Qais Alefan

Drug-related problems in a sample of outpatients with chronic diseases: a cross-sectional study from Jordan.

Optimization of drug therapy and preventing drug-related problems (DRPs) are major factors to improve health care, reduce expenditure, and potentially save lives. This study aimed at describing the types, numbers, and frequencies of DRPs in the outpatient settings of a group of hospitals in Jordan. The study was set in the cardiology, endocrine, and respiratory outpatient clinics of five major hospitals in Jordan. Patients who visited the above clinics during the period from September 2012 to December 2013, were candidates for this study. Each included subject was fully assessed for DRPs by clinical pharmacists according to a specially designed and validated pharmaceutical care manual. The main outcome measures were the number and types of DRPs. Data were collected from 2,898 patients (mean age ± standard deviation: 56.59±13.5 years). The total number of identified DRPs was 32,348, with an average of 11.2 DRPs per patient. The most common DRPs were a need for additional or more frequent monitoring, a problem in patients’ adherence to self-care activities or nonpharmacological therapy, and that the patient was not given instruction in or did not understand nonpharmacological therapy or self-care advice. The numbers of DRPs per patient in our sample were associated with older age (>57 years), being unmarried, having an education level of high school or less, not having health insurance, and the presence of certain clinical conditions, including hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, cardiac catheterization, heart failure, and gout. In conclusion, implementation of clinical pharmacy services is a strategy to limit DRPs. Certain patient populations are more vulnerable to DRPs.

Pharmacy education in Jordan: updates

To describe the increasing number of pharmacy schools in Jordan.

Smoking prevalence, knowledge and attitudes among primary healthcare professionals: a study from Jordan

This was a questionnaire-based cross-sectional study of 400 healthcare professionals recruited from primary healthcare centres in northern Jordan between April and October 2015. The questionnaire included questions about smoking behaviour, risks, opinions and providing anti-smoking counselling. More than 80% of participants reported that smoking-free policies were not enforced at primary healthcare centres. Compared to hospitals and the general population, smoking was less prevalent among primary healthcare professionals and more prevalent in men. More than 90% of participants believed that smoking was dangerous and associated with cardiovascular and respiratory diseases. Around 92% believed that they should set a good example to patients by not smoking and advise them about smoking cessation. Only 15.3% of participants felt well prepared when counselling patients about smoking and 92.8% believed that they needed training. This study suggests that primary healthcare professionals should act as anti-smoking role models after receiving professional training.

Off-label medicine use in children, a study of community pharmacists in Jordan

The aim of this study was to explore self‐reported experiences of community pharmacists towards off‐label prescribing.

Availability, prices and affordability of selected essential medicines in Jordan: a national survey

BackgroundFree access to essential medicines is a fundamental right. Governments should provide accessible and affordable medicines to people. The purpose of this study was to evaluate medicines’ prices, availability and affordability in Jordan.MethodData was collected from 30 public sectors and 30 private sectors in 6 regions in Jordan. At each institution, the availability and prices data of 50 originator brand (OB) medicines and lowest-price generic (LPG) equivalent medicines were collected. Medicines’ prices were compared with international reference prices (IRPs) to obtain a median price ratio (MPR). Availability of medicines was determined on the day of data collection. Affordability was calculated with regards to the daily income of the lowest-paid unskilled government employee.ResultAvailability of medicines in public and private sectors was 72% and 76% for LPGs, respectively. Median MPRs of procurement prices for OBs and LPGs in the public sector were 1.1 and 5.5 times the IRPs, respectively. Private sector OB medicines were priced 4.8 times higher than IRPs, whereas LPGs were 3.8 times higher. OBs cost 14% more than LPGs in private sector. The median MPRs of patient prices for LPGs in the public sector were lower than in the private sector (1.1 versus 7.6). Generally, medicines’ prices are affordable in public sector that the lowest paid unskilled government employee need less than a 1 day income to purchase the LPGs. While in private sector, the medicine prices are not affordable. For example, the treatment of hypertension either by LPGs or OBs needs more than 1 day income by lowest paid unskilled government employee.ConclusionThis study showed good availability of LPGs in the public sector. In private sector, it showed good availability of LPGs and OBs with higher patient prices. The procurement prices in the public sector were reasonable in comparison to IRPs. Policy evaluation efforts must be directed to cut medicines prices and to improve affordability in private sector.

PHARMACOECONOMIC STUDIES IN WORLD HEALTH ORGANIZATION EASTERN MEDITERRANEAN COUNTRIES: REPORTING COMPLETENESS

OBJECTIVES The aim of this study was to evaluate the extent of reporting necessary information in published health economic research in World Health Organization Eastern Mediterranean Countries (WHO EMC). METHODS A systematic literature search was conducted using PubMed and Google Scholar to identify pharmacoeconomic studies conducted in WHO EMC. The inclusion criteria for the studies were: (i) original studies, (ii) compared pharmaceutical services or drugs, (iii) conducted in WHO EMC, (iv) manuscript published in English. The articles were reviewed by two independent reviewers using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS A total of seventeen studies were included, each of which were published in seventeen different journals. The mean CHEERS checklist score was 16 ± 4. Most studies were published in journals outside WHO EMC (n = 12; 71 percent). Cost-effectiveness (n = 5; 29 percent) and cost-utility analyses (n = 5; 29 percent) were the most frequently used methods of economic evaluation. CONCLUSIONS Pharmacoeconomic studies in WHO EMC are limited and sometimes incomplete. Economic evaluation of pharmaceuticals should be encouraged in WHO EMC to ensure the appropriate allocation of healthcare resources.

Drug Shortages in Jordan : A Cross-Sectional National Survey = نقص الدواء في الأردن : دراسة مسحية وطنية مستعرضة

This study was conducted to understand the extent of drug shortages in Jordanian MOH hospitals and collects more evidence of the size and health care effect of shortages. A validated questionnaire was distributed to physicians and pharmacists in MOH main hospitals and drug stores in all twelve Jordanian governorates. Overall, a total of 357 respondents completed the survey, yielding a response rate of 66.4%. The majority of the respondents were males (68%) and mean age of all respondents was 38.97 years. About two thirds (64.7%) of them were pharmacists and more than half (54.06%) were from the central province hospitals. More than half of respondents had trouble locating medications either during last week (54.06%) or last six months (56%) and the mean time spent dealing with shortages ranged from 23 minutes to more than one hour. Pharmacists spent more time (minutes = 78.5, ±214) dealing with shortages. About half of participants had either never (n = 56, 15.69%) or rarely (n = 131, 36.69%) received advance notice of shortages. About two thirds of respondents (n = 232, 64.98%) reported that patients were stressed, confused and felt angry; and experienced loss of trust in the medication and the pharmacists due to shortages (n = 221, 61.9%). Majority of respondents indicated an increase in their work load (n = 264, 73.95%) because of shortages. Implementing ICT such as electronic medical records was ‘number one’ strategy while implementing out of pocket payment by patients was ‘number last’ strategy according to respondents’ responses. In conclusion, drug shortages in Jordan are real and time consuming.

OHP-001 Medicines shortages in MOH hospitals in Jordan: problems & solutions

Background Jordan is an upper middle-income country with a per-capita GNI of US

COST OF TREATING HYPERTENSION IN MALAYSIA

4,340 and is located in the Middle East. Drug shortages are a persisting matter and are considered a global problem. Medicines shortage is defined as a supply issue that affects how the pharmacy department prepares or dispenses a product or affects patient care when prescribers must choose an alternative treatment because of supply problems. Purpose To determine the magnitude of the medicines shortage problem in Jordan and to assess its impact on patient outcomes and on health care practice. Materials and methods A validated questionnaire was administered to physicians and pharmacists in MOH main hospitals in all twelve Jordanian governorates and main MOH drug stores. Data were collected in July & August 2013. Results A total of 357 respondents completed the survey, yielding a response rate of 66.4%. About 54% of respondents had had trouble locating medicines during their last week of practice and 56% during the last six months. Pharmacists spent more time dealing with drug shortages than did physicians. More than 70% of respondents were not satisfied with the resources available for notification of about a shortage in certain drugs. Their responses also showed that patient outcomes and providers’ practice were being affected by the shortage of medicines. Conclusions A survey of hospital doctors and pharmacists revealed that the time required to manage drug shortages is noteworthy and that the impact of medicines shortages on their practice and patients’ health outcomes is real and significant. No conflict of interest.