View
215
Download
0
Category
Preview:
Citation preview
1
Table of Content
Quality Use of Medicine and Patient Care:
An Interprofessional Approach
12
th-13
th March 2016
Applied Science Private University
Amman- Jordan
Conference Book
ASU-Second International Medical Conference
Location: Conference Palace
Applied Science University, Alarab St 11931,
Amman, Jordan www.asuconf.org
2
Table of Content
Table of Content
Table of Contents
2
Important Information
3
Welcome from the Chair
4
About the Conference
5
Conference Higher Committee Members
6
Conference Agenda
8
Moderators List
14
Speakers’ Profile
15
Speakers’ Abstracts
23
Workshops
37
Posters Abstracts
43
Advertisement
65
3
Important Information
Important Information
Registration
Conference registration will be held at the entrance of
the Conference Palace.
Registration will be open from 9:00 am till 10:00 am, on
both conference days.
Registration fees will be as following:
25 JD for Healthcare Providers
15 JD for Students
Badges and conference bags will be available at the
registration desk.
Workshops
Workshops registration can be completed during the
conference, before the workshop.
The fee per workshop is: 20 JD.
Workshops will be held at the Faculty of Pharmacy,
ASU (5 minutes walking distance from the Conference
Palace).
Prayer
Coffee breaks are organized to suit prayer times.
The Conference Palace is very close (1 minute walking
distance) from the University Mosque.
Dinner
Dinner on both days will be served in the Conference
Palace, Second floor.
The dinner will include a buffet. Suitable for vegetarians
as well.
4
Chair Welcoming Words
Welcoming Words from the Chair
Under the patronage of his Excellency Doctor Haitham Abu Khadija, deputy in the Jordanian
parliament and Council Vice President of Applied Science Private University, the Faculties
of Pharmacy and Nursing are pleased to invite you to join us for the Second ASU
International Medical Conference 2016.
This year’s conference theme ‘Quality Use of Medicines (QUM) and Patient Care’ is
interesting, significant and important for all healthcare professionals, health consumer
groups, the pharmaceutical industry, and the government. For healthcare professionals QUM
ensures the availability of evidence-based information to ensure proper prescribing and
knowledge of alternative options. For consumers, QUM ensures access to a medicine that
will help their particular condition at the time they need it, comprehending why they have
been prescribed the medicine and how to use it properly. For the industry, QUM involves
patient support initiatives, appropriate marketing and education through post-marketing
surveillance. For the government, QUM means overall improvements to quality of life of
consumers and their careers, in addition to cost savings to the health system.
Today, more than ever, QUM demands a multidisciplinary approach. The conference
guarantees a forum that will present the most recent findings in QUM in Jordan and around
the world. In addition to practical presentations and wide-ranging debates which answer the
question about how health professionals from different areas of specialization can best work
together to achieve greater treatment results and better patient care. The conference will host
leaders, experts, scientists, and researchers in the field of pharmacy, nursing, and medicine.
This conference should offer a unique opportunity to promote the international exchange of
expertise and I hope that you will find it both valuable and enjoyable.
Dr Iman Amin Basheti
Chair of the Conference
5
About the Conference
About the Conference
At Applied Science Private University (ASU), the Faculties of Pharmacy and Nursing are
dedicated to excellence and innovation in research and teaching directed towards quality use
of medications and patient care. Our mission is to promote people’s health and wellbeing
through implementing inter-professional collaboration, addressing existing public health
issues, and proposing solutions to policy makers in the country.
To meet our mission, we are pleased to
announce the hosting of the ASU-Second
International Medical Conference, under the
patronage of his Excellency Doctor Haitham
Abu Khadija, Council Vice President of
Applied Science Private University. The
conference will be held under the theme
‘Quality Use of Medicines and Patient Care:
an inter-professional Approach’. Last year’s first installment of the ASU-First Medical
Conference introduced a forum hosting the most recent findings in quality use of medications
in Jordan. This year’s conference will repeat last year’s story of success, in addition to
bringing a group of worldwide experts and leaders in the field of pharmacy and quality use of
medications. Keynote speakers will include top national and international researchers from
the medical field.
The conference guarantees a forum that will present the most recent findings in Quality Use
of Medicine in Jordan and abroad. The conference will include keynote presentations, invited
papers and five workshop sessions provided/endorsed by international scientists.
The conference will wrap up by presenting chief recommendations for the direction of
Quality Use of Medications in the country. Conference abstracts, executive summary and
recommendations will be published in the Jordan Journal of Applied Science as a way of
disseminating the presentations and discussion that will occur during the event to interested
parties.
6
Conference Committee
Higher Committee Members
Dr. Rana Abu Farha
Assistant Professor
Member
Faculty of Pharmacy
ASU
Dr. May Abu Taha
Assistant Professor
Member
Faculty of Pharmacy
ASU
Dr. Maysoon Saleh
Assistant Professor
Member
Faculty of Pharmacy
ASU
Dr. Raghad Abdelqader
Assistant Professor
Member
Faculty of Nursing
ASU
Dr. Hikmat Alaksh
Assistant Professor
Member
Faculty of Nursing
ASU
Dr. Alberto Berardi
Assistant Professor
Member
Faculty of Pharmacy
ASU
Dr. Iman Basheti
Chair of the
Conference
Associate Professor
Dean of Pharmacy
Faculty of Pharmacy
ASU
Prof. Samiha Jarrah
Head of Organizing
Committee
Professor
Dean of Nursing
Faculty of Nursing
ASU
Dr. Wamidh Talib
Associate Professor
Member
Faculty of Pharmacy
ASU
Dr. Feras El-Hajji
Assistant Professor
Member
Faculty of Pharmacy
ASU
7
Conference Committee
Higher Committee Members
MSc. Jumana Alshiekh
Lecturer
Member
Faculty of Nursing
ASU
Ph. Ena'm Atieh
Teaching Assistant
Member
Faculty of Pharmacy
ASU
MSc. Ghadeer Dwaiek
Lecturer
Member
Faculty of Nursing
ASU
MSc. Samar Khater
Lecturer
Member
Faculty of Pharmacy
ASU
Ph. Dalal Alnatour
Teaching Assistant
Member
Faculty of Pharmacy
ASU
Ph. Yara Salhi
Teaching Assistant
Member
Faculty of Pharmacy
ASU
MSc. Raja Al-Quda
Lecturer
Member
Faculty of Pharmacy
ASU
Rozan Ibdah
IT Technician
Member
Faculty of Pharmacy
ASU
Mr. Fawzi Arini
Lab Technician
Member
Faculty of Pharmacy
ASU
8
Conference Agenda
Conference Agenda
First Day Saturday 12
th March 2016
10:00-10:05
Dr. Haitham Abu Khadija Welcoming Words
Council Vice President of Applied Science University
10:05-11:20
Silver Jubilee Ceremony
11:20-11:25
Dr. Iman Basheti Welcoming Words
Chair of the Conference, Applied Science University, Jordan
11:25-12:00
Signing Memorandum of Understanding
Applied Science University with University of Sydney
Council Vice President of Applied Science University
12:00-12:30
Opening of Exhibition and Poster Session
Coffee Break with Continental Breakfast
12:30-12:35
Professor Samiha Jarrah Welcoming Words
Dean of Nursing, Applied Science University, Jordan
Council Vice President of Applied Science University
9:00-10:00
Registration
9
Conference Agenda
12:35-1:05
Prof. Iqbal Ramzan, Dean of Pharmacy, Sydney University, Australia
