Public awareness of online pharmacies,consumers’ motivating factors,experience and satisfaction with online pharmacy services,and current barriers and motivators for non-consumers: The case of Saudi Arabia

PurposeOnline pharmacies (OPs) represent a growing field that plays a major role in providing pharmaceutical services in Saudi Arabia (SA). Thus, investigating public awareness of this option and assessing consumers’ experiences and satisfaction, as well as opportunities and barriers for OPs, were the main aims of this study.Participants and methodsIn this cross-sectional study, adult participants (≥18 years) in SA completed a three-part, custom-designed online questionnaire. The first section collected information on participants’ demographic characteristics, their awareness of the existence of OPs, and history of OP purchases. The second section explores customer satisfaction levels and motivating factors. Finally, the third section investigated non-consumers’ reasons for not purchasing from OPs and sought information about services that could motivate them to make future purchase decisions.ResultsIn total, 487 participants completed the questionnaire; they were mostly female (65.7%) and younger than 40 years (57.1%). Among all the respondents, 89.3% were aware of the existence of OPs, and 60.2% purchased from OPs in the past. Most were satisfied with the product quality (92.7%), completeness of order delivery (91.2%), and condition of the product and packaging (89.3%). Furthermore, 99.2% of respondents indicated that they would continue to purchase from OPs. Customers’ main motivational factors included saving time (85.5%), offers and discounts (83.6%), and variety of products (82.1%). Among non-consumers, the main reasons for not purchasing from OPs included a personal preference to visit a community pharmacy (87.2%), the ability to talk to pharmacists directly (83.6%), and the vicinity of a pharmacy (80.0%).ConclusionsThese findings confirm the increasing level of awareness regarding the existence of OPs in SA. Overall, OP customers expressed satisfaction with the services provided. Nevertheless, various areas of improvement have emerged, such as improved delivery time and providing medical consultation services. Increasing public awareness of OP services provided is essential considering their significant role in reforming the healthcare system in SA.     

Consumers’ attitude towards the use and safety of herbal medicines and herbal dietary supplements in Serbia

Background The use of herbal medicines and herbal dietary supplements in Serbia is very common and many patients consume herbal preparations with conventional drug therapy. Objective The aim of this survey was to evaluate the consumers’ awareness of herbal remedies and the safety of herbal dietary supplements, their attitude towards combining herbals and drugs, and the source of recommendations for their use. Setting The study included all consumers who bought herbal remedies and herbal dietary supplements in 15 pharmacies on the territory of Novi Sad during 2011 and who accepted to be interviewed. Methods Structured interviews using questionnaire, conducted by pharmacists. The questionnaire included 4 parts: socio-demographic characteristics of consumers, source of recommendations for the use of herbal products, attitude towards safety of herbal remedies and herbal dietary supplements use and their combination with regular drugs, as well as the question of purchased herbal products. Main outcome measure Consumers’ attitude towards the safety and use of herbal medicines and herbal dietary supplements measured by 9 items. Results The majority of interviewed participants were highly educated, aged 41–60 and they consumed herbal remedies on their own initiative or on recommendation of nonmedically educated person, without previous consultation with medical doctor or pharmacist. Out of all participants: 88.9 % did not consider it important to inform their physician or pharmacist about use of herbal remedies and herbal dietary supplements; 73.3 % found the use of herbal remedies harmless (where 9.4 % did not have any attitude towards that issue), while 40.3 % of participants regarded the combining of herbal and regular drugs unsafe. Conclusion There is a need for consumers’ education on reliable use of herbal medicines and herbal dietary supplements, in order to improve their awareness of the limits of herbal remedies safety and potential risks of their combination with drugs.     

Patients’ perception,views and satisfaction with pharmacists’ role as health care provider in community pharmacy setting at Riyadh,Saudi Arabia

Objectives

This study will provide guiding information about the population perception, views and satisfaction with pharmacist’s performance as health care provider in the community pharmacy setting in Riyadh, Saudi Arabia.

