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Background: Clinical pharmacists are uniquely positioned to effectively bridge the gap between patients and physicians. However, there is still a lack of legislation and logistical enforcement in the provision of clinical pharmacy services. There is also lack of the effective collaboration between pharmacists and other healthcare professionals that ensures service standardization. The purpose of this study was to investigate healthcare professionals’ and students’ attitudes toward integrating clinical pharmacy services into primary care in the United Arab Emirates (UAE). Methods: Face-to-face structured interviews were conducted with 545 healthcare professionals and medical students from various medical institutions across the UAE over the course of three months (January to March 2021), using a 10-statement questionnaire that measured their level of agreement on a 3-point Likert scale. Results: The study interview was successfully completed by all respondents (response rate 100%). More than half of all healthcare professionals (pharmacists, physicians, and nurses) agreed that there is a growing interest in clinical pharmacy services in the UAE, but 27% said clinical pharmacists have performed such a role. Both physicians and nurses expressed an interest in working with a clinical pharmacist (94% and 98 %, respectively). A majority of physicians and nurses (76 % and 67 %, respectively) agreed that the clinical pharmacist could improve the quality of medical care in a hospital setting. Conclusion: Despite the positive attitudes observed among other healthcare professionals toward collaboration and the use of clinical pharmacists’ skills, it was discovered that the latter had not yet fulfilled their roles. There are still numerous obstacles that prevent pharmacists from expanding their role to include and provide optimal direct patient care.

Background: Different studies have shown that hemodialysis patients require higher doses of Vitamin D3 (VD3) than the general population to achieve satisfactory replenishment. This study aims to assess the safety of such practice and its benefits on some of the parameters of Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD). Methods: A single-center clinical trial assessing the benefits of high dose VD3 in hemodialysis patients. The dose of VD3 (300,000 IU) was administered orally and monthly from April to December 2020 (9 months) at the dialysis unit. The data analyzed were blood levels of calcium, phosphorus, alkaline phosphatase, 25(OH)D, 1,25(OH)2D and intact parathyroid hormone (iPTH) done every three months. Results: We could recruit a cohort of 23 patients. Blood levels of 25(OH)D increased significantly in 82.6% of the patients to above 30 ng/ml. A similar effect was observed with 1, 25(OH)2D levels. iPTH levels decreased significantly when levels of 25(OH)D exceeded 30ng/ml at the end of the nine months. Vitamin D serum levels were typically measured immediately before the next monthly dose was administered. Blood levels of calcium, phosphorus, and alkaline phosphatase were stable during the study period. No events of hypercalcemia were reported, and no patient discontinued the monthly VD3 supplementation. Conclusion: Monthly administration of a high dose of VD3 over a long period of nine months in hemodialysis patients was found to be safe and beneficial in VD3 replenishment. It also allowed a significant decrease in iPTH levels. Further studies are warranted to identify the therapeutic target level of 25(OH)D in hemodialysis patients, allowing beneficial effects on iPTH.

Background: Very few extensive studies have measured the prevalence and usage pattern of drug information leaflet (DIL) for oral non-prescription drugs (ONPDs) or identified the associated risk factors for not reading DIL among university students in the UAE. Objective: The current study aimed to estimate the prevalence of the usage pattern of DIL for ONPDs, and delineate the associated risk factors for not reading the DIL among university students. Methods: A cross-sectional survey-based multistage sampling technique conducted among 2875 students at three major universities in UAE. The self-administered validated questionnaire was constructed and developed based on Andersen’s behavioral model. Binomial logistic regression performed to ascertain the effects of 25 potential predictors on the likelihood that participants not reading (discarded) the DIL after reading them. The primary outcome measure was reading (discarding without reading) the DIL, and the associated behaviours. Results: 2875 university students were eligible to participate in the study, but only 2519 students agreed to participate, indicating an 88% of intent participation. However, only 2,355 (81.9%) students completed the questionnaire. 1348 respondents reported using NPD (response rate 46.9%) during the past three months before conducting the study, which comprised the sample analysis (1307 were excluded). More than three-quarters of them read the DIL (always or often) at the first use (1049 of 1348, 77.8%). Approximately a quarter of those who read the DIL reported that they discarded them after reading (24.1%). The survey has identified four risk factors for not reading the DIL: those who get the drug information from physicians or pharmacists had lower odds of discarding the DIL (odds ration [OR] = 0.491, 95% confidence interval [CI]: 0.273-0.884, p value< 0.05). Medical students had lower odds of discarding the DIL (OR = 0.598, 95% CI: 0.412-0.868, p value< 0.05). Those participants who believ