Pharmacy Education and National Registration and Accreditation
Scheme for Pharmacists in Australia
1:05-1:35
Prof. Francesco Amenta, Dean of Pharmacy, University of Camerino, Italy
Revisiting Profile/Indications of Old Drugs: An Experience in the
Field of Cognitive Dysfunction
1:35-1:45
Dr. Yousef Najajreh, Dean of Pharmacy, Al-Quds University, Palestine
Quality Use of Medicines and Patient Care Challenges in Palestine
1:45-2:00
Dr. Maher Khdour, AlQuds University, Palestine
Antimicrobial Stewardship Program in the ICU at Palestine Medical
Complex: Multidisciplinary Team Led by Clinical Pharmacist
2:00-2:20
Dr. Lama Alnazer, Clinical Pharmacy Specialist, KHCC, Jordan
Improving the Quality of Care through Research
2:20-2:50
Poster Session, Exhibition and Coffee Break
2:50-3:15
Dr. Hayel Obeidat, JFDA Director General, Jordan
Jordan Food and Administration, and its Role in the Enhancement
of medicines rational use
3:15-3:40
Prof. Nathir Obeidat, Respiratory Consultant, JUH, Jordan
Non Invasive Ventilation: Latest Trends in Patient Care
10
Conference Agenda
4:40-6:00
Conference Formal Dinner
Workshops
4:20-4:40
Dr. Zeid Abu Goush, Chief Medical Officer, Hakeem-EHS, Jordan
Electronic Health Solutions Profile
3:40-4:00
Dr. Majed Habahbeh, Neurology Consultant, RMS, Jordan
Epilepsy: Diagnostic and Treatment Pitfalls
4:00-4:20
Dr. Dalia Bajis, Pharmacy Specialist, Sydney University, Australia
Education and Training in the Arab Region: Food for thought
2:20-4:20
Learning Evidence Based Medicine in Hospitals
Hosted by Dr. Delia Omar, Dr. Enas Hijjih and Dr. Hanan Abu Nema, Ibn
Alhaitham Hospital, Amman, Jordan
2:20-4:20
Diabetes Complication and Patient Care in the MENA Region:
an Example of New Approaches in Palestine
Hosted by Dr. Abdulsalam Alkhayyat, An-Najah University, Palestine
11
Conference Agenda
12:15-12:45
Coffee Break, Poster Session and Exhibition
Conference Agenda
Second Day Sunday 13th March 2016
10:15-10:45
Prof. Lynn Weekes, NPS Medicine Wise, Sydney University, Australia
Rational Use of Medicines and Medical Tests
10:45-11:15
Dr. Nadir Kheir, Assoc Prof. in pharmacy Practice, Qatar University, Qatar
Continuing Professional Development in Pharmacy: Quality
Expectations and Relevance to QUM
11:15-11:35
Dr. Iman Basheti, Dean of Pharmacy, Applied Science University, Jordan
Home Medication Management Review Service in Jordan and the
UAE: a Story of Success
11:35-11:55
Dr. Betty Chaar, President of AAPAE, Sydney University, Australia
Research in Healthcare Ethics at the University of Sydney
11:55-12:15
Dr. Rebeka Moles, Sydney University, Australia
Education through Simulation
Council Vice President of Applied Science University
9:00-10:00
Registration
12
Conference Agenda
Dr. Iman Basheti , Associate Profes
Chair of the Conference
Dean of Pharmacy
Faculty of Pharmacy/ASU
12:45-1:15
Dr. Abdulsalam Alkhayyat, An-Najah University, Palestine
Retinopathy Among Diabetes Patients in Jordan: Time for Action
1:15-1:35
Prof. Giovanni Palmieri, University of Camerino, Italy
Drugs beyond the Label
1:35-1:50
Dr. Omaima Nassar, HCAC, Jordan
Promoting Patient Safety through the Implementation of Health Care
Accreditation Council Medication Management Standards
1:50-2:05
Dr. Thaira Madi, HCAC, Jordan
The Effect of HCAC Primary Health Care Accreditation on PHC
Core Principles
2:05-2:25
Poster Session, Exhibition and Coffee Break
2:25-2:45
Dr. Mohammad Samaha, Neurology Consultant, Ibn Alhaitham Hospital
Neuromodulation of Brain for Control of Movement Disorders
and Gamma Knife Radiosurgery
2.45-3:05
Prof. Naiyla Bulatova, The University of Jordan, Jordan
An Innovative Geriatric-Psychiatric Rotation: Example of
Pharmacist Interprofessional Collaboration
3:05-3:25
Dr. Mohammad Alshara, Vice Dean of Pharmacy, JUST, Jordan
Current Pharmacy Practice: What is Clinical and Why? Settings,
Expertise & Opportunities
13
Conference Agenda
1:30-4:30
Applications in Pharmacy Education
Hosted by Dr. Betty Chaar, Dr. Rebeka Moles and Dr. Dalia Bajes, Sydney
University, Australia
Workshops
3:25-3:55
Dr. Nile Khanfer, Assistant Dean of Pharmacy, Nova University, USA
Direct-To-Consumer-Advertising (DTCA) from a Pharmaceutical
Marketing Perspective
3:55-4:30
Recommendation Session, Awards and Closing Ceremony
11:30-1:30
Strategies to Reduce Medication Errors in Hospital Patients
Hosted by Nursing Faculty, Applied Science University, Jordan
2:30-4:30
Professional Ethics: Basic Principles and a Tool Kit to Practice Ethically
Hosted by Dr. Nadir Kheir, Qatar University, Qatar
Council Vice President of Applied Science University
4:30-6:00
Conference Formal Dinner
14
Moderators List
Moderators List
Prof. Mayyada
Wazayfi
The University of
Jordan
Prof. Mahmoud Abu
Samak
Applied Science
University
Prof. Tariq AL-Qirim
Alzaytoona University
Prof. Enam Ayoub
Applied Science
University
Dr. Emad Nsoor
Royal Medical Service
Dr. Ibrahim Al-abbadi
Alyarmouk University
Dr. Penelope Shihab
MONOJO
Dr. Karem Al-zoubi
Jordan University of
Science and
Technology
Prof. Samiha Jarrah
Applied Science
University
Prof. Abla Bsoul
The University of
Jordan
15
Speakers’ Profiles
Speakers’ Profiles
16
Speakers’ Profiles
Prof. Iqbal Ramzan, Australia Professor Iqbal
Ramzan is Dean and
Professor of
Pharmacy at The
University of
Sydney’s Faculty of
Pharmacy. Professor
Ramzan is a
recognized expert in
drug
pharmacokinetics/pharmacodynamics, has
published 141 refereed papers and provides high
level advice to the Australian Federal Government
on drug registration. Professor Ramzan is an
international leader in pharmacy education and is
Past-President of the Asian Association of Schools
of Pharmacy and current Director of the Council of
Pharmacy Schools – Australia and New Zealand.
Professor Ramzan is also a Director of the
Australian Pharmacy Council and the current Chair
of the Australian Pharmacy Leaders Forum. He is a
Pharmacist and holds a Diploma from the
Australian Institute of Company Directors.
Prof. Francesco Amenta, Italy
Professor Francesco
Amenta is Dean and
Professor of Human
Anatomy in the
School of Medicinal
and Health Products,
faculty of Pharmacy
at the University of
Camerino in Italy.
Prof Amenta
graduated with first
honors as Doctor of Medicine and Surgery in 1977
and later received his speciality in neurology.
Since 1992, Professor Amenta has been teaching
and doing research as a professor in the faculty of
Pharmacy at the University of Camerino. He has
more than 500 publications in international
journals. His scientific interests include
neurochemistry, neurohistology, clinical
neuropharmacology, drug pharmacokinetics and
analysis of pharmacological therapy of aging. He
is also an expert of telemedicine, telepharmacy and
E-health. Professor Amenta has professional
associations with universities in the U.S., U.K.,
Germany and Hungary. He has been a consultant
to several pharmaceutical companies and to the
European Economic Community.
Dr Lynn Weekes, Australia
Dr Lynn Weekes is
the inaugural Chief
Executive Officer of
NPS Medicine Wise.
Lynn has a MSc in
Pharmaceutics and a
PhD in Community
Medicine. Currently
in her role at NPS
Medicine Wise she
works with a talented team of people to support the
best use of medicines and medical tests – both by
health professionals and within the community. She
and her colleagues have implemented a wide range of
behavioural interventions that have been shown to
influence the prescription and use of medicines. She
has a strong professional interest in quality assurance,
behaviour change and pharmacoepidemiology. Lynn
believes that the public health benefits of quality use
of medicines and medical tests include better patient
care, improved patient safety and better value for
health expenditure.
