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Background: Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods: Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients’ adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients’ adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient’s details and medications was done via the patient’s hospital file. Results: The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients’ adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. Conclusion: Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in f

Objective: The aim of this study was to explore association of initial laboratory parameters of hospitalized patients with COVID-19, with the severity and death incident. Methods: In this retrospective study, patients were classified based on mortality outcome (survivor and non-survivor) and disease severity (non-severe, severe, and critical). The initial laboratory data (within the first two days of hospital admission) were compared between these categories. Results: Of 362 COVID-19 patients hospitalized between January-2021 and May-2021, 39.0% were non-severe, 32.2% severe, and 28.7% critical. 77.3% were lived and 22.7% died in hospital. Non-survivors were significantly older than survivors. There was a statistically significant association between exceeding the cut-points of laboratory parameters and the severity of the disease or even death. These laboratory parameters included D-dimer, C-reactive protein, prothrombin time, ferritin, white blood cells, neutrophil count, aspartate aminotransferase, creatinine, blood urea nitrogen, lymphocyte count, and albumin. Also, exceeding the cut-points of these parameters showed high odds of death. The highest odds ratio was reported for albumin <3.5 g/dL (OR=14.318 [4.784-42.851], p<0.001). Conclusion: The cut-points of the laboratory parameters could effectively be used as predictors to assess the severity and risk of death to improve the management of COVID-19 patients.

Background: Inhaled drug delivery has been hailed as a major advancement in respiratory therapeutics. However, a major limitation to use the inhaled medications effectively is the inability of patients and nurses to use and demonstrate the proper use of these devices correctly. Being the drug experts, pharmacists are in a pivotal position to delivered tailored education to their peers, the nurses. Aim: This study aims to examine nurses’ knowledge of asthma management, their ability to demonstrate proper inhaler technique, and the impact of a specialized workshop training program delivered by skilled pharmacists on improving their performance. Methods: This is a pre- and post-cross-sectional study design in hospital setting where nurses were recruited from the respiratory and emergency departments within a healthcare facility in the United Arab Emirates (UAE). The nurses attended a training workshop prepared and delivered by skilled pharmacists on inhaler technique demonstration skills. Nurses’ inhaler technique demonstration skills for Diskus, Turbuhaler, and pMDI were assessed at baseline, immediately after the workshop, and after four weeks. The nurses completed the demographic and Asthma Knowledge Questionnaire (AKQ). Results: A random convenience sample of registered nurses (n=20) from the respiratory and emergency departments was recruited from a tertiary hospital in Sharjah, UAE, with a mean age of 35.25 (SD=6.96) years, of whom 90% were females. The mean number of years of experience was 12.00 years (SD=5.81). Inhaler technique assessment revealed low inhaler technique scores for all the three study inhalers at baseline (mean score for Diskus=3.85 (SD=2.87); Turbuhaler=3.70 (SD=3.20); pMDI=4.50 (SD=2.65)) Significant improvements in inhaler technique scores were noted after the workshop (Diskus=8.9 (SD=0.31); Turbuhaler=8.9 (SD=0.31); pMDI=8.0 (SD=0.00), P<0.001). A significant difference in AKQ scores was found before (mean=4.85 (SD=1.27)) and after (mean=7.

Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public’s perception of the role of pharmacists regarding children’s health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists’ role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children’s health-related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Background: Adherence to medication is the cornerstone to achieve the best treatment outcome. Pharmacists are healthcare professionals found in a pivotal position to assess asthmatic patients’ adherence to medication. A brief, reliable, and valid measure of patients adherence to mediations is useful to enable the pharmacists to deliver that vital service. Objective: To develop a reliable and valid adherence assessment tool for asthmatic patients. Methods: The Adherence to Asthma Medication Questionnaire (AAMQ-13) was developed based on an extensive literature review, followed by applying the Delphi technique, and then it was pilot-tested by 55 patients. The final AAMQ-13 was completed by 213 patients. Psychometric evaluation was assessed including reliability, criterion validity, and construct validity. Results: The AAMQ-13 is a feasible 13-item questionnaire, as it can be completed within an average of two minutes. It has high reliability (Cronbach’s alpha= 0.87). Criterion-concurrent validity was established by comparing the AAMQ-13 to the Test of the Adherence to Inhaler (TAI) and the pharmacy refill records. Criterion-convergent validity was established by comparing the AAMQ-13 to the Asthma Control Test (ACT) questionnaire and the Positive Health Behaviors Scale (PHBS). Construct validity was established through AAMQ-13 factor analysis which revealed two factors explaining 51.76% of the total variance. Conclusion: The AAMQ-13 is a reliable and valid questionnaire with several desirable characteristics as it has high reliability, good criterion validity, and strong construct validity. The AAMQ-13 is a suitable questionnaire that can identify non-adherent patients and reveal the reasons behind their non-adherence.

Objective: To investigate the effectiveness of an online tutorial and its impact on improving knowledge and skills of pharmacy students in the clinical problem-solving process that is necessary to implement pharmaceutical care. Methods: This is a prospective interventional study conducted during the COVID-19 pandemic restrictions using four novel templates. The first two levels of Kirkpatrick’s Model (Reaction and Learning) were used. Results: 129 participants completed all of the online training parts. The findings indicated a significant improvement in the students’ knowledge and skills. The participants achieved higher score following the tutorial than the baseline, with a statistically significant difference (p < 0.001). There was a significant improvement in the number of detected treatment-related problems. The majority of students were satisfied with the overall training process and stated a high evaluation score out of 10 (mean = 7.93 ± 1.42, median = 8.00). Conclusion: The educational intervention achieved a substantial positive impact on decision-making skills of participating students and was considered effective in helping them attain basic skills such as teamwork, peer assessment, communication and critical evaluation. Healthcare providers must work together to ensure accurate medication use during care transitions. Pharmacists, as medication experts, play an important role in the implementation process. Pharmacy educators must prepare pharmacy student to use pharmaceutical care in their future practice.

Razan Izzat Nassar,1 Iman Amin Basheti,1 Bandana Saini2 1Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan; 2College of Pharmacy, The University of Sydney, Sydney, NSW, AustraliaCorrespondence: Iman Amin Basheti, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan, P. O. Box 166, Email dr_iman@asu.edu.joObjective: To provide an overview of instruments that measure adherence to medications to facilitate selection of an instrument and to provide a summary of some published adherence assessment tools tailored to be used by the healthcare team, especially the pharmacists.Data Sources: Studies were identified via PubMed, Medline, Embase, and Google Scholar using the search terms medication adherence, compliance, persistence, combined with the terms questionnaire, scale, survey, self-report, and instrument.Study Selection: Articles written in English, describing questionnaire instruments that were psychometrically evaluated (reporting a good coefficient of internal consistency, reliability assessed through Cronbach’s alpha, and had been validated against a subjective or objective measure), and containing 30 or fewer items were included.Data Synthesis: Twelve instruments were identified and included in this review. Instruments were reviewed by evaluating specific characteristics (number of items, sample size, reliability, sensitivity, specificity, questionnaire completion time, criterion validity, and component analysis).Conclusion: Various instruments are used to assess patient adherence to medications; however, no single one performs well on all criteria. Every instrument has different advantages and unique properties. A particular instrument can be chosen after considering certain factors, such as the specific requirements, population, the needed time to complete the questionnaire, the sensitivity, and the specificity of th