Eman A. Abahussain

Self-Reported Medication Use among Adolescents in Kuwait

Objective: The objectives of this study were to describe and examine the pattern of medication use, including age and gender differences among adolescents in Kuwait, and to establish the sources of information on medicines in this age group. Subjects and Methods: A cross-sectional survey of 1,110 male and female students (14–21 years) from 10 randomly selected public schools in Kuwait was conducted.The prevalence of self-medication was estimated.Results: The prevalence of self-medication among the high school students was 92%. The prevalence increased by age from 87% among 14-year-olds to 95% among 18-year-olds. Sixty-five percent of medicines used were for pain relief, 54% for respiratory conditions, 39% for allergic conditions, and 37% for dermatological conditions. Twenty-two percent of medicines were nutritional supplements and vitamins, 21% gastrointestinal products, 17% antidandruff products, 15% hair products, 13% for migraine while 8% were for athlete’s foot. Pain relief, respiratory, dermatologic and hair products were more prevalent in female adolescents than in male while antidandruff and athlete’s foot preparations were used more by male adolescents. The most common sources of information on medicines were parents.Conclusion:The prevalence of self-medication among adolescents in Kuwait is high. Self-medication tended to increase with age and differed between male and female students. Few students consulted pharmacists for information on drugs. There is need to promote the image of the pharmacist in Kuwait as a provider of medication information.

Physicians’ Perceptions and Expectations of Pharmacists’ Professional Duties in Government Hospitals in Kuwait

Objective:The objectives of this study were to evaluate the perceptions, expectations and experience of physicians with hospital-based pharmacists in Kuwait. Materials and Methods: A piloted self-administered questionnaire was hand delivered to 200 physicians practicing in four government hospitals in Kuwait. Main sections of the questionnaire comprised a series of statements pertaining to physicians’ perceptions, expectations and experiences with pharmacists. Results: One hundred and twenty (60%) questionnaires were returned. At least 57% of physicians in Kuwait appear comfortable with pharmacists carrying out patient-directed roles. In addition, they appeared to have high expectations of pharmacists, with 79% of them regarding pharmacists as knowledgeable drug therapy experts. Less than 60% considered pharmacists as applying their drug knowledge in practice and only 29% agreed that pharmacists routinely counselled their patients. There was no correlation between physician variables such as number of years since graduation from medical school, age, area of practice and their perceptions of pharmacists. Conclusion: Physicians in Kuwait appear comfortable with pharmacists providing a broad range of services but appear somewhat less comfortable with pharmacists’ provision of direct patient care. Physicians considered pharmacists knowledgeable drug therapy experts, but regarded them as not routinely providing a broad range of higher-level pharmacy services.

Practice and Opinion towards Disposal of Unused Medication in Kuwait

Objectives: The aim of this study was to measure the attitude and practice of Kuwaiti patients in Kuwait with regard to safe disposal of unwanted medicines. Subjects and Methods: Three-hundred patients or their family members waiting for prescriptions at public general hospitals in Kuwait completed a questionnaire soliciting their practice with regard to medication use and disposal, and their opinion of the best way to dispose of unwanted medicines. Results: Almost half of the respondents (45.4%) obtained medicines on prescription more than 3 times a year and almost all had unwanted medicines in the home. Reasons for possessing unused medication were mostly due to a change of medication by the doctor (48.9%), or self-discontinuation (25.8%). Their most common method of disposal was to throw unwanted medicines in the trash (76.5%) or flush them down the drain (11.2%). Half (54.0%) thought that a system of taking medicines to pharmacies for safe disposal would be favorable. Conclusion: The study indicates that the need for an appropriate method for disposal of unwanted medication exists in Kuwait. Hence, guidelines on safe disposal of unwanted medicines are required and an organized method of collecting unused medication needs to be introduced.