Dr. Nile Khanfer, USA Dr. Nile Khanfar is
the Assistant Dean
/Associate Professor
of Department of
sociobehavioral and
Administration
Pharmacy, College
of Pharmacy at Nova
Southeastern
University. He is
also the Adjunct
Professor (Marketing / Entrepreneurship Master
Program), H.Wayne Huizeng a school of Business
and Entrepreneurship for Lauderdale in Florida.
He completed his PhD in pharmacy
Administration. Interestingly his Masters was in
Business Administration MBA, both from
University of Louisiana. He is interested in Direct
to Consumer Advertising of Prescription
Medication and its Influence on their behavior, as
well as in Management Leadership research.
17
Speakers’ Profiles
Dr. Nadir Kheir, Qatar
Dr. Kheir holds an
Honorary Senior
Clinical Lectureship
with the School of
Pharmacy, University
of Auckland. He is
also a Fellow with
New Zealand College
of Pharmacists,
member of the
Pharmaceutical Society of New Zealand, the
Clinical Advisory Pharmacists Association, and
New Zealand’s Healthcare Pharmacists’
Association. While in New Zealand, he functioned
as pharmaceutical care consultant and clinical
pharmacy consultant. Dr. Kheir has 22 peer-
reviewed publications, over 50 research abstracts
and presentations, and over 40 invited presentations
to his credit. He has published a chapter in a book
edited by Professor Linda Strand, Cipolle, and
Morley on Medication Therapy Management, and
is an international research advisor in collaborative
projects with research teams from Brazil and New
Zealand, involving the application and evaluation
of pharmaceutical care.
Dr. Nathir Obeidat, Jordan
Dr. Nathir M Obeidat
is a full professor and
Department
Chairman of Internal
Medicine at the
faculty of Medicine,
University of Jordan.
He is also the
Division Director of
Respiratory and
Sleep Medicine and
Director of Medical ICU at Jordan University
Hospital. Dr. Obeidat is member and head of
several committees: to mention some, he is Head
of Jordanian Board Committee for Internal
Medicine, Head of Drug and Therapeutic
Committee at Jordan University Hospital and Head
of National committee for pharmacovigilance in
the Jordanian FDA (from 2004 to 2008). Dr.
Obeidat holds a degree of Medicine and received
his speciality in internal medicine. Aside from his
long medical and academic career in Jordan, Dr.
Obeidat worked as senior registrar in Sydney,
Australia, from 1996 to 2000.
Dr. Hayel Obeidat, Jordan
Dr. Hayel M. Obeidat
is the Director General
of Jordan Food and
Drug Administration
since the year 2012.
He received his BSc of
Medicine in 1985. He
joined the Jordanian
Board of
Ophthalmology in
1999. He received his Fellowship in
Ophthalmology from the University of Tubingen /
Germany in (2001-2002). Throughout his extensive
career he held the following positions: Technical
Advisor to the Minister of Health and Chief of
Ophthalmology Directorate (2011-2012). Head of
the Ophthalmology Department at several
Jordanian hospitals: AL- Bashir Hospital (2009),
Prince Hamza Hospital (2005) and Princess Basma
Hospital (1999). Clinical Lecturer at: Hashemite
University and Balqa Applied University (2006), as
well as Teaching Assistant at Jordan University of
Science and Technology (2009-2011). He is head
of the steering committee for the Drug
Transparency Project and the higher committee for
drug and pharmacy/ JFDA.
Prof. Giovanni Palmieri, Italy
Prof. Giovanni
Palmieri graduated in
Industrial Pharmacy
with full marks the
1989 at the University
of Camerino. In
October 1990, he
began to approach
technological
problematics of
research, such as the use of cyclodextrins, during
his post-graduated stage inside the department of
Chemical Sciences of Camerino University.
From June 1991 to December 1993 he was a
visiting scientist in the laboratory of
Pharmaceutical Technology of Prof. André Stamm
in Strasbourg. In the meanwhile he became
researcher of Pharmaceutical Technology at the
Faculty of Pharmacy of the University of
Camerino.
18
Speakers’ Profiles
Prof. Nailya Bulatova, Jordan
Prof. Bulatova, MD,
PhD, is a Professor of
Pharmacology and
Therapeutics also the
Chair of the
Department of
Biopharmaceutics and
Clinical Pharmacy,
Faculty of Pharmacy,
The University of
Jordan.
Prof. Bulatova has more than 23-year teaching and
research experience in the field of Pharmacology
and Therapeutics. She has 50 publications in peer-
reviewed journals in addition to 15 conference
presentations and reviewing manuscripts for a
number of international journals in the field of
pharmacotherapy. Dr. Nailya has supervised 28
Master in Clinical Pharmacy dissertations. She is
the member of Jordan Medical Association, DAAD
Committee for selection of candidates for
postgraduate study in Germany and World Society
of Anti-aging Medicine.
Dr. Mohammad Alshara, Jordan
Dr. Mohammad
AlShara, PharmD,
Ph.D, FACN.
Dr. Alshara is an
associate professor
of clinical pharmacy
at Department of
Clinical Pharmacy,
Jordan University of
Science and
Technology (2010-
current). He is the clinical pharmacy department
chairman at King Abdullah University Hospital and
Clinics, and Vice Dean of Research. From the
University of Nebraska Medical Center, dr.
Mohammad completed his PharmD in 1985, his
M.Sc. in 1985, and his PhD in 1990. He has
worked as clinical pharmacist from 1991 till 1993
at Alegent Health, Omaha Nebraska. Aferwards, he
joined Creighton University School of Pharmacy,
Dept. clinical pharmacy from 1994 till 2010.
Expertise: Clinical pharmacy, clinical research
trials & Implementing US standard Doctor of
Pharmacy clinical pharmacy training.
Dr. Rebekah Moles, Australia
Dr. Rebekah
completed her PhD in
the area of Private
Hospital Pharmacy
Services. She is
interested in the
transition from
hospital to home
(continuity of care).
Her doctoral research focused on developing a
Medication Education Service (MES) for patients
on multiple medications at the time of discharge.
This tailored counselling service - coupled with
recommendations for ongoing care - resulted in
intervention patients being on significantly fewer
medications (and having fewer expenses) in
comparison with control patients who did not
receive this service.
Having a background in hospital pharmacy,
including being Assistant Secretary on the Hospital
Pharmacy Section of The International Pharmacy
Federation (FIP), there is also scope to explore
hospital pharmacy from an international policy
perspective. In 2008, the FIP developed global
statements for the future of hospital pharmacy, and
exploration of factors that influence how hospitals
comply with these statements needs to be explored.
In 2006 Rebekah was awarded the International
Pharmacy Federation's Young Scientists' Award for
Professional Innovation, for a project to develop
medication education packages for children. This
triggered the initiation of several projects in the
area of paediatric medicines.
19
Speakers’ Profiles
Dr. Lama Al-Nazer, Jordan
Dr Nazer is a Clinical
Pharmacy Specialist
at King Hussein
Cancer working in
both adult and
pediatric intensive
care units. She is also
Clinical Assistant
Professor with the
college of pharmacy
at Rosalind Franklin
University in Chicago. Prior to this, she held
clinical, academic and administrative positions at
universities, hospitals, and pharmaceutical
companies. Dr. Nazer is actively involved with
local and international societies and is the President
of the Middle East Critical Care Assembly. She is
also active in research and her areas of publication
and interests are infectious diseases and medication
safety in critically ill patients.
Dr. Iman Basheti, Jordan
Dr. Basheti is the
Dean of Pharmacy
at ASU and Head of
the Pharmaceutical
Care Unit at Ibn
AlHaitham
Hospital. She has
more than 60
conference
presentations and
over 45 publications
in International Journals. A reviewer to prestigious
International journals such as the British Medical
Journal, Respiratory Care, and BMC Medical
Journal. She published many papers and book
chapters focusing on exploring various educational
methods to maximize the effectiveness of
pharmacy undergraduate education. She specializes
in asthma research, working in collaboration with
researchers from the Woolcock Institute of Medical
Research (Sydney University) one of the top
institutions in respiratory research worldwide. Dr.