Method

The study was conducted in Riyadh, Saudi Arabia, from July through December 2010. A total of 125 community pharmacies in Riyadh city were randomly selected according to their geographical distribution (north, south, east, and west). They represent about 10–15% of all community pharmacies in the city. The questionnaire composed of 8 items about patients’ views and satisfaction with the pharmacists’ role in the current community pharmacy practice. The questionnaire was coded, checked for accuracy and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 for Windows (SPSS Inc., Chicago, Illinois).

Results

The response rate was almost 85% where 2000 patients were approached and 1699 of them responded to our questionnaire. The majority of respondents is young adults and adults (82.8%), male (67.5%) and married (66.9%). Seventy one percent of respondents assured that community pharmacist is available in the working while only 37.3% of respondents perceived the pharmacist as a mere vendor. About 38% assured sou moto counseling by the pharmacist, 35% reported pharmacist plays an active role in their compliances to treatments, 43% acknowledged the role of pharmacist in solving medication related problems, 34% considered the pharmacist as a health awareness provider and 44.6% felt that pharmacist is indispensable and an effective part of the health care system.

Conclusion

The image and professional performance of community pharmacist are improving in Saudi Arabia. The Saudi patients show better satisfaction, perception and appreciation of the pharmacists’ role in the health care team. However, extra efforts should be paid to improve the clinical skills of the community pharmacists. Community pharmacists need to be able to reach out to patient, assess their hesitations and promptly offer solution which was appreciated by the patients as the survey indicates. They should play a pro-active role in becoming an effective and indispensable part of health care. Furthermore, they should be able to advice, guide, direct and persuade the patient to comply correct usage of drugs. Finally, community pharmacists should equip themselves with appropriate knowledge and competencies in order to tender efficient and outstanding pharmaceutical health care.     

Pharmacists’ satisfaction with their involvement in the management of COVID-19 patients in Saudi Arabia

IntroductionThe Coronavirus Disease 2019 (COVID-19) is a public health emergency and during this unprecedented situation, health care providers across the globe are at the frontline in the fight against this disease. Countries that have been severely hit by the pandemic are using pharmacists to help triage patients. In order to ensure the continuity of these services, it is of paramount importance that pharmacists be formally involved and engaged in the management of this pandemic. In response to the underlying knowledge deficit, this study was undertaken as the first of its kind in the entirety of Saudi Arabia.MethodsThis study is a questionnaire based cross-sectional study that was carried out for a period of five months from March 2020 to July 2020 to assess the role of working pharmacists in the management of the COVID-19 pandemic under different health care settings across Saudi Arabia.ResultsA total of 398 responses were recorded, in which 51.1% of the respondents were not involved in any learning or awareness activities involving health care providers (HCPs) or patients. The majority of respondents (62.9%) were not involved in creating or evaluating therapeutic plans for COVID19 patients, and 55% were not involved in therapeutic mentoring of COVID19 patients. Only a very low percentage of respondents were participating in COVID19-related research within their institution. Only 37% of respondents reported being satisfied with their role and contribution in the management of COVID-19.ConclusionThe present study reveals that pharmacists are underutilized in the management of COVID-19 patients in Saudi Arabia. As such, the findings emphasize the importance of enhancing the role and contribution of pharmacists in patient care management across all hospitals and especially under health care crisis conditions. The establishment of a crisis standard of care guideline for all HCPs, including pharmacists, would help in improving patient overall care under crisis conditions like the present COVID-19 pandemic.     

Students’ attitude toward use of over the counter medicines during exams in Saudi Arabia

Purpose

To explore the use of over the counter (OTC) medicines among students during exams in Riyadh City, Kingdom of Saudi Arabia.

Method

A cross-sectional study was designed; using a self-administered twenty-two item online questionnaire for the students’ convenience and easy response disclosure. Data were analyzed using Statistical Package for Social Science (SPSS) version 13®.