Health promotion and education activities of community pharmacists in Kuwait

Objectives To investigate self-reported practice of pharmacists regarding health promotion and education activities, explore the barriers that may limit their involvement in health promotion and education, and identify their willingness to participate in continuing education programs related to health education. Setting Community pharmacies in Kuwait. Method A descriptive cross-sectional study was performed using a pre-tested questionnaire on a sample of 223 community pharmacists. Main outcome measures The extent of the pharmacists’ involvement in counselling patients about health promotion and education topics, their preparation to counsel patients in health promotion and education topics, and their perceived success in changing the patients’ health behaviour. Results The response rate was 92%. Information on medication use was the most frequent reason for consumers seeking community pharmacists’ advice. The majority of respondents believed that behaviour related to the proper use of drugs was very important. There was less agreement on the importance of other health behaviours. Respondents indicated they were involved in counselling patients on health behaviours related to use of drugs as prescribed/directed, weight management, medicine contents and side effects, diet modification and stress reduction, but were less involved in counselling on other health behaviours. Respondents’ perception of themselves as “most prepared” to counsel patients closely reflected their involvement. Pharmacists reported high levels of success in helping patients to achieve improvements in using their drugs properly compared to low levels in changing patients’ personal health behaviours. The majority of respondents believed that pharmacists had a responsibility for counselling consumers on health behaviours (97%, 95% CI 95–99%), and indicated their willingness to learn more about health promotion (84%, 78–88%). Lack of pharmacists’ time was reported by about 58% of respondents as the major barrier limiting pharmacists’ provision of health promotion. Conclusion The role of community pharmacists in health promotion and education is primarily focused on pharmaceutical issues rather than health behaviour modification. The majority of respondents have a positive attitude towards counseling the population on health behaviours and indicated their willingness to learn more about health promotion.

Disposal of unwanted medicines from households in Kuwait

ObjectiveTo test the effectiveness of a simple educational intervention to encourage households to return unwanted medicines via a municipal collection program and to investigate the most common sources and types of unwanted medicines in the home.SettingHouseholds in Kuwait City, Kuwait.MethodA convenience sample of 200 households in Kuwait received an educational letter and special plastic bags in which to place unwanted medicines to be collected by the municipality. They also completed a short self-administered questionnaire on medicine disposal habits. A second convenience sample of an additional 14 households in Kuwait received the same educational letter together with a face-to-face interview and assistance in collecting unwanted medicines. Returned medicines were categorized and their source and expiry dates noted.Main outcome measureQuantity and types of medicines returned.ResultsNo medicines were collected from the 200 households participating in the municipal collection scheme in spite of 45% of respondents agreeing that this was an appropriate method of disposal. 97% of the respondents said they currently disposed of their medication in the garbage. The second intervention yielded 123 medicines from 14 homes, a third of which were for the respiratory system (38% of these were cough and cold preparations). The majority of returned medications were for acute conditions, almost all were from government health centers and 52% were expired.ConclusionSimple collection of unwanted medicines by municipal authorities is unlikely to be effective. A multifaceted approach is more effective but resource intensive. Using local pharmacies as collection points in a reverse distribution system may be more cost-effective.

Pharmacists’ attitudes and awareness towards the use and safety of herbs in Kuwait

Objectives The purpose of this study was to investigate the knowledge and attitudes among pharmacists in Kuwait towards the use of herbs. Methods Self-administered questionnaire was designed as the study instrument and distributed among 100 qualified pharmacists working in government and private pharmacies in Kuwait. Results The mean age was 34.2 (SD=7.5) years. About 51% of pharmacists reported they had used herbal therapy in their lifetime. The majority were interested in herbal information, and their herbal information came mainly from their previous classes during college. Although the pharmacists’ knowledge about uses of selected herbs was good, their awareness about side effects of those herbs was modest. About 31% of the pharmacists did not have enough information about potential interactions between herbs and conventional medicines. Conclusion Herbal information is needed for pharmacy students as part of the Pharmacy College curriculum. Continuing education programs for practising pharmacists about the safety of different herbal products should be established in Kuwait.

Self-Medication Practices among Diabetic Patients in Kuwait

Objectives: The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and/or herbs among diabetic patients and evaluate factors associated with self-medication among diabetic patients. Subjects and Methods: A total of 104 diabetic patients were selected randomly from eight diabetic clinics from three governorates. Data were collected via face-to-face structured interview of the respondents in the clinics using a developed and piloted questionnaire. Results: The response rate was 96.2%. Seventy-four percent of the study participants reported that they seek medical consultation when they get an illness, 92% indicated that they know that the use of medicines and/or herbs to treat an illness without a medical consultation can be harmful. Only 13% of the respondents reported that they had used medicine or herbs without medical consultation to treat an illness within the previous 2 months of the study period. Nine percent of the study population reported that they used herbs to treat diabetes, and 2% used them for other illness. Only two (2%) indicated that they used medicines, which were analgesics, diet pills and vitamins. There was no significant association between self-medication with medicines or herbs and the sociodemographic characteristics of the respondents (p > 0.05). Conclusion: The prevalence of self-medication with medicines, including herbs, among diabetic patients in Kuwait is low. Enforcement of a strict prescription policy and coverage of medical consultation and treatment by health insurance may have contributed to low self-medication practices among diabetic patients.