Basheti has numerous publications sighted in
International Therapeutic Guidelines such as GINA
and the NHLBI, the Current Australian Asthma
Handbook and the Australian NPS Medicine Wise.
She won many prizes, including Excellence in
teaching award presented by the Faculty of
Pharmacy, University of Sydney; Young
Investigator of the year prize (Australia); Best
Researcher Award for the years 2012, 2013, 2014
and 2015 (Applied Science University), wining
university level over two years.
Dr. Betty Chaar, Australia
Dr Betty Chaar is a
senior lecturer in
Pharmacy Practice in
the Faculty of
Pharmacy at the
University of Sydney,
Australia. She has
been working in the
field of pharmacy for
many years, with experience in community
pharmacy ownership, hospital pharmacy,
pharmaceutical industry, academia and research. Dr
Chaar has more than 50 publications in
international scientific journals. Her current
research involves several practice-based projects,
such as health literacy, weight management,
hospital pharmacy, direct-to-consumer advertising
and the needs of patients from various ethnic
backgrounds. Dr Chaar is also an active member on
a number of Human Research Ethics committees
and she is immediate past President of the
Australian Association for Professional and
Applied Ethics [AAPAE].
Dr. Dalia Bajis, Australia
Ms. Dalia Bajis is
currently a PhD
candidate at the
University of
Sydney. She
graduated with a
Bachelor of
Pharmacy from the
University of
Sydney with First
Class Honors. Her
past pharmacy experience includes practice in
community and hospital settings. In 2011, Ms.
Bajis moved to Saudi Arabia where she
commenced work in the academic field. Dalia’s
areas of interest in her research are competency-
based pharmacy education, pharmacy human
resource management and staff professional
development with particular focus on the Eastern
Mediterranean Region (EMR). Ms. Bajis aspires to
join transformational leaders of tomorrow in the
EMR to foster a competent and capable pharmacy
workforce in the region in hospital and community
pharmacy.
20
Speakers’ Profiles
Dr. Maher Khdour, Palestine
Dr. Maher Khdour
is an associate
professor of
Pharmacotherapy
and Pharmacy
Practice in the
Faculty of
Pharmacy at Al-
Quds University in
Palestine. He
obtained his PhD in
Clinical Pharmacy and Practice from Queen's
University Belfast (UK) in 2008, working in the
research group of Professor James McElnay. Dr
Khdour gained his clinical setting experience in the
Newham Hospital, Matter Hospital and Antrim
Hospital in the UK. Since then, he has worked and
published in the clinical research fields of “off-
label” medication in pediatric population,
prevention of medication errors and drug related
problems in hospitals, and Pharmaceutical care
Practice. Dr. Khdour has received several awards
throughout his career, including the Award from
the Chest Heart and Stroke, UK (2007), the Best
Researches award for press release at the British
Pharmaceutical Conference, Manchester, UK
(2008) and the Daniel Turnberg Fellowship UK/
Middle East (2010).
Dr. Abdulsalam Alkhayyat,
Palestine
Dr. Abdulsalam
Alkhayyat,
pharmacist (BSc),
trained in molecular
biology, and
epidemiology (PhD),
pursues research on
non-communicable
diseases in the Middle
East region.
Abdulsalam is a post-
doctoral scientific collaborator at the Swiss
Tropical and Public health Institute in Switzerland
and Assistant Professor at the Faculty of Medicine
and Health Sciences at An-Najah National
University, in Palestine.
Dr. Omaima Nassar, Jordan
Ms. Omaima
Nassar is HCAC’s
Standards
Development
Senior Specialist
since 2011. She is
a Certified Hospital
Surveyor, Certified
Primary Health
Care Surveyor,
Certified Breast
Imaging Surveyor, and Certified Center of
Excellence Assessor at HCAC. She chairs the
research and development committee at HCAC.
Additionally, Omaima has special expertise in the
developing and maintaining HCAC standards that
improving the quality and safety and driving
change in patient care.
Ms. Omaima holds a Master’s in quality control
and management from Jordan University of
Science and Technology, and a Bachelor in
Pharmacy from Jordan University of Science and
Technology, Ms. Omaima is a certified CAP
inspector within the Middle East region, she
participated in inspections at Lebanon, Cairo, UAE,
and Saudi Arabia.
Dr. Thaira AlMadi, Jordan
Ms. Thaira Madi is the Director, Surveys and
Standards Development in the Health Care
Accreditation Council, the Arab region’s only
independent non-profit organization that aims at
improving the quality
of health care
services across the
spectrum. She has
over 22 years’
experience in health
care industry with
special expertise in
management, staff
development, and
performance improvement. Ms. Madi holds a
Master’s in Quality Management and a Bachelor of
Nursing from University of Jordan. She started her
career working as a registered nurse in medical
wards including oncology, nephrology, neurology
and general medicine. She had been later assigned
as Hospital Nursing Supervisor. Since 2004 she has
been involved in healthcare quality and
accreditation.
21
Speakers’ Profiles
Dr. Mohammad Samaha, Jordan
Dr. Mohamed is a
specialist at the
director gamma
Nayef Center and
Surgery corrected
(stereotactic) at Ibn
al-Haytham Hospital,
Amman/Jordan. He is
an adviser to the brain
and nerves and spinal surgery and Surgery
corrected radiographic and functional surgery for
Parkinson's. Dr. Mohammad is currently the
president of the Jordanian Association for surgical
brain and nerves. He has a fellowship from the
Surgery British brain and nerves, and the American
University of Pittsburgh surgically corrected
stereotactic surgery and radiotherapy.
He holds the Certificate of Jordanian Medical
Council surgery and Jordanian Medical Council of
brain and nerve surgery. He is the first director of
the Center for Middle East and the Arab world (the
only one in region) to treat brain tumors and other
diseases without surgery, in addition to the
treatment of Parkinson's and involuntary
movements surgically.
Dr. Majed Habahbeh, Jordan
Dr. Majed Habahbeh.
MBBS (London),
FRCP (London)
Dr. Majed has
specialty certificate in
Neurology from the
UK, and is currently a
clinical Associate
Professor at the
University of Jordan. He is a member in the
European Board of Neurology and Jordanian Board
of Neurology, and is a consultant Neurologist at
King Hussein Medical Centre.
22
Speakers’ Abstracts
Speakers’ Abstracts
23
Speakers’ Abstracts
Pharmacy Education and National Registration and
Accreditation Scheme for Pharmacists in Australia
Prof. Iqbal Ramzan, Dean of Pharmacy, Sydney University, Australia
Professor Iqbal Ramzan, Dean of Pharmacy, the University of Sydney, Sydney, Australia.
This presentation will provide an overview of Pharmacy education programs at Australian
Universities using the University of Sydney undergraduate B Pharm, graduate entry M Pharm
and post degree Internship Training Program (ITP) as exemplars of the programs available in
Australia as entry into the pharmacy profession as Pharmacists. In addition, a synopsis will be
provided of the national (Australia-wide) registration scheme for Pharmacists and the
accreditation of pharmacy degrees and ITP programs by the Australian Pharmacy Council
(APC) on behalf of the Pharmacy Board of Australia (PBA) which undertakes this function as
part of the remit of The Australian Health Practitioner Registration Authority (AHPRA)
which regulates Australia’s health practitioners. One major objective of the NRAS scheme is
to provide for the protection of the public but ensuring a balance between the burden (cost) of
registration and accreditation vs the need to ensure public safety. Future trends in Pharmacy
education in Australia and internationally will also be discussed.
Drugs beyond the Label
Prof. Giovanni Palmieri, University of Camerino, Italy
The presentation introduces and defines the concept of off-label use of medicines in
derogation from the authorized mode by some Regulatory Agency.
The term off-label use refers to the prescribing or administration of an authorised medicinal
product outside any of the terms of the marketing authorisation, as reflected in the Summary
of Product Characteristics (SmPC). This might include use for a different indication, at a
different dosage (or dosage frequency) or in a different patient group (for example, children
or pregnant women).
Some examples of off-label use of medicines are subsequently listed and discussed.
pharmacological, and clinical technology.
