Nadir Kheir

Quality of Life of Caregivers of Children With Autism in Qatar

Introduction: Caring for a child diagnosed with autism could affect the quality of life of the caregiver in various different ways. No previous research has assessed the quality of lives of caregivers of children with autism in Qatar. Methods: Caregivers of a child with autism between 3 and 17 years old were recruited from child rehabilitation clinics in Qatar. The non-autism group was represented by caregivers of a typically growing child visiting a primary health care facility for a routine medical examination. Data collected from both groups included demographic and quality of life information for caregivers. Results: A total of 98 participants consented to take part in the study. Fifty-six of these were caregivers of a child with autism and 42 were caregivers of a typically growing child. There was no significant difference between quality of life domains between the two groups of caregivers, but caregivers of autistic children rated their health as poor and likely to get worse (p < 0.05). Conclusions: This study provided some evidence for the impact of caring for a child with autism on the life of the caregiver. The findings should help health policy-makers in Qatar to provide better and more focused support to children with autism and their caregivers.

Pharmacy practice in Qatar: challenges and opportunities

The State of Qatar is a small oil and gas-rich Gulf country that is experiencing rapid development in health care services, including pharmaceutical services. To date, there is no autonomous professional pharmacy association or society that regulates or promotes the practice of pharmacy in Qatar, and the challenges that face the profession of pharmacy in Qatar mirror the challenges facing the profession in all other Middle Eastern countries. However, a set of initiatives and projects that include pioneering educational initiatives, close alignment of practice with the educational providers, stronger leadership from a National Health Strategy, and the development of pharmacy leadership groups at the practice level all contribute in the fast development of the practice of pharmacy in this country. In this commentary, we provide a snapshot of the pharmaceutical scene in Qatar, and in doing so, we shall discuss the challenges that face the practice, and the main landmarks and initiatives that are destined to move pharmacy forward in Qatar.

An exploratory study on medications in Qatar homes

Background Drug therapy is the most often used intervention for treatment and prevention of disease. However, if used inappropriately, drugs can cause more harm than good. Improper drug storage and disposal can have a direct impact on public safety, the environment, and the health care services. The purpose of this study was to characterize medications stored in Qatar homes and to explore their methods of storage and disposal, and to identify the public’s source of information related to medicines. Methods For the purpose of this cross-sectional exploratory study, a list of telephone numbers was generated from Qatar’s telephone directory using a systematic sampling method. Individuals consenting to participate were interviewed using a multipart pretested survey instrument. Results Data were collected from a total of 49 homes. Most respondents did not have a designated compartment or box specifically for storing medications. The majority of drugs (48%) were kept in bedrooms and a number of respondents were keeping their drugs in the fridge and in the kitchen. The most often stored classes of medicines were analgesics, antihistamines, nutritional supplements, and medications used for the respiratory system. Most respondents disposed of unwanted medicines by throwing them in the trash. In about 15% of cases, the dosage of drug taken was different from the instructions on the label. Sharing of prescription medicines was not uncommon. The majority of respondents sought information related to drugs from doctors. Conclusion These findings raise concerns about how medications are stored and disposed of in the community. The fact that no household routinely returned unwanted medications to a pharmacy for proper disposal places the environment at risk. There is a need for more societal awareness about the safe handling and storage of drugs in the home, and about the professional role of the pharmacist.

Pharmacist characteristics, medication use perceptions, and professional satisfaction: a first national survey in the state of Qatar