Results

A total of N = 1596 students participated in this survey, of whom 829 (51.9%) were university students and 767 (48.1%) were high school students. Overall, 80.0% of the respondents disclosed the use of OTC non-steroidal anti-inflammatory drugs for headache and pain relief. In addition, other substances used during the exams were Energy Drinks (5.0%), Flu Medication (5.0%), Vitamins (5.0%) and Antibiotics (5.0%). Female students were found to be more knowledgeable about safety issues concerning the use of OTC medicines (5.11 ± 1.27, p = <0.001) than male students. Ease in access to OTC medicine, availability of pharmacist consultation and advertisement in print and electronic media were the main factors disclosed by the respondents that may result in an increase in the use of OTC products. The use of OTC medicines was generally higher among female students (p = 0.001).

Conclusion

The use of OTC medication during exams was more among high school and university students. Gender, age and educational institution were found significantly affecting the use of OTC medicines during exams.     

The safety,stability, and compatibility of fragrances in skin and hair products†

Abstract

The efforts of the formulating chemist, perfumer, and toxicologist represent the creative forces that ultimately merge to accomplish a finished formulation. Because the ingredients in a compounded fragrance are proprietary to the company that produces them, the formulating chemist must add a mixture of unknown substances to his basic formulation with the hope that they will be compatible in functionality, stability, and safety. A well-controlled stability and safety testing program is needed to assure complete compatibility between the base formulation and the fragrance.

Potential stability problems include changes in viscosity, color, odor, clarity of transparent systems, and emulsion stability. These changes may be caused by hydrolysis, oxidation, reaction to light, reaction to metals, insolubilities, reaction to processing conditions, and packaging materials. The interactions which occur during these changes can cause the formation of new materials that may have irritation or sensitization potential. We recommend that samples of product that have successfully passed shelf-life testing be furnished to the toxicologist for a complete battery of safety tests, including controlled use testing. This procedure should help to assure that untoward reactions do not occur during consumer use.     

Community pharmacists’ knowledge,behaviors and experiences about adverse drug reaction reporting in Saudi Arabia

Objective

To assess community pharmacists’ knowledge, behaviors and experiences relating to Adverse Drug Reaction (ADR) reporting in Saudi Arabia.

Methods

A cross-sectional study was conducted using a validated self-administered questionnaire. A convenience sample of 147 community pharmacists working in community pharmacies in Riyadh, Saudi Arabia.

Results

The questionnaire was distributed to 147 pharmacists, of whom 104 responded to the survey, a 70.7% response rate. The mean age of participants was 29 years. The majority (n = 101, 98.1%) had graduated with a bachelorette degree and worked in chain pharmacies (n = 68, 66.7%). Only 23 (22.1%) said they were familiar with the ADR reporting process, and only 21 (20.2%) knew that pharmacists can submit ADR reports online. The majority of the participants (n = 90, 86.5%) had never reported ADRs. Reasons for not reporting ADRs most importantly included lack of awareness about the method of reporting (n = 22, 45.9%), misconception that reporting ADRs is the duty of physician and hospital pharmacist (n = 8, 16.6%) and ADRs in community pharmacies are simple and should not be reported (n = 8, 16.6%). The most common approach perceived by community pharmacists for managing patients suffering from ADRs was to refer him/her to a physician (n = 80, 76.9%).

Conclusion

The majority of community pharmacists in Riyadh have poor knowledge of the ADR reporting process. Pharmacovigilance authorities should take necessary steps to urgently design interventional programs in order to increase the knowledge and awareness of pharmacists regarding the ADR reporting process.     

Determination of tetracycline,oxytetracycline and chlortetracycline residues in seafood products of Saudi Arabia using high performance liquid chromatography–Photo diode array detection

Residues of oxytetracycline, tetracycline and chlortetracycline in seafood products of Saudi Arabia were detected by using a simple, sensitive and rapid method via HPLC-PDA.The protein precipitation method that was used for sample extraction demonstrated high recoveries of OTC, TC and CTC. The limits of detection were 0.015 µg/g and 0.025,0.062 µg/g for all TCs in fish and shellfish, respectively. The limits of quantitation were 0.125 µg/g and 0.175 µg/g for all TCs in fish and shellfish, respectively. The method was precise and accurate since the RSD was less than 2%, while the % recovery was 95–105%. This study determined the occurrence of OTC, TC and CTC in seafood products that are sold in KSA’s markets. The overall occurrence of these three medications in 249 seafood products was 24%(n = 60), while 15%(n = 37) exceeded the MRL. Thus, our recommendations are to enhance the monitoring of food production prior to marketing and to educate people regarding the proper disposal of antibiotics.     

Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia

Medical terminology is the vocabulary used to describe the human body and its conditions; fluency in this language is essential for health care professionals. We examined the level of basic medical terminology understanding among 347 pharmacy students in four different colleges of pharmacy in Saudi Arabia using a newly developed test of 30 multiple choice questions. Students in the relatively new colleges of pharmacy were more likely to have a higher score in the medical terminology test compared to their counterparts from the old college of pharmacy (β = 1.23, 95% CI = 0.16–2.30, P-value = 0.02). Female gender (β = 1.72, 95% CI = 0.57–2.88, P-value = 0.003), and advanced class level (β = 0.84, 95% CI = 0.36–1.32, P-value < 0.001) were also positively associated with high medical terminology test scores. The findings of this study reveal a deficiency in the pharmacy students’ level of understanding of basic medical terms which may necessitate a reintroduction of the medical terminology course into the pharmacy curriculum.     

Evaluating the geochemistry of groundwater contamination with iron and manganese and probabilistic human health risk assessment in endemic areas of the world’s largest River Island,India

Iron (Fe) and manganese (Mn) are harmful for human health, if present in a higher concentration, particularly in groundwater. The results of the study revealed that the concentration of Fe and Mn exceeded the WHO guideline for safe drinking water in 88 % and 74 % of groundwater samples, respectively. The non-carcinogenic health risk as assessed through computation of hazard quotient (HQ) due to intake of Fe and Mn contaminated groundwater was found much higher for children and adults. The values of HQ were recorded up to 1.96 for children and 1.52 for adult in case of Fe; and up to 2.13 for children and 1.61 for adult associated with Mn. On the basis of occurrence and spatial distribution of Fe and Mn in groundwater, the study area was delineated under high, elevated and low risk zone for priority attention.     

Communicating THC levels and ‘dose’ to consumers: Implications for product labelling and packaging of cannabis products in regulated markets

In a well-regulated drug market, consumers should be able to understand and titrate their dose with little difficulty. In the cannabis market, despite substantial increases in THC levels over time, users have had limited information on the strength of their products. In principle, cannabis legalization provides greater opportunity to communicate clear, accurate information to consumers through packaging and labelling standards. However, jurisdictions that have legalized cannabis have experienced an increase in adverse events from higher strength products, particularly from edibles and other concentrates. What little research exists suggests that current regulatory practices of labelling THC levels on packages may be ineffective due to consumer difficulties understanding numbers (e.g., mg vs. percentage), and the different ways THC levels are communicated across product categories. In particular, current labelling practices provide little guidance in terms of ‘dose expression’—how THC ‘dose’ translates into consumption amounts for specific products. The current paper identifies five principles to guide cannabis labelling and packaging regulations, including considerations for numeric THC labelling, the use of standard servings or dose across different product forms, strategies to communicate ‘dose expression’, and ‘dose-unit packaging’. Overall, there is a need for regulated cannabis markets to develop more effective packaging and labelling standards to allow consumers to effectively titrate their THC intake, with the goal of promoting lower-risk cannabis use.     

Hospital pharmacists’ roles and attitudes in providing information on the safety of non-steroidal anti-inflammatory drugs in Thailand