Reasons for off label use in clinical practice are also discussed.
Although precise figures are unavailable, it is clear that off-label use is common. This is
particularly so in neonatology, where the percentage of off-label use could be as high as 90%,
and paediatrics. Other areas where off-label use is particularly common include oncology,
infectious diseases (HIV/AIDS), psychiatry and disphagic patients.
Finally, the role of the hospital pharmacist in the use of off-label drugs will be discussed.
Pharmacists bear a significant responsibility for ensuring optimal outcomes from all drug
therapy. With respect to unlabeled uses, the pharmacist should fulfil the roles of patient
advocate and drug information specialist, and develop policies and procedures for evaluating
drug prescriptions and dispensing drugs for unlabeled uses in their own work settings.
24
Speakers’ Abstracts
Revisiting Profile/Indications of Old Drugs: An Experience in
the Field of Cognitive Dysfunction
Prof. Francesco Amenta, Dean of pharmacy, University of Camerino,
Italy
Treatment of adult-onset dementia disorders represents a challenge for pharmacotherapy. The
‘‘only’’ approved treatments by US Food and Drug Administration (FDA) and European
Agency for the Evaluation of Medicinal Products (EMEA) , include five drugs used to treat
the cognitive manifestations of Alzheimer’s disease (AD), namely the (acetyl)-cholinesterase
inhibitors (ChE-I) rivastigmine (Exelon), galantamine (Razadyne, Reminyl), tacrine (Cognex,
marketed only in the USA), donepezil (Aricept) and NMDA receptor antagonist memantine
(Namenda). The above drugs have all been shown to modestly slow the progression of
cognitive symptoms and reduce problematic behaviors in some people, but at least half of the
people who take these drugs do not respond to them. The first therapies introduced into the
clinical practice for symptomatologic treatment of AD were cholinergic precursors.
Controlled clinical trials with choline or the choline-containing phospholipid
phosphatidylcholine (lecithin) failed to show relevant effects. These negative results,
although should not be extended to all cholinergic precursors, were probably the cause of the
discontinuation of the precursor loading strategy for treating AD.
It is since 1993 that a group of neuromorphology research started its activity in Camerino for
investigating neuroanatomical correlates of hypertensive brain damage primarily using
spontaneously hypertensive rats (SHR). Analysis of the above topic did bring to the
suggestion that SHR may represent a reasonable model of cerebrovascular brain injury and to
some extent of vascular dementia. From a basic neuromorphological analysis, research in this
field was extended to the investigation of cholinergic and monoaminergic systems on the
above animal model and to the analysis of the influence of drugs (primarily cholinesterase
inhibitors and choline-containing phospholipids) on neuroanatomical, neurochemical and
behavioural correlates of brain injury in SHR. A main contribution of this research was the
identification that the association between a cholinesterase inhibitor and the cholinergic
precursor choline alphoscerate is more affective than single compounds in countering brain
damage occurring in this model. The above pharmacological association was also
investigated in clinical settings, by the ASCOMALVA (Effect of association between a ChE-
I and choline alphoscerate on cognitive deficits in AD associated with cerebrovascular injury)
trial. It is a double-blind trial investigating if the ChE-I donepezil and choline alphoscerate in
combination are more effective that donepezil alone. The trial has recruited AD patients
suffering from ischemic brain damage documented by neuroimaging and has completed 2
years of observation in 113 patients of the 210 planned. Patients were randomly allotted to an
active treatment group (donepezil + choline alphoscerate) or to a reference group (donepezil
+ placebo). Cognitive functions were assessed by the Mini-Mental State Evaluation and
Alzheimer’s Disease Assessment Scale Cognitive subscale. Daily activity was evaluated by
the basic and instrumental activities of daily living tests. Behavioral symptoms were assessed
by the Neuropsychiatric Inventory. Over the 24/36-month observation period, patients of the
reference group showed a moderate time-dependent worsening in all the parameters
investigated. Treatment with donepezil plus choline alphoscerate significantly slowed
changes of the different items analyzed suggesting that combination of choline alphoscerate
with a ChE-I may prolong/increase the effectiveness of cholinergic therapies in AD with
concomitant ischemic cerebrovascular injury.
25
Speakers’ Abstracts
Rational Use of Medicines and Medical Tests
Prof. Lynn Weekes, NPS Medicine Wise, Sydney University,
Australia
NPS MedicineWise is an independent, non-profit and evidence-based organization that
provides practical tools such as medicines lists, evidence-based information, shared decision
making tools and educational activities for health professionals and patients. The aim to
improve the way health technologies, medicines and medical tests are prescribed and used
and so to improve the health and economic outcomes of care.
NPS MedicineWise works across Australia and throughout the Asia-Pacific region to
positively change the attitudes and behaviours which exist around the use of medicines and
medical tests, so that consumers and health professionals are equipped to make the best
decisions when it counts.
The organisation has demonstrated significant impact on the way health technologies are used
in Australia, so much so that our work has become a benchmark for similar organizations
overseas. Our educational programs reach over half of all Australian GPs, and through our
website, resources and campaigns consumers are now able to access important health
information which previously didn't exist.
Since inception in 1998, we have directly saved the Australian Government over AUD 700
million in reduced cost of pharmaceuticals. Recent independent showed that for every dollar
invested in NPS MedicineWise, nine dollars are returned either as savings to the health
system or improved productivity in the overall economy. More importantly we now also have
data to show the improvements in health outcomes that arise from our work including
reductions in diabetes complications and reductions in stroke secondary to antipsychotic use
in older people.
NPS MedicineWise is globally recognized for its work in quality use of medicines and
medical tests, and is acknowledged by the World Health Organization (WHO) as a world-
leading organization in this space.
Improving the Quality of Care through Research
Dr. Lama Alnazer, Clinical Pharmacy Specialist, KHCC, Jordan
Research within health-care settings is essential for developing knowledge in drug therapy, as
well as for optimizing the quality of care that we provide. The goal of this presentation is to
demonstrate the importance of clinical research through examples of research projects that
helped improve the quality of care and the safe use of medications in the inpatient setting.
26
Speakers’ Abstracts
Direct-To-Consumer-Advertising (DTCA) from a
pharmaceutical marketing perspective
Dr. Nile Khanfer, Assistant Dean of Pharmacy, Nova University, USA
The effect of direct-to-consumer advertising (DTCA) of prescription medications is a
growing concern worldwide. While it is still illegal in the Middle East, actually has been only
legalized in 2 countries (United States and New Zealand), the current technologies and
availability of internet allowed unrestricted access to such advertising. That being said, the
impact of DTCA overcame preset geographical boundaries and is obviously able to reach
millions of consumers worldwide. Due to such power, pharmaceutical companies have and
continue to invest billions of dollars every year on direct-to-consumer advertising of their
drugs. Different types of DTCA have emerged over time and accordingly new laws and
regulations were put in place to protect the consumers and ensure complete and non-
fragmented information dissemination to the public. In this presentation, we will discuss
further the emergence of DTCA from a marketing perspective. We will review DTCA
evolvement in parallel with regulations timeline and then differentiate among the different
types of DTCA while going over real examples. Before we conclude, being pharmacists, it is
always important to explore pharmacy perception toward DTCA as well as other Healthcare
professionals and global reactions to DTCA.
Continuing Professional Development in Pharmacy: Quality
Expectations and Relevance to QUM
Dr. Nadir Kheir, Assoc Prof. in pharmacy Practice, Qatar University,
Qatar
Continuing Professional Development (CPD) is fundamental to the professional development
of all health care practitioners, and is a pre‐requisites for the delivery of high quality patient
care. Quality use of medicines (i.e. the judicious selection of treatment options and the safe
and effective use of medicines) requires that healthcare providers acquire the professional
competencies necessary to provide patient‐centered care. These attributes, personal and
professional, are best acquired through embracing a culture of lifelong learning, facilitated by
participation in a structured, relevant, and focused CPD program. In Qatar, the Accreditation
department of Qatar Council for Healthcare Practitioners (QCHP) has been established and
tasked with developing and implementing a coordinated system to facilitate accreditation of
CPD providers and activities in advance of launching a new licensure system in 2016 that
shall affect all healthcare practitioners, including pharmacists, in the state of Qatar. In this
presentation, the speaker shall introduce Qatar’s CPD experience (using the Continuing
Professional Development for Healthcare Practitioners Program of the College of Pharmacy;
Qatar University) as a model to discuss the place of CPD in this new era, and what makes a
truly effective CPD program.