correspondence: Peter J Jewesson College of Pharmacy, Qatar University, Doha 2713, Qatar Tel +974 4403 5553 Fax +974 4403 5551 Email pjj@qu.edu.qa Purpose: To characterize the professional demographics, opinions about the medication use process, perceived public satisfaction with pharmacy services, and professional satisfaction of pharmacists practicing in the state of Qatar. Materials and methods: The study was designed as a hypothesis-generating, online, anonymous, opinion survey of practicing pharmacists in Qatar. Results: Two hundred and sixty-four survey accesses were recorded during the 6-week study period, and 250 surveys containing responses to one or more questions were included in the analysis. Eighty-four percent of respondents reported graduating at least 5 years prior to the survey, and 86% held a baccalaureate degree in pharmacy as their highest degree. The most common source of the highest degree was one of five countries (Egypt, Jordan, India, Sudan, or Pakistan). Forty-five percent of respondents were working in a hospital setting, and 33% were in a community pharmacy. The lowest incidence of agreement across the 10 drug procurement and distribution process statements was observed for the adequacy of medication supplies statements (33% of all respondents). The highest incidence of agreement across the eight medication use process statements was for the statement pertaining to infrequent dispensing errors (68%), and the lowest incidence of agreement was observed for the statement pertaining to the adequacy of patient monitoring (30%). The pharmacist was chosen as the best candidate to resolve perceived unmet medication needs for four of eight statements, whereas physicians were most frequently chosen for three of the four remaining statements. Respondents’ perceptions regarding patient satisfaction with the different elements of the medication use process revealed that the lowest incidence of agreement pertained to patients’ satisfaction with the waiting time required to obtain their medications (35%). Forty percent of all respondents rated themselves as professionally dissatisfied. Improvements to their professional role, greater opportunities for professional development, and enhancements in human resource-related conditions were identified as potential remedies to this situation. Conclusion: This study represents the first known attempt to formally solicit the opinions of pharmacists in Qatar. The study results have provided valuable information regarding the demographic characteristics, pharmacist perceptions about the medication use process, and professional satisfaction of practicing pharmacists in the country. This information is being utilized to guide workforce planning, to help identify potential shortcomings in the health care system, and to better understand continuing education and professional satisfaction needs of Qatar’s pharmacy practitioners. We encourage other countries to conduct similar surveys in order to better understand the characteristics, perceptions, and needs of their health care workers.

Knowledge, attitude and practices of Qatari patients with type 2 diabetes mellitus

Objectives  Patient compliance with their medications and their ability for self‐management in type 2 diabetes mellitus (T2DM) is a growing cause of concern to healthcare providers. Knowledge about diabetes, attitude towards the condition and time management with respect to the condition (practice), collectively known as KAP, are known to affect compliance and play an important part in diabetes management. We aimed to describe the knowledge, attitude, practice and psychological status of adult Qatari patients with T2DM, and to explore the interaction between these and other patient‐related factors which could impact on the ability of the patients to manage their diabetes and to achieve desirable health outcomes.

Pharmacist-documented interventions during the dispensing process in a primary health care facility in Qatar.

Objectives: To characterize prescribing error interventions documented by pharmacists in four pharmacies in a primary health care service in Qatar. Methods: The study was conducted in a primary health care service in the State of Qatar in the period from January to March 2008. Pharmacists in four clinics within the service used online, integrated health care software to document all clinical interventions made. Documented information included: patient’s age and gender, drug therapy details, the intervention’s details, its category, and its outcome. Interventions were categorized according to the Pharmaceutical Care Network Europe Classification of drug-related problems (DRP). Results: The number of patients who had their prescriptions intercepted were 589 (0.71% of the total 82,800 prescriptions received). The intercepted prescriptions generated 890 DRP-related interventions (an average of 1.9% DRPs identified across the four clinics). Fifty-four percent of all interventions were classified as drug choice problems, and 42% had safety problems (dose too high, potential significant interaction). The prescriber accepted the intervention in 53% of all interventions, and the treatment was changed accordingly. Interventions as a result of transcription errors, legality and formulary issues were eliminated from this study through the use of computerized physician order entry (CPOE). Conclusions: Documenting and analyzing interventions should be a routine activity in pharmacy practice setting in primary health care services. Educational outreach visits and other strategies can improve prescribing practices and enhance patient safety.

Pictorial health warnings on cigarette packages in qatar: preimplementation awareness and perceptions of ever-smokers versus never-smokers.

INTRODUCTION Studies have demonstrated that pictorial health warnings (PHWs) on cigarette packages were significantly associated with increased awareness of smoking-related health hazards and behavior change. A new legislation on PHWs was recently endorsed and PHWs have recently been introduced in Qatar. This study aims to evaluate the general publics awareness, beliefs, and perceptions on antitobacco PHW labels on cigarette packs prior to the implementation of the new regulation. METHODS A cross-sectional survey using a pretested 23-item questionnaire was conducted among randomly approached adults in Qatar. Data were analyzed using IBM SPSS(®) version 19. Demographic characteristics and other outcomes of interest were compared using chi-square or Fishers exact tests. RESULTS A total of 500 participants (59% male) responded to the survey. Most notably, ever-smokers did not significantly differ from never-smokers on awareness of PHW. About one third of the respondents had no idea about any specific text warning messages on tobacco products sold and nearly 45% of them did not know what a PHW was. Furthermore, a substantial proportion (more than 20%) of the respondents in both groups did not believe that introducing PHWs will enhance smoking behavior change. Nonsmokers generally tended to have more positive attitudes than smokers toward perceived impact of PHWs. CONCLUSION These findings suggest the needs for increased awareness about the value of PHWs and call for further research to determine the effectiveness of PHW labels on cigarette packages in Qatar and greater Middle Eastern region, where legislations on PHWs are still at infancy.

The first pharmacist-managed anticoagulation clinic under a collaborative practice agreement in Qatar: clinical and patient-oriented outcomes

Optimal outpatient anticoagulation management requires a systematic and coordinated approach. Extensive evidence regarding the benefits of pharmacist‐managed anticoagulation services has been reported in the literature. The quality and outcomes associated with pharmacist‐managed anticoagulation clinics under collaborative practice agreements in the Middle East have rarely been reported. The first pharmacist‐managed ambulatory anticoagulation clinic in Qatar was launched at Al‐Wakrah Hospital in March 2013. The objectives of this study were to: (i) describe the practice model of the clinic, (ii) evaluate the quality of the clinic [i.e. the time in therapeutic range (TTR)] and the clinical outcomes (i.e. the efficacy and safety), and (iii) determine the patients’ satisfaction and overall quality of life (QoL).

Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial

BackgroundIt had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar.Methods/DesignA prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome.DiscussionIf proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden.Trial registrationClinical Trials NCT02123329.

Concerns and considerations among caregivers of a child with autism in Qatar

BackgroundAutism impacts the lives of the family looking after a child with the condition in different ways, and forces family members to modify their daily lives to suit their reality. To our knowledge, no previous research investigated concern and considerations of parents/caregivers of children with autism in Qatar or the Arabic speaking Middle Eastern region.MethodsCaregivers of a child who was between the age of 3 to17 years old at the time of the study and who was diagnosed with ASD (Autistic Group or AG) were recruited from the two main developmental pediatric and children rehabilitation clinics in Qatar. The control group (non-autism group, or NAG) was represented by caregivers of a non-autistic child between the age of 3 to 17 years old at the time of the study and who were visiting a family clinic of a primary health care facility for routine medical check-up. Data collected from both groups included related to the child (e.g. the child’s date of birth, his/her relation to the caregiver, number of siblings, number of hours of sleep in a day, number of hours spent watching television or videos prior to age 3, time spent indoors prior to age 3, absenteeism from school, and use of a nanny to care for the child) and to the caregiver (education level, profession, level of consanguinity using the phylogram method). In addition to these questions, caregivers in the AG were asked specific questions around maternal concern and considerations in respect to the future of their children and the specialized services they receive.ResultsChildren in the autism group spent more time indoors, watching television, or sleeping than children in the non-autism group. Only around 40% of caregivers in the autism group said they would encourage their child to get married and become a parent when s/he grows up. A number of caregivers of children with autism frequently utilize specialized rehabilitation services; others did express their needs for these services and made comments about having to wait a long time before they were provided with some of the services. Religious faith helped caregivers in accepting having a child with autism. General health-related quality of life did not differ significantly between the caregivers of the two groups, although mental health was consistently poorer in the autism group of caregivers.ConclusionsThe study draws attention to the concerns of the families of children with autism and their expectations about the future of their children. The findings can be used by policy makers in planning services to support these families in Qatar.