Objectives: To assess and evaluate OTC package inserts in terms of availability of key medical information and patient understanding of such information, as well as package insert user satisfaction and perceptions. Methods: This study used two quantitative methods: Evaluation of the Over-the-Counter Package Inserts and assessing package inserts user’s satisfaction and perspectives using a cross-sectional survey. Descriptive analysis was used to calculate the response proportion of each group of respondents. Results: A total of 60 package inserts of Over-the-Counter drugs were evaluated. Less than one-third (30%) of the medication under investigation was found to have information about the unit of measurement of the active ingredient. Less than half (44.5%) of respondents reported they usually use the package inserts for information about their medication, and 42.2% rarely use or read package inserts. Difficulty reading or finding information in the package inserts was reported by 37.3 % of respondents. Conclusion: This research identified several factors associated with the proper use of package inserts among the general population in the United Arab Emirates and potential opportunities. Also, due to the lack of binding legislative texts, consumers are dissatisfied with the packaging inserts regarding their appearance and content. A mandatory guideline should be enacted by the competent authorities to ensure the comprehensiveness and readability of pharmacological information.

Abduelmula R Abduelkarem,1,2 Adnane Guella,3 Amar M Hamrouni,4 Mohammed M Hassanein,1 Ahmed Nasr,5 Owais Rana6 1Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates; 2Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 3Department of Nephrology, University Hospital Sharjah, Sharjah, United Arab Emirates; 4Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates; 5Pharmacy Department, University Hospital Sharjah, Sharjah, United Arab Emirates; 6Department of Internal Medicine, University Hospital Sharjah, Sharjah, United Arab EmiratesCorrespondence: Abduelmula R Abduelkarem, Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates, Tel +97165057443, Email aabdelkarim@sharjah.ac.aeAbstract: Chronic kidney disease (CKD) and hemodialysis (HD) patients have a high incidence of bone disease and increased fracture risk, making effective management of their bone health a clinical challenge. Denosumab, a human monoclonal antibody, has been investigated as a therapeutic option in this patient population. In this review, we summarize the current evidence on the efficacy and safety of denosumab in CKD and HD patients. A comprehensive search of the relevant literature was conducted, including randomized controlled trials, observational studies, and meta-analyses. The findings suggest that denosumab reduces the risk of fractures and improves bone mineral density in all stages of CKD. The results of this review support the use of denosumab as a promising option for managing bone disease in CKD and HD patients.Keywords: denosumab, chronic kidney disease, hemodialysis, bone disease, fracture risk reduction