27
Speakers’ Abstracts
Non Invasive Ventilation: Latest Trends in Patient Care
Prof. Nathir Obeidat, Respiratory Consultant, JUH, Jordan
NIV is a type of mechanical ventilation used to treat patient with respiratory
failure caused by different diseases affecting normal breathing without use of endotracheal
intubation, laryngeal mask or tracheostomy.
NIV can be negative pressure ventilation but most of the centers use a positive pressure
ventilation which is a subtype of a pressure control ventilation.
Positive Pressure Non Invasive Ventilation( PPNIV) can be in form of continuous pressure
airway pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP).
The best results from treating patient by NIV was seen in the treatment of patients with acute
exacerbation of COPD. Treatment of patient with acute cardiogenic pulmonary edema,
Obesity Hypoventilation Syndrome is also showed encouraging results. The uses of patients
with other acute or chronic respiratory diseases are not very well established.
Jordan Food and Administration and its Role in the
Enhancement of medicines rational use
Dr. Hayel Obeidat, JFDA Director General, Jordan
The aims of rational medicine use and pharmacovigilance at Jordan food and drug
administration (JFDA) are to enhance patient care and patient safety in relation to the use of
medicines; and to support public health programs by providing reliable, balanced information
for the effective assessment of the risk-benefit profile of medicines. Side by side with the
policy of rational medicine use to insure that patients receive medications appropriate to their
clinical needs, in doses that meet their own individual requirements, for an adequate period of
time, and at the lowest cost to them and their community. Taking into consideration patient
safety through the time receiving their medications, and where ever there is a required action
should be done Therefore, guidelines were approved to achieve the aim of patient safety and
to enable us as a health authority to take the appropriate regulatory action in a systematic
approach depending on JFDAs data base so to improve patients safety and to maintain
medicines sustainability in the market at the appropriate price.
28
Speakers’ Abstracts
An Innovative Geriatric-Psychiatric Rotation: Example of
Pharmacist Inter-Professional Collaboration
Prof. Naiyla Bulatova, The University of Jordan, Jordan
Similar to most healthcare professionals, pharmacists contribute to the health and wellness of
individuals and communities. It is well recognized that in complex clinical cases, and in
complex health organizations, no one person has the capability to deliver high-quality care by
acting alone. The paradigm of an ‘inter-professional approach’ in patient-centered care has
thus emerged in recognition of the synergistic roles that discipline specialists bring to
decision-making and care provision.
Pharmacists work collaboratively as members of an inter-professional healthcare team to
provide patient-centered care by functioning as the medication experts. A pharmacist’s
unique role is in ensuring the safe, effective, and appropriate use of medications.
Nearly all health professional students and prescribers, regardless of specialty, will care for
older adults. Given the growing numbers of older adults, the increased burden of chronic
disease, and the escalating costs of health care, health professionals across disciplines should
learn strategies to promote cost-effective medication use and collaborate with each other.
People with severe and persistent mental illnesses, such as schizophrenia or depression, often
receive inadequate general medical care and are documented to have shorter lifespan than
those without serious mental illness. In addition, it is important for pharmacists, as health
care professionals to be familiar with the most common drugs (whether prescription, OTC or
illicit) and the medical complications they pose upon misuse/abuse, understand the drug user
and the most common methods applied in treatment of drug dependence. A new team that
involves sixth year PharmD students, their preceptors and Master in Clinical Pharmacy
students was established recently to provide training and education to clinical pharmacists in
the area of geriatrics and psychiatrics. Examples of successful pharmacists’ interventions
towards detection, prevention and/or resolution of medication-related problems in geriatric
and psychiatric patients are discussed.
Epilepsy: Diagnostic and Treatment Pitfalls
Dr. Majed Habahbeh, Neurology Consultant, RMS, Jordan
Epilepsy is a common neurological disorder, but it is also commonly misdiagnosed. This talk
will address the diagnostic and treatment approach to patients with suspected epilepsy.
Potential diagnostic and treatment errors will be highlighted and real local data will be
presented as an example of how common this problem is in clinical practice in Jordan.
29
Speakers’ Abstracts
Current Pharmacy Practice: What is Clinical and
Why? Settings, Expertise and Opportunities
Dr. Mohammad Alshara, Vice Dean of Pharmacy, JUST, Jordan
Patient-centered pharmacy practice is often referred to as pharmaceutical care. This
terminology which supplanted “clinical pharmacy” is currently being replaced particularly in
the USA with medication therapy management (MTM). In fact, any and all actions performed
by pharmacists beyond medications dispensing can improve patient outcomes and should be
practiced by most if not all pharmacists regardless of their degree type. There is some
confusion in the ranks of current pharmacy and particularly Doctor of pharmacy (Pharm.D.)
students and recent graduates. Many Pharm.D. graduates apparently feel that there is no
defined role or a specific job description for them. They often bemoan the lack of "befitting"
job opportunities and often express frustration with the lack of "clarity" of their role. Some,
strictly describe themselves as "Clinical" without mentioning the word “pharmacist” and
expressing concern that clinical people like us have no job opportunities. Conversely, some
BS pharmacy graduates appear content that their primary responsibility is medication
dispensing and that their education simply prepared them for that task and in all likelihood to
be practiced in a community pharmacy setting. In contrast, PharmD. graduates tend to believe
that they are overqualified for work as community pharmacists. While the advent of the
Doctor of Pharmacy degree training (Pharm.D.) in Jordan has certainly strengthened
pharmacists preparedness for a clinical practice, only a few of each graduating PharmD. class
possess the knowledge, skills, and attitude to immediately serve in advanced clinical practice
setting. Yet, all pharmacy graduates regardless of the degree type are adequately prepared to
provide some level of pharmaceutical care in any setting. Advancing one’s skills either
requires further advanced training such as a pharmacy residency and/or hard work and a
commitment to continued personal development and accepting the responsibility of being a
life-long learner. Acceptance of this path requires perseverance and most of all commitment
to caring for the patients. The pharmacy profession in Jordan is in dire need of a unified
vision that recognizes that delivering patient centered care will be mutually beneficial to both,
the profession and the community.
Education through Simulation
Dr. Rebeka Moles, Sydney University, Australia
Often we are asked to learn only by reading and listening to facts. For some, this will suffice,
and they will be able to put knowledge into practice. For others, the application of knowledge
is a difficult process, and practice at skills is required in order to learn and master essential
skills. Unfortunately practice is not always an option before one is required to master a skill.
This presentation will outline new approaches to learning through simulation including the
use of "mystery shopping" placements, teaching asthma first-aid to educators, teaching
parents to manage their children's fever and redesigning a large unit of study in the final year
of the bachelor of pharmacy degree at Sydney University to incorporate more competency
based learning.
30
Speakers’ Abstracts
Home Medication Management Review Service in Jordan
and the UAE: a Story of Success
Dr. Iman Basheti, Dean of Pharmacy, Applied Science University,
Jordan
Medication Management Review (MMR) service is a patient-focused, structured and
collaborative health care service provided in the community and hospital settings to optimize
patient understanding and quality use of medicines. MMR identifies treatment related
problems (TRPs) and measure patient medication adherence. TRPs have a variety of different
causes, ranging from unneeded medications, adverse effects and interactions to
ineffectiveness, inappropriate use, inappropriate dosage regimen and poor adherence. As a
result of increase in medication complexity, in the use and in the costs of medications, the
need emerged for the MMR service. Worldwide, the expansion of clinical services provided
by pharmacists includes different models of MMR, such as the Medication Therapy
Management (MTM) in the USA and MMRs in Australia. It has been suggested that it is
necessary to visit patients in their own homes to get the complete representation of a patient’s
medication regimen. TRPs which can be identified at home visits include poor adherence
with medication regimens, inappropriate medication storage, multiple medication storage
locations and expired medication. A number of studies related to MMR conducted in Jordan
and the UAE involving home visits (HMMR) have been published by Basheti et al. These
interventional outpatient HMMR randomized control trials were delivered by clinical
pharmacists with the aim of identifying TRPs through home visits, assessing TRP types and
frequencies, physician’s acceptability to the program, physician approval rate of the TRPs
identified, and eventual effect of resolving the identified and physician’s accepted TRPs on
the health outcomes of the participating patients including adherence, self-care and quality of
life. Collectively these studies have shown that the HMMR service is successful at decreasing
the mean number of TRPs, improving medication adherence, patient self-care, and quality of
life.