Pharmaceutical and chemical pediatric poisoning in Kuwait: a retrospective survey

Past studies of pediatric poisoning in Kuwait have suggested differences at hospital level which could impact on the implementation of public health interventions. The objective was to compare pediatric poisoning admissions at general hospitals in Kuwait. Methods Retrospective survey of all pediatric poisoning cases at the six general hospitals from January 2004 to December 2005. Case data were documented using ICD-10 criteria and the poisoning severity score. Aggregated data was also obtained from five private hospitals. Results 978 children were admitted in public hospitals over 2004 and 2005 (no fatalities) being 1.8% and 1.6% of all pediatric admissions (private hospitals admitted 293 cases). The majority of the poisoning cases came from Jahra hospital (>35%), the median age was 2.3 yrs, 93% of cases were under 6 yrs old and 71% were Kuwaiti. Two thirds of cases involved pharmaceuticals although this varied between hospitals with a tendency for more severe cases with chemical poisoning (p=0.011). Kerosene was an important problem at Jahra hospital (34.7% of chemical exposures). Non-opioid analgesics constituted 22.3% of medication exposures with hormones and drugs affecting the autonomic nervous system also common with some difference in pattern between institutions. Conclusion Case demographics do not vary significantly between the hospitals but there are differences in the nature of toxic agents to which children are exposed suggesting that preventive and educational programs could be targeted to specific areas for maximal effect particularly with regard to household chemical and kerosene exposures.

Self-Monitoring of Blood Pressure and the Role of Community Pharmacists in Kuwait

Objective: To determine the types of devices for self-monitoring of blood pressure available to consumers in Kuwait and the pharmacists’ knowledge and level of information provided to consumers when purchasing such devices.Materials and Methods: It was possible to contact 196 of the 230 eligible pharmacies from five governorates in Kuwait. Ten of these were used to pretest the questionnaire and six declined to participate. Another six did not carry any blood pressure monitoring devices and hence were excluded. Data was then collected from pharmacists at the 174 remaining community pharmacies via face-to-face structured interview of the respondents at their work sites. Results: Of the 174 pharmacists, 173 (99.4%) claimed to offer or provide advice to clients at the time of purchasing devices, 117 (67.1%) of them stating that they did so even if the patients did not ask. Although 147 (84.5%) respondents correctly identified the mercury sphygmomanometer as the most reliable device for measuring blood pressure, less than half (86, 49.4%) claimed to know how to check the accuracy of the devices they sold. Only 25 (14.4%) pharmacists could actually identify the correct procedure for checking the accuracy of the devices and only 25 (14.4%) pharmacists could correctly identify cutoff points for systolic and diastolic blood pressure delineating clinical hypertension. Only 1 pharmacist could correctly name a reference source for blood pressure measurement. Conclusion: There is a need for improvement of community pharmacists’ competence in supporting patients and in providing them with information regarding devices for measuring blood pressure in Kuwait.

Adverse drug reaction reporting among physicians working in private and government hospitals in Kuwait

Introduction To improve patient safety and care, the identification and reporting of adverse drug reactions (ADRs) should be systematic and mandatory for all healthcare professionals (HCPs). Physicians remain the main HCPs with direct patient care whose role in ADRs reporting should not be ignored. Objective To document the awareness and attitude of physicians working in private and government hospitals in Kuwait with regard to pharmacovigilance (PV) and ADR reporting and to identify their practices of reporting ADRs. Material and methods A cross-sectional study was conducted using a paper-based 25-item questionnaire. The Statistical Package for Social Science (SPSS) was used for data analysis. Results A total of 1017 questionnaires were distributed to the eligible physicians in the government and private hospitals, giving a response rate of 84.2% and 83.0%, respectively (an overall response rate of 83.8%). Private physicians exhibited a better knowledge profile with regards to the purpose of PV (75.2% vs 64.8%; p = 0.002) and the correct ADR definition (75.8% vs 65.3%; p = 0.001). The majority of physicians showed good attitude towards reporting ADRs, nevertheless, private physicians had a significantly stronger belief that reporting ADRs is a professional obligation (93.4% vs 85.5%; p = 0.001). Three quarters of the study population (74.6%) had identified an ADR during their daily practice, however, only a small proportion (34.2%) confirms having ever reported ADRs. Regardless, significantly more private physicians had done so (42.4% vs 29.6%; p < 0.001). ADR reporting was significantly higher in physicians who knew the correct ADRs to be reported (adjusted OR = 1.86, p = 0.036), and those who were aware of any center or ADR reporting system in Kuwait (adjusted OR = 2.88, p = 0.020). Conclusions A national PV center empowered by clear legislation on “how” and “what” to report should improve physicians’ reporting practices and hence is required in the country. This should be combined with constant training and education in this regard.