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Background: Adherence to treatment recommendations is challenging in hemodialysis (HD) patients, yet it has been found to be extremely crucial in obtaining positive clinical and health outcomes. Aim: To evaluate the influence of implementing an educational process provided by the clinical pharmacist on HD patients' adherence to treatment recommendations and clinical outcomes. Method: A randomized controlled trial was conducted in which patients from three HD units in Jordan were randomly allocated to either an intervention (n = 60) or a control group (n = 60). During a three-month period, the intervention group received a monthly educational approach from a clinical pharmacist with recommendations for improving medication, nutrition, and fluid adherence, whereas the control received standard medical care. The primary outcome was patient adherence to HD-related recommendations. Quality of life (QOL), disease awareness, hospitalization, and changes in biochemicals were secondary outcomes. Results: The final analysis included 114 patients (n = 57/group). In the intervention group, there was a significant improvement in total adherence score versus control (1170.6 ± 44.1 vs. 665.8 ± 220.7, p < 0.001), and adherence to various aspects including episodes/duration of shortening HD, dietary guidelines, fluid restriction, and prescription medications. The clinical pharmacist intervention enhanced patients' QOL and improved awareness and perspective of the disease. Following the intervention, laboratory values for urea, creatinine, phosphorus, and hemoglobin were considerably improved. Additionally, the intervention group had fewer hospitalizations than the control group (0.54 ± 0.07 vs. 0.78 ± 0.26, p < 0.001). Conclusion: Providing clinical pharmacy education to HD patients improved adherence behavior and clinical outcomes. This illustrates the importance of clinical pharmacists as interdisciplinary team members in dialysis care. Trial registration This trial has been registered in ISRCTN Register (ISRCTN75517095). https://clinicaltrials.gov/ct2/show/ISRCTN75517095 [ABSTRACT FROM AUTHOR]

Background: Psycho-educational interventions for people diagnosed with schizophrenia (PDwS) and their primary caregivers appear promising, however, the majority of trials have significant methodological shortcomings. There is little known about the effects of these interventions delivered in a booklet format in resource-poor countries. Methods: A randomized controlled trial was conducted from September, 2012 to July, 2013 with 121 dyads of PDwS and their primary caregivers. Participants aged 18 years or older with DSM-IV schizophrenia or schizoaffective disorder, and their primary caregivers, from four outpatient mental health clinics in Jordan, were randomly assigned to receive 12 weeks of a booklet form of psycho-education, with follow-up phone calls, and treatment as usual [TAU] (intervention, n = 58), or TAU (control, n = 63). Participants were assessed at baseline, immediately post-intervention (post-treatment1) and at three months follow-up. The primary outcome measure was change in knowledge of schizophrenia. Secondary outcomes for PDwS were psychiatric symptoms and relapse rate, with hospitalization or medication (number of episodes of increasing antipsychotic dosage), and for primary caregivers were burden of care and quality of life. Results: PDwS in the intervention group experienced greater improvement in knowledge scores (4.9 vs -0.5; p <0.001) at post-treatment and (6.5 vs -0.7; p <0.001) at three month-follow-up, greater reduction in symptom severity (-26.1 vs 2.5; p <0.001: -36.2 vs -4.9; p <0.001, at follow-up times respectively. Relapse rate with hospitalization was reduced significantly at both follow-up times in the intervention group (p <0.001), and relapse with medication increased in the intervention group at both follow-up times (p <0.001). Similarly there was a significant improvement in the primary caregivers knowledge score at post-treatment (6.3 vs -0.4; P < 0.001) and three month-follow-up (7.3 vs -0.7; p <0.001). Primary caregivers burden of care was significantly reduced in the intervention group (-6.4 vs 1.5; p <0.001; -9.4 vs 0.8; p <0.001), and their quality of life improved (9.2 vs -1.6; p = 0.01; 17.1 vs -5.3; p <0.001) at post-treatment and three month-follow-up. Conclusions: Psycho-education and TAU was more effective than TAU alone at improving participants' knowledge and psychological outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Women''s traditional way of breastfeeding has altered in Jordan with rates declining in recent years. Objective: The objectives of this study were to test whether the introduction of an educational program supporting breastfeeding would increase the proportion of women who breastfed fully to six months, improve the women''s level of breastfeeding knowledge, and decrease the proportion of infants admitted to hospitals due to gastrointestinal illnesses. Methods: A randomized controlled trial was conducted in 90 primiparous women who had given birth to a healthy, full term, singleton baby at two hospitals in the southern region of Jordan. Women were randomly allocated to either the intervention group (n =45), in which they were offered a one-to-one postnatal educational session and follow-up phone calls at two months and four months postpartum, or the control group (n =45), in which they received routine postnatal care. The primary outcomes were the proportion of women fully breastfeeding their babies at six months and the women''s level of breastfeeding knowledge at six months postpartum. Results: The postnatal education and support program significantly improved breastfeeding knowledge measured by differences between mean pre- and post-test scores. This was statistically significant for the intervention group (p <0.001) but was not significant for the control (p =0.23). The proportion of women fully breastfeeding their babies at 6 months was not found to be statistically significantly different between the intervention group (39%) and the control group (27%), percentage difference=12% (95% confidence interval [−9% to 30%], Chi squared: χ 2 =3.54, p >0.05). Conclusions: Although the postnatal education and support program improved breastfeeding knowledge among women in the study, this increase in knowledge did not translate to an increase in the duration of full breastfeeding to six months. [Copyright &y& Elsevier]

Dead Sea (DS) salt solution soaks are used in combination with narrowband ultraviolet B (NB-UVB) to treat psoriasis in many centres, particularly in continental Europe. No previously published controlled study has assessed DS salt + NB-UVB balneophototherapy. To compare DS salt balneophototherapy with NB-UVB monotherapy for chronic plaque psoriasis. Sixty patients with chronic plaque psoriasis participated in this paired, controlled study, with pretreatment DS salt soaks randomly allocated to each participant's right or left study limb. Psoriasis severity was assessed with a Scaling, Erythema and Induration score by a blinded observer. Assessments were weekly during the therapy course, and thereafter 8-weekly until relapse or for up to 1 year after clearance. The mean area under the psoriasis severity–time curves during treatment was not detectably lower with DS salt balneophototherapy than with NB-UVB monotherapy ( P = 0·099). The psoriasis severity score fell slightly more from beginning to end of courses with DS salt balneophototherapy than with NB-UVB monotherapy ( P = 0·019). There was no detectable difference in times to relapse. In this population the addition of pretreatment DS salt soaks to NB-UVB did not result in a clinically important improvement in clearance of psoriasis. [ABSTRACT FROM AUTHOR]