Research in Healthcare Ethics at the University of Sydney
Dr. Betty Chaar, President of AAPAE, Sydney University, Australia
There is a plethora of interesting research projects and topics in healthcare
to explore at the University of Sydney.
Topics relating to professional ethics and contemporary issues of concern to healthcare
providers are of particular interest to Dr Betty Chaar and her research team at the Faculty of
Pharmacy. In this day and age there are many ethical issues for consideration in healthcare.
The advent of high level technology and the healthcare needs of ever growing and ageing
populations are examples.
At this plenary, Dr Betty Chaar will provide an overview of some of the many aspects and
topics that have been explored in our research projects at the Faculty of Pharmacy – the
University of Sydney. Topics will range from those related to everyday practice, to the
broader issues pertinent to healthcare in general.
31
Speakers’ Abstracts
Education and Training in the Arab Region: Food for
Thought.
Dr. Dalia Bajis, Pharmacy Specialist, Sydney University, Australia
In the Arab region, non-communicable diseases such as heart disease and diabetes are
causing increasingly more premature mortality and morbidity. This shift in chronic disease
burden, compounded by the increasingly dynamic environment of rising healthcare costs, has
increased demand for health services. Pharmacists are uniquely positioned as the most
accessible of all healthcare providers to the public and can play an important role in the
delivery of healthcare services. However, ensuring a competent pharmaceutical workforce
that is able to adapt to new roles and responsibilities poses challenges to stakeholders of the
profession. Upon the request of UNESCO Office in Beirut, Regional Education Bureau for
the Arab States and in light of improving pharmacists’ competence in the Arab region,
recommendations for quality assurance in pharmacy education in the Arab Region were
produced. A collaborative authorship was formed to produce a document which forms an
integral part of the Regional Higher Education Policy Framework and Resource Pack (in the
course of publication). The presentation by Dalia Bajis will provide a summary of the
recommendations outlined in this document and aims to initiate dialog amongst key
stakeholders from the region to share ideas and strategies on how to successfully implement
some of the outlined recommendations when deemed applicable.
Neuromodulation of Brain for Control of Movement
Disorders and Gamma Knife Radiosurgery
Dr. Mohammad Samaha, Neurology Consultant, Ibn Alhaitham
Hospital
The Stereotactic target calculation and reaching any point in deep brain in accurate way was
introduced to our hospital in 1996 to treat the brain tumors without surgery by Gamma Knife
and treat of Movement Disorders and Parkinson's disease by accurate lesioning of small foci
in brain or implantation of chronic leads to the basal ganglia for deep brain stimulation by
modulation of the abnormal brain electrical signals in movement disorders, Parkinson's
disease, and Psychosomatic diseases.
Since that time we treated more than 4000 patients with successful rate ranging between 85-
90% and many minimal complications.
32
Speakers’ Abstracts
Antimicrobial Stewardship Program in the Intensive
Care Unit at Palestine Medical Complex:
Multidisciplinary Team Led by Clinical Pharmacist
Dr. Maher Khdour, Al-Quds University, Palestine
Background: High rates of antimicrobial use and increasing antimicrobial resistance make
intensive care units (ICUs) ideal wards to implement antimicrobial stewardship program
(ASP) efforts. The purpose of this study was to determine if the implementation of a
pharmacist-led ASP in a community hospital ICU decreased antimicrobial utilization and
improved antimicrobial susceptibilities. Methods: An ASP was established at a community
teaching hospital in April 2015, with 12 ICU beds. The program was led by an infectious
diseases-trained pharmacist who worked daily with a clinical pharmacist rounding with the
ICU care team to make ASP interventions. Prospective audit with intervention and feedback
began in Sep, 2015. We chose to compare 4 months of pre-ASP data with 4-months of post-
ASP data. Data collected included clinical and demographic data; included utilization of
antimicrobials which was calculated using Defined Daily Doses DDD/100 bed, hospital stay ,
intervention Type, acceptance rate and susceptibility trends. Results: A total of 376
antimicrobial prescriptions for 157 patients were revised during a 4 month period. There
were 8 drugs in the DU 90% segment out of 21 drugs prescribed in the ICU. In all, 166
prescriptions (44.1%) were considered inappropriate in 93 patients. The majority of
interventions were de-escalating or discontinuing antimicrobial therapy (68.7%), intravenous
to oral conversion (16.8%). and dose optimization (12.7%) and with acceptance rate of
(80.7%), Overall Utilization Reduced By 33.0% (95.4 DDD/100 bed. vs 63.9 DDD/100 bed
p<0.001). Carbapenems Utilization decreased by 39 (11.3 DDD/100 vs 6.9 DDD/100 bed
p<0.001) and Pip/Taz Utilization decreased by 30.1% (9.9 DDD/100 bed vs 6.7 DDD/100
p<0.001). there was a non-significant reduction in the average hospital stay (7.4 day Vs 6.3
day ; p=0.17). Conclusions: A pharmacist-led ASP in a community teaching hospital ICU
significantly impacted antimicrobial prescribing, reduced antimicrobial utilization and
hospital stay with high acceptance rate.
33
Speakers’ Abstracts
Promoting Patient Safety through the Implementation of
Health Care Accreditation Council Medication
Management Standards
Dr. Omaima Nassar, HCAC, Jordan
Background: The HCAC standards for Medication Management (MM) are among the most
rigorous and challenging for health care organizations to implement. To prepare your health
care organization for compliance, all stages of the medication use process — selection,
storage, ordering, dispensing, administration, and monitoring — must be appropriately
integrated into a comprehensive medication management system. The standards require a
hands-on approach that assures implementation of practices that are evidence-based and in
line with the applicable laws and regulations according to the scope of practice. The aim of
this paper is to highlight how the medication management standards have contributed to
improving the safety and quality of medication usage in Jordan through accreditation. This
has led to improving patient outcomes by reducing error and harm from medicines through
safe and quality usage. Methods: The study included all health care organizations that have
participated in accreditation and showed compliance with the medication management
standards and awarded accreditation. The data was captured from survey reports which
completed by HCAC surveyors during the survey process of the health care organizations.
Results: HCAC Accreditation Medication Management Standards contain the following
sections: Planning the Medication Management System ,Training and Competency
Evaluation, Accessing client and Medication Information, Selecting and Procuring
Medications Storing Medications in the Pharmacy and Client Service Areas, Prescribing and
Ordering Medications, Preparing Medication, Labelling and Packaging Medications,
Dispensing and Delivering Medications, Administering Medications and Client Monitoring,
Evaluating the Medication Management System.
The survey report results showed that the compliance with the medication management
standards have led to improving the patient safety in the healthcare organizations awarded the
accreditation, the health care organizations have assessed their medication system and
identify risk points, reduced medication errors, improved patient outcomes, and boosted staff
performance and confidence. Conclusion: The medication management is a patient safety
priority, it’s one of the most important processes in treating patients, at the same time,
medication management is one of the most complex parts in health care delivery. Medication
management is an integrated process that needs different disciplines at multi levels in care,
without full coordination of among clinicians who orders a drug, the pharmacy that fills the
order, the staff delivers the medication, the nurse who administers it, the risk of potentially
harmful medication errors multiplies. Accreditation is one of the tools that promotes the
quality and safety of medication usage and accreditation has activated the implementation of
the applicable drug laws and regulations and implementing the clinical guidelines related to
medication safe practices in different health care settings which indicated the need of the
presence of follow up and monitoring system to maintain the quality and safety of medication
care.
34
Speakers’ Abstracts
Retinopathy among Diabetes Patients in Palestine: Time
for Action
Dr. Abdulsalam Alkhayyat, An-Najah University, Palestine
Diabetes remains a major contributor to the burden of diseases in Palestine and the wider
Middle East region. Patient care, adequate tertiary prevention, appropriate medication and
follow up can retard its serious complications including retinopathy. The aim of this research
was to investigate the importance of early detection of diabetic retinopathy through means of
screening.
The study was conducted in the National Palestine Diabetes Institute. A total of 278 diabetic
patients registered at the institute were screened for diabetic retinopathy. An investigator-
administered questionnaire was conducted among 232 patients.
Out of the 278 patients screened, 14.38% had signs of diabetic retinopathy; 62.5% had
nonproliferative diabetic retinopathy (NPDR), 20% had proliferative diabetic retinopathy
(PDR) and 17.5% had maculopathy. Of all participants, 16.6% had combined NPDR and
maculopathy while 25% percent had PDR and maculopathy. Around 40% were referred to an
ophthalmologist for follow up and management. It was found that old age group, long
duration of diabetes and poor glycemic control were significantly associated with diabetic
retinopathy. Among the 232 patients interviewed, 83.7% defined diabetes as an increase in
blood sugar. Awareness toward retinopathy as a complication of diabetes was the highest
(97.3%).
Treatment interventions at early stages of diabetic retinopathy can reduce burden of blindness
attributed to diabetic retinopathy. With the available cost-effective methods of early
screening, appropriate strategies/models need to be developed to spread and promote
awareness and establish screening programs on a national level.
35
Speakers’ Abstracts
The Effect of HCAC Primary Health Care Accreditation
on PHC Core Principles
Dr. Thaira Madi, HCAC, Jordan
Background: Primary health care became a core policy for WHO in 1978, with the adoption
of the Declaration of Alma-Ata and the strategy of "Health for all by the year 2000". The
WHO describes primary health care as the principal vehicle for the delivery of health care at
the most local level of a country’s health system. Primary health care is essential health care
made accessible at a cost the country and community can afford with methods that are
practical, scientifically sound and socially acceptable. Health Care Accreditation Council in
Jordan (HCAC) developed the Primary Health Care (PHC) Accreditation Standards within
this context and in line with the common philosophical framework used throughout the
world. HCAC framework, focus on five core principles; accessibility, appropriate technology,
health promotion, public participation, and evidence-based practice.
To get the HCAC accreditation, the PHC center has to achieve predetermined percentages of
the HCAC PHC standards requirements. This will be evident while assessing the PHC
performance by a group of surveyors, who will submit the survey’s results for the Board of
Directors for the accreditation decision.
Objectives: To measure the effect of being an HCAC accredited PHC center on the main five
PHC core principles; accessibility, appropriate technology, health promotion, public
participation, and evidence-based practice at 48 accredited PHC centers in Jordan.
Methods: Indicators were identified from the requirement of the HCAC primary health care
standards, the achievement of these indicators will lead to achieve at least one core principle;
five indicators for accessibility, two indicators for appropriate technology, nine indicators for
health promotion, four indicators for public participation, and two for evidence-based
practice were identified. The percentage of compliance is calculated for each indicator at two
times; during the mock survey (pre-accreditation) and during the accreditation survey (6-8
months after the mock survey) for all 48 PHC accredited centers.
Results: There was a significant progress in the compliance percentage results for all
indicators, from the pre-accreditation to accreditation results. Table (1) shows the result of
improvement for each indicator.
Conclusion: The adoption and implementation of HCAC primary health care accreditation
will lead to achieve and improve PHC core principles (accessibility, use of appropriate
technology, health promotion, public participation, and evidence-based practice), and will
assist services to incorporate the core principles in PHC everyday practices.
36
Speakers’ Abstracts
Electronic Health Solution Profile
Dr. Zeid Abu Goush, Chief Medical Officer, Hakeem-EHS, Jordan
Electronic Health Solutions
Electronic Health Solutions is a private non-profit company funded by the Jordanian
government for serving public sector healthcare projects. Our vision is “To transform and
sustain a continuously improving healthcare system in Jordan by leveraging technology”.
Hakeem Program
‘Hakeem’ program was launched in 2009 under the patronage of his Majesty King Abdullah
II. 'Hakeem' program represents the company's first initiative aiming to deploy a nationwide
electronic health record system in Jordan, based on the VistA system developed by the US
Department of Veterans Affairs. 'Hakeem' is currently implemented in 17 governmental
hospitals, 21 comprehensive clinics and 52 primary care clinics by the end of February, 2016
and another 7 projects in progress and due in the 1st quarter of 2016.
Health Analytics Department
Hakeem “Health Analytics Department” is dedicated to the analysis and use of big data in
evidence-based decision making. We aim to aid healthcare providers in improving the quality
of delivered care, decreasing resource waste and increasing efficiency. Through conducting
innovative research, we strive to conduct not only preventive, but also predictive medicine.
37
Workshops
Workshops
38
Workshops
Workshop 1
Learning Evidence Based Medicine in Hospitals
Hosted by Dr. Delia Omar, Dr. Enas Hijjih and Dr. Hanan Abu Nema, Ibn
Al-haitham Hospital, Amman, Jordan
Venue: Faculty of Pharmacy/ASU
Date: 12th March 2016
Time: 2:20-4:20
Referring to authentic clinical and pharmacotherapeutic sources is considered crucial for
clinical pharmacy practice in hospitals. Large number of evidence based medicine resources
(books, indices, websites, medical journals search engines, and mobile applications) are
available for use by the clinical pharmacists and medical staff working in the hospital wards.
However, available references vary in the quality, sufficiency, specialty and reliability of
information they provide for along different therapeutic cases. They even differ in the level of
accessibility, ease of use, and searching efficiency.
This workshop aims to show the importance of evidence based medicine in clinical pharmacy
routine practice and decision making. The facilitators, who are professional clinical
pharmacists, will explore the commonly used resources of information in the Pharmacy Care
Unit in Ibn Al-Haytham Hospital in Amman. The trainees will work in groups, and each
group will refer to a different resource of clinical information. Based on the clinical case that
will be presented, participants are going to be asked to take therapeutic decisions supported
by the reference they use. Then participants will prepare formal recommendations based on
their decision. The facilitators and participants will then discuss and compare the decisions
and recommendations made by the different groups, and then decide on the weaknesses and
strengths of the different references used for that specific clinical case.
This workshop is expected to encourage group work in searching for evidence based
medicine. It is also designed to give the chance for the participants to participate in the
discussions about clinical pharmacy practice tools and resources.
39
Workshops
Workshop 2
Diabetes Complication and Patient Care in the MENA Region: an Example
of New Approaches in Palestine
Hosted by Dr. Abdulsalam Alkhayyat, An-Najah University, Palestine
Venue: Faculty of Pharmacy/ASU
Date: 12th March 2016
Time: 2:20-4:20
This workshop aims to inform participants about the complications that the diabetic patients
usually have, and the challenges that face the healthcare professionals in providing the
optimum care to this group of patients. The Middle East and North Africa (MENA) region is
considered as a hotspot for diabetes mellitus (DM) due to the high and increasing number of
diabetic patients. A considerably high percentage of these patients do suffer from DM
complications. Based on a research that was carried out in Palestine, the workshop will use
the surveillance materials and epidemiological tools to create a model of care for diabetic
patients in the MENA region, and hopefully globally. Participants are expected to be familiar
with diabetes as a chronic disease with long-term complications and morbidities.
40
Workshops
Workshop 3
Medication Errors in Hospitals: An Interprofessional Approach to
overcome the problem
Hosted by Nursing Faculty, Applied Science University, Jordan
Venue: Faculty of Pharmacy/ASU
Date: 13th March 2016
Time: 11:30-1:30
Medication error are "Any preventable event that may cause or lead to inappropriate
medication use or patient harm, while the medication is in the control of the health care
professional, patient, or consumer. