, medication profiles, and medication administration records were reviewed for medication errors. Once identified, etiology and cause were further investigated through interviews. Results: In the first example, 29 actual drug-related problems were identified in 9 patients, median age of 71, range 51-88. There was an average of three drug-related problems per patient, range 1-5. In the later study 69 combined ARTand (OI)-related medication errors were identified in 20 of 26 (77%) evaluated patients, with 2.7 medication errors per patient with 54% of the errors occurred within the first 24 hours of admission. Inadequate medication reconciliation on admission caused 21 of 37 (57%) admission related errors. The most prevalent error types included missing doses (20%), under-dosing (13%), over-dosing (13%), therapy omission (13%), and drug-drug interaction (12%). Conclusions: Prospective investigation of potential for medication errors provided in-depth insight into the diverse nature of medication errors, risk factors and potential preventive strategies of the errors. Various approaches can be used based on resources and primary concerns. Maintaining the service and reevaluation of the changes is possible. Ann Marie Snyder, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004A is a common psychiatric disorder that affects between 8% and 12% of school aged Children worldwide while up to 5% of children and 3-5% of adults are affected in USA. Symptoms include inattention, impulsivity and hyperactivity, and in 60% of cases, the symptoms of ADHD endure into adulthood. There are many notions postulated to explain ADHD; among these is dopamine dysfunction. Animal Models are indispensable to comprehend human disorders. For instance using rodent models have enabled us to pinpoint some of neurological changes underlying behavioral aspects of ADHD. There are several animal models for studying ADHD, each one of them has pros and cones; for examples some of these models have decreased dopamine concentration extra-cellular while DA concentration have been increased in other models. Consequently, it is essential to study animal models to fully apprehend the neuropathology and remedy of ADHD. First, I will discuss the neurobiology of ADHD and review a variety of animal models of ADHD. Thenceforth review methods used in the clinical assessment of ADHD, including behavioral measures, cognitive / neuropsychological tests, and psycho physiological/biobehavioral paradigms. The utility of diagnostic measures to predict treatment response will be conferred. Conclusively I will end by discussing the stimulants (e.g. methylphenidate and amphetamines) as the first line of treatment of juvenile and adult ADHD patients. In spite of their effectiveness in managing the core symptoms of the disease, these medications are associated with many adverse events. The presentation will discuss the standard, novel and experimental pharmacological treatments for ADHD. Wael Mohamed, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004Improving Patient Care is a program adopted by the Indian Health Service to enhance patient care and to improve outcomes by reducing health disparity to the Native American patient populations. In 2007, this rural Indian Health hospital underwent a massive renovation to implement IPC. This patient practice model involves a multi-disciplinary approach in which all health care disciplines come to the patient to review and evaluate patients’ disease state(s). Pharmacists are an integral and important member of the IPC. Pharmacists involved in the IPC are able to devote more face to face time with patients and are able to provide them with more detailed education on their medications. In addition, pharmacists are able to intervene on patient’s behalf because of greater access to the providers with great efficiency. Improving Patient Care program has shown to increase pharmacy patient satisfaction in a variety of areas.A can be effectively treated by inhaler therapy. Yet all too often, patients do not get the full value of their inhaled medications because they use their inhaler incorrectly. The objective of the study was to evaluate the knowledge and appropriate use of asthma inhaler therapy among asthmatic children and their parents. A cross-sectional study was conducted from April 15 to May 20, 2013 on 161 children (87% of the total asthmatic children at the hospital) who were provided asthma care in the pediatric inpatient and outpatient departments of the Gondar University Teaching and Referral Hospital. The mean age of the asthmatic children was 4.7 + 3.7 years; 35 (57.4%) were males and 26 (42.6%) were females. One hundred sixteen (72.1%) children were under the age of five. Fifty three (86.9%) asthmatic children were not rinsing the mouth after inhaling, 40 (65.6%) had slow rate of breathe through the inhaler and 23 (37.7%) did not shake before inhaling. One hundred eight (67.2%) asthmatic children used mask; 116 (72.1%) did not clean the spacer (bottle), 44 (72.1%) were not cleaning the devices at all. There were significant mistakes related to inhaler use that could affect the treatment outcome. These mistakes were associated to the device used, lack of giving appropriate instructions, some parents give too much responsibility to the child for treating their asthma. The inhalation device used in the hospital should be modernized. Health care workers should provide simple verbal and written instructions and information on treatment for children and their parents. Bayew Tsega Abebe, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004