Background Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for patients to manage pain and inflammation, especially in older adults. Failure to cope with some adverse drug reactions (ADRs) of NSAIDs could lead to more serious symptoms, therefore, providing useful information about medicine is an important step in protecting patients from developing serious ADRs. The pharmacy service should be a frequent source of medicine information for patients, however in Thailand, little is known about pharmacists’ provision of safety information to patients for management and prevention of these ADRs. Objective Aims of this study were to determine Thai hospital pharmacists’ roles in providing drug safety information and to assess their attitudes towards the importance of giving drug safety education to patients. Setting All government hospitals in north-eastern Thailand. Methods This study was a cross-sectional survey. A total of 761 pharmacists in 287 hospitals in north-eastern Thailand were selected by stratified random sampling. Self-administered questionnaires were sent by post, with two reminders. Main outcome measures Proportion of hospital pharmacists providing ADR information on NSAIDs to patients, factors affecting this provision, and pharmacist attitudes towards drug safety education for patients. Results The response rate was 54.8 % (N = 417), the majority of respondents worked in community hospitals (57.2 %). A total of 347 pharmacists (83.6 %) had informed patients about ADRs, although less than half had informed patients about ADR monitoring and management (36.6 % and 44.1 % respectively). The proportion of time spent in direct patient contact, type of hospital, and other routine work were associated with the frequency of drug safety information provision. Pharmacists had moderately good attitudinal scores towards drug safety education (62.2 ± 5.4), with significantly higher scores found in those who provided most ADR information to patients (60.3 ± 5.2 vs. 62.6 ± 5.4, P = 0.002). The majority (82.2 %) agreed that patient information leaflets should be provided. Conclusions Thai hospital pharmacists’ provision of ADR information for NSAIDs may occur less frequently than is desirable. However, their positive attitude towards provision of ADR information suggests that drug safety education by pharmacists should be routinely provided to patients, particularly patients at high risk of NSAID use.     

Cholinesterase inhibitory,anti-amyloidogenic and neuroprotective effect of the medicinal plant Grewia tiliaefolia – An in vitro and in silico study

Context: Grewia tiliaefolia Vahl. (Tiliaceae) is a sub-tropical plant used as an indigenous medicine in India. However, its efficacy has not been evaluated against Alzheimer’s disease.

Objectives: The objective of this study is to evaluate cholinesterase inhibitory, anti-aggregation and neuroprotective activity of G. tiliaefolia.

Materials and method: Grewia tiliaefolia leaves were collected from Eastern Ghats region, India, and subjected to successive extraction (petroleum ether, chloroform, ethyl acetate, methanol and water). The extracts were subjected to in vitro antioxidant, anticholinesterase and anti-aggregation assays. The active methanol extract (MEGT) was separated using column chromatography. LC-MS analysis was done and the obtained compounds were docked against acetylcholinesterase (AChE) enzyme to identify the active component.

Results: Antioxidant assays demonstrated that the MEGT showed significant free radical scavenging activity at the IC₅₀ value of 71.5?±?1.12?μg/mL. MEGT also exhibited significant dual cholinesterase inhibition with IC₅₀ value of 64.26?±?2.56 and 54?±?0.7?μg/mL for acetyl and butyrylcholinesterase (BChE), respectively. Also, MEGT showed significant anti-aggregation activity by preventing the oligomerization of Aβ_25–35. Further, MEGT increased the viability of Neuro2a cells up to 95% against Aβ_25-35 neurotoxicity. LC-MS analysis revealed the presence of 16 compounds including vitexin, ellagic acid, isovitexin, etc. In silico analysis revealed that vitexin binds effectively with AChE through strong hydrogen bonding. These results were further confirmed by evaluating the activity of vitexin in vitro, which showed dual cholinesterase inhibition with IC₅₀ value of 15.21?±?0.41 and 19.75?±?0.16?μM for acetyl and butyrlcholinesterase, respectively.

Discussion and conclusion: Grewia tiliaefolia can be considered as a promising therapeutic agent for the treatment of AD.     

Impacts of plastic products used in daily life on the environment and human health: What is known?

Plastics are indispensable and persistent materials used in daily life that can be fragmented into micro- or nanoplastics. They are long polymer chains mixed with additives that can be toxic when in contact with distinct species. The toxicity can result from polymer matrix, additives, degradation products and adsorbed contaminants. Notwithstanding, there is still an immense gap of information concerning the individual and mixed impacts of plastics. Hence, in this study, we characterize the most common plastic materials widely used in our daily life by its polymer type and compile the environmental and human health hazards of these polymers including the impacts of monomers, additives, degradation products and adsorbed contaminants based on literature review. In summary, polyvinyl chloride is the most toxic polymer type used daily (monomer and additives); additives are more toxic than monomers to wildlife and humans; and the most toxic additives are benzene, phthalates and lead stabilisers.