Linda Tahaineh

Abuse and Misuse of Prescription and Nonprescription Drugs Sold in Community Pharmacies in Jordan

The aim of this study was to investigate abuse/misuse of prescription and nonprescription drugs in community pharmacies in Jordan by random distribution of a structured questionnaire to 405 pharmacies (November 2005–January 2006). Data were analyzed using SPSS for windows (version 14.0). Most respondents (94.1%) suspected that some level of abuse/misuse occurred in their pharmacy, which was highest for decongestants, cough/cold preparations, benzodiazepines, and antibiotics. Abuse/misuse of prescription and nonprescription drugs is present in Jordan, but current methods for controlling the problem are ineffective, and better methods should be developed. The studys limitations are noted..

Physicians' perceptions, expectations, and experience with pharmacists at Hamad Medical Corporation in Qatar.

Objectives: The purpose of this study was to investigate the physicians’ perceptions, and expectations of their experiences with the pharmacists at Hamad Medical Corporation (HMC) in Qatar. Method: A cross-sectional study was conducted at HMC between January and March 2006 using a validated questionnaire. The self-administered questionnaire was distributed to 500 physicians who were working at HMC comprising Hamad General Hospital, Women’s Hospital, Rumaila Hospital, Al-Amal Hospital, Al Khor Hospital, and primary health centers. The questionnaire was composed of four parts, investigating the physicians’ expectations, experiences, and perceptions of the pharmacists. Results: A total of 205 questionnaires were completed (response rate 41%). A total of 183 physicians (89%) expected the pharmacist to educate patients about safe and appropriate use of drugs, whereas 118 (57%) expected the pharmacist to be available for health-care team consultation during bedside rounds. The indices of physicians showing how comfortable they were with pharmacists, and their expectations of pharmacists, were 61% and 65%, respectively, whereas the index on experience of physicians with pharmacists was lower (15%). Conclusions: Physicians were comfortable with pharmacists and had high expectations of pharmacists in performing their duties. However, physicians reported a poor experience with pharmacists, who infrequently informed them about the effectiveness of alternative drugs, patients experiencing problems with prescribed medications, and who took personal responsibility to resolve any drug-related problem.

Tablet Splitting and Weight Uniformity of Half-Tablets of 4 Medications in Pharmacy Practice

Background: Tablet splitting is a common practice for multiple reasons including cost savings; however, it does not necessarily result in weight-uniform half-tablets. Objectives: To determine weight uniformity of half-tablets resulting from splitting 4 products available in the Jordanian market and investigate the effect of tablet characteristics on weight uniformity of half-tablets. Methods: Ten random tablets each of warfarin 5 mg, digoxin 0.25 mg, phenobarbital 30 mg, and prednisolone 5 mg were weighed and split by 6 PharmD students using a knife. The resulting half-tablets were weighed and evaluated for weight uniformity. Other relevant physical characteristics of the 4 products were measured. Results: The average tablet hardness of the sampled tablets ranged from 40.3 N to 68.9 N. Digoxin, phenobarbital, and prednisolone half-tablets failed the weight uniformity test; however, warfarin half-tablets passed. Digoxin, warfarin, and phenobarbital tablets had a score line and warfarin tablets had the deepest score line of 0.81 mm. Conclusion: Splitting warfarin tablets produces weight-uniform half-tablets that may possibly be attributed to the hardness and the presence of a deep score line. Digoxin, phenobarbital, and prednisolone tablet splitting produces highly weight variable half-tablets. This can be of clinical significance in the case of the narrow therapeutic index medication digoxin.

Jordanian community pharmacists’ experience regarding prescription and nonprescription drug abuse and misuse in Jordan – An update

ABSTRACT Background: The problem of prescription and nonprescription drug abuse and misuse is well known worldwide. It has been 8 years since this problem has been investigated in Jordan. Objectives: This study aims to investigate the abuse/misuse of drugs sold with or without a prescription in community pharmacies in Jordan in 2014 and to document any changes that may have aroused in the past 8 years. Methods: A cross-sectional survey using a structured questionnaire based on one used previously in 2006 was sent to a stratified random sample of 320 community pharmacies. Data were managed and analyzed in SPSS. Results: A total of 290 questionnaires were completed (response rate = 92.4%). The pharmacists named 727 nonprescription and 372 prescription drugs as being suspected of abuse, each classified into 6 categories. New products have appeared on the list such as: ophthalmic drops (n = 39, 13.4%) and the anti-epileptic; Lyrica (pregabalin; n = 19, 6.5%). Other drugs previously on the 2008 list like misoprostol have retracted in 2014 (from 7.1% to 1.3%). Conclusion: Patterns of suspected prescription and nonprescription drug abuse/misuse have slightly changed in Jordan over time, with new drugs emerging and previous ones disappearing from the list.

Behaviors and Attitudes towards Dysmenorrhea; a Cross-sectional Survey of 2,000 Jordanian University Students

Background and Aims: Dysmenorrhea is a very common gynecologic condition encountered by women. The majority of women suffering from dysmenorrhea self-medicate with over the counter medications, which might be inadequate or not very effective. The present study aims to determine the prevalence of dysmenorrhea, the factors significantly associated with the prevalence of dysmenorrhea, the attitudes and behaviors towards dysmenorrhea among Jordanian female students, and the pharmacists role in the management of dysmenorrhea. Materials and Methods: A total of 2,000 female university students in seven public universities were randomly approached and anonymously surveyed by our research team using a validated structured questionnaire technique. Responses were coded and entered into a customized database in SPSS, version 17, for statistical analysis. Results: Two thousand female university students took part in this survey. The prevalence of dysmenorrhea among the study group was 90.1% (50.5% had pain during each menstruation while 39.6% had pain during some menstruations). Participants were statistically more likely to have dysmenorrhea if they were underweight, having a low family income, living in a rural area, and reporting to have a family history of dysmenorrhea. The majority of respondents thought that the pharmacist had a major role in the treatment of dysmenorrhea. Conclusion: This study has reported a high prevalence of dysmenorrhea among female university students in Jordan. There are growing opportunities for pharmacists to act in the treatment and management of dysmenorrhea.

A randomised control trial to evaluate the clinical pharmacist's role in managing iron deficiency anaemia patients

To investigate the role of clinical pharmacists in managing iron deficiency anaemia patients.

Evaluation of factors in a primary care setting which may cause failure to respond to oral iron treatment in iron deficiency anaemia patients

The purpose of this study was to evaluate therapeutic outcomes in patients treated for iron deficiency anaemia and to analyse potential factors relevant to therapy success or failure.

Tablet splitting practice in Jordan

To investigate the practice of tablet splitting and the frequency of using different techniques for tablet splitting at outpatient pharmacies in Jordan.

Healthcare providers’ attitude and knowledge regarding medication use in breastfeeding women: a Jordanian national questionnaire study

Abstract Medication use among women who have recently given birth is unavoidable in some situations. The aim of this study was to assess the attitude and knowledge of healthcare providers (HCPs) in Jordan about the safe use of medications during breastfeeding. The data were collected from HCPs in maternal and children care centres and hospitals from April 2015 to January 2016, using a self-administered questionnaire. A total of 904 HCPs (79.3%) were enrolled in the study. Half of the participants followed the World Health Organisation’s and American Academy of Pediatrics’ recommendations. The awareness of HCPs regarding these recommendations was lower among nurses (OR 0.212, 95%CI 0.132–0.338, p < .001) and pharmacists (OR 0.476, 95%CI 0.297–0.763, p = .002) than physicians. The majority of participants (80%) had low level of knowledge and nurses were more likely to have low knowledge than physicians (OR 0.099, 95%CI 0.050–0.197, p < .001). Professional continuous education programmes were highly encouraged. Impact statement What is already known on this subject: Use of medications among women who have recently given birth is unavoidable in some situations and most of them are safe to be given during breastfeeding. What the results of this study add: Healthcare providers in Jordan have variable attitudes regarding the safety of medication use during breastfeeding. The majority of healthcare providers have a low level of knowledge regarding the safe use of medication during breastfeeding. Nurses are more likely to have low knowledge as compared to physicians. Implications for clinical practice: Healthcare providers should be encouraged to seek information regarding compatibility of medication use during breastfeeding from reliable sources. Professional continuing education programmes concerning the safety of medication use during breastfeeding period are needed to target all involved HCPs. More attention should be directed toward medical schools’ curricula to widen the knowledge of medication use and focus on practice-based clinical experience.

Anti-factor Xa levels in obese patients receiving enoxaparin for treatment and prophylaxis indications

Objectives To evaluate the degree of anticoagulation achieved with different enoxaparin dosing regimens used in obese and morbidly obese patients in a hospital setting in Jordan. Methods All obese adult patients who were prescribed enoxaparin for various indications were invited to participate in the study. The anti-factor Xa (anti-Xa) level was checked once after 4–6 hours of the third or fourth dose of enoxaparin (at steady state). Patients were followed daily to evaluate drug efficacy and safety through their hospital course. Results Enoxaparin daily dose used for prophylaxis indications ranged from 0.3 to 0.85 mg/kg and from 0.31 to 2.25 mg/kg in case of certain treatment indications. Most participants who received enoxaparin for treatment indications (76.9%) were on capping dosing regimens, which was <1 mg/kg twice daily. On the other hand, most patients (88.5%) who received enoxaparin for prophylaxis indications were on a fixed 40 mg/d dose. Among the 52 patients who completed the study, 19 patients (36.5%) had therapeutic anti-Xa levels. The results showed no statistically significant associations between regimens that were used and achieving therapeutic anti-Xa level (p>0.05). No bleeding events or thrombocytopenia were noticed, and there was one case of recurrent thrombosis. Conclusion Enoxaparin dosing regimens that were used for obese patients varied based on prescribing physicians. Regardless of the regimen used, the majority of participants had nontherapeutic anti-Xa. Individualized dosing regimens based on anti-Xa levels are warranted for obese patients on enoxaparin.