Background: Proper self-medication with Over the Counter (OTC) medicines can benefit both the patient and the healthcare sector. Although OTC medications are considered relatively safe, their improper use can lead to serious health risks and implications. This study investigates the self-medication practices with OTC medicines among medical and non-medical students at different universities in the United Arab Emirates. Methods: A cross-sectional study was carried out over six months (January-June 2021). The desired confidence level was set at 95%, and the precision level was 0.03. A three-step cluster sample method was employed. A self-administered questionnaire that assessed predisposing, enabling and need factors associated with the use of OTC medicines was developed based on Andersen’s behavioural model. Results: A total of 2355 students completed the study questionnaire. The mean age was 20.94, and 76.3% were female. More than half of the participating students (57.5%) reported using OTC medicines during the past 90 days of conducting the study. A good proportion (67.8%) reported performing a high level of self-care. Student’s perceived health (p<0.0001), educational background (p=0.003), use of left-over drugs (p=0.002), relies on informal sources for drug information (p=0.0001) and reading drugs information leaflets (p<0.0001) were all significantly associated with whether students sought medical advice or not. Conclusion: Many university students were observed that they never sought pharmacist advice when taking OTC medications. The likelihood of consulting a pharmacist when using an OTC medication was lower among medical students than non-medical students and among those who do not read the drug information leaflets. The proactive role that a pharmacist can play can have paramount importance in promoting the proper and safe use of OTC drugs.

Background: Since the declaration of the COVID-19 pandemic, the United Arab Emirates (UAE) government has taken a series of preventive measures to control the spread of the Coronavirus. Dealing with the unforeseen challenges caused by the pandemic has had a profound impact on people all around the world. Pharmacists played an important public health role during the COVID-19 pandemic, and they were the first point of contact with the public and the first source of information, providing accurate and reliable management and preventive measures. The aim of this study was to analyse the distress symptoms and the associated factors among a sample of the UAE population. Materials and Methods: This was an observational cross-sectional study conducted over the period of September to October 2020. A bilingual online self-administered questionnaire was distributed among individuals aged 15 years and above. Data was analyzed using Statistical Package for Social Sciences (SPSS). Results: Most of the students in the sample found online learning less effective than in-class learning. Among these, 49.9% and 62.8 % reported that they had normal sleep and eating habits, respectively. In all the sample, most of the participants (96%) were adherent to preventive measures. Higher levels of distress during the COVID-19 lockdown were found among females, individuals younger than 35 years old, those who neglected personal hygiene and who had worse quality of family gatherings and relationships. Conclusion: This study identified factors associated with distress symptoms experienced by people during the lockdown and perceived attitudes regarding online learning, preventive measures and changes in people’s behaviours and family environment. Knowledge about how lockdown has affected the lives of the populations can be used to design public health interventions aimed at promoting the health and well-being of the communities.

Background: Mental disease burden is increasing globally, and a substantial shortage of mental health professionals remains. Community pharmacists can improve population mental health outcomes to bridge the mental health care gap. However, there is a paucity of data on community pharmacists’ provision of mental health care. Objective: To assess community pharmacist-delivered care to people with mental illness in the United Arab Emirates (UAE), focusing on dispensing and counseling practices, pharmacists’ confidence and comfort in providing care, and attitudes and beliefs towards mental illness. Methods: This was a mixed-methods study with an exploratory, sequential design. Semi-structured interviews explored community pharmacists’ practices, challenges and strategies to improve care. Data were analyzed thematically, and the results guided questionnaire development. The questionnaire was also informed by the Framework of Core Mental Health Competencies for All Pharmacy Professionals and other relevant literature and administered to community pharmacists in four out of seven emirates. Logistic regression was used to identify the predictors of pharmacist practices. Results: In the interviews, community pharmacists described adopting a precautionary attitude and perceived their role as a dispensing one. They reported challenges such as emotional discomfort and lack of training but highlighted the need for a different approach to patients with mental illness. In total, 252 pharmacists completed the questionnaire, and 74% reported performing at least five counseling practices. Logistic regression showed that pharmacists who performed a higher number of practices (≥5) were younger, received continuing education on mental health care in the last two years, and had higher confidence levels. Conclusion: UAE community pharmacists performed basic dispensing practices and reported discomfort during encounters with patients with mental illness. Training on patient-centered commun

Amar M Hamrouni,1 Rubian S Sharif,2 Suleiman I Sharif,3 Mohammed M Hassanein,3 Abduelmula R Abduelkarem3 1Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates; 2Faculty of Dentistry, University of Benghazi, Benghazi, Libya; 3Department of Pharmacy Practice & Pharmacotherapeutics, College of Pharmacy-University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Abduelmula R Abduelkarem, College of Pharmacy-University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates, Tel +971 6-5057443, Fax +971 6-5585812, Email aabdelkarim@sharjah.ac.aeAbstract: The number of active cases of COVID-19 and deaths is markedly escalating. The pandemic had affected almost every aspect of our lives including geopolitics, health, economics, education, and sociocultural events. However, besides the negative impacts of the pandemic, there are some positive impacts as well, such as improving our awareness of the daily hygienic practices, emphasizing digital inequality, and increasing global collaboration in combating the crisis by intensifying scientific research to establish a promising vaccine. Other positive impacts are the activation and use of online education, also raising awareness about close family relationships and much more. This review addresses the impacts of the COVID-19 pandemic on various important aspects of life.Keywords: COVID-19 outbreak, life aspects, health measures, economy, educational challenges

Abduelmula R Abduelkarem,1 Amna M Othman,1 Zakieh M Abuelkhair,1 Mariam M Ghazal,1 Sawsan B Alzouobi,1 Mohamed E El Zowalaty2 1Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates; 2Infectious Diseases and Anti-Infective Therapy Research Group, Sharjah Medical Research Institute and College of Pharmacy, University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Abduelmula R AbduelkaremPharmacy Practice and Pharmacotherapeutics Department, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, United Arab EmiratesTel +971503655610Fax +971 055585812Email aabdelkarim@Sharjah.ac.aeBackground: Self-Medication with antibiotics is a human practice and attitude in which an individual uses antibiotics to treat self-diagnosed symptoms. The self-medication with antibiotics is a common practice among residents in the UAE.Purpose: The present study aimed to determine the prevalence of self-medication of antibiotics among residents in the UAE population to determine its associated risk factors and to increase awareness regarding the abuse of antibiotics.Patients and methods: Three hundred and fifteen participants from different public places in Abu Dhabi, Dubai and Sharjah,UAE received the validated questionnaire over the five-month study period. Collected data were analyzed using SPSS statistical software and the Chi-square test to assess the relationships between categorical variables.Results: Of 315 participants, 31.7% (n=100) of the respondents reported the use of non-prescription antibiotics within a three-month study period. Self-medication with antibiotics was significantly associated with ethnicity and employment. The participants reported their previous experience with the disease (69; 21.9%), as the main reason for self-medication with antibiotics. The primary sources of antibiotics were those purchased from community pharmacies (70; 22.2%) and household (21; 6.7%).Conc

Background: Bacterial resistance to antibiotics is considered as natural phenomenon that occurs over the time due to genetic changes. Bacterial resistance to antibiotics is significantly increasing in the UAE. Self-medication with antibiotics has been identified as a major factor for the development of antibiotic resistance, which is significantly increasing in the UAE. Objectives: The purpose of this study was to explore the factors that contribute to the use of antibiotics without prescriptions among first year healthcare university students in UAE. Methods: Based on the findings of an earlier survey study, a qualitative interview study was designed to explore common themes related to student’s knowledge, awareness, attitude, views, and perceptions. Data were analyzed thematically for the identification of themes and subthemes within the data through the use of coding. Results: The interview study identified four main themes with multiple subthemes related to the use of antibiotics without a physician’s prescription by first-year healthcare students. The thematic analysis of the interviews revealed four main themes; medication habits and practices; reasons for self-medication; access to antibiotics without a prescription and gaps in students’ knowledge regarding antibiotic resistance Conclusions: Healthcare students in UAE are influenced by several factors including parents and friends influence, successful previous experience and investment of time and money to visit a physician. Our sample of healthcare students has a misconception about the use of antibiotics. The current interview study identified six new reasons for using antibiotics without prescriptions as compared to our earlier survey study. There is a need of multifaceted strategies to decrease unnecessary antibiotic use in our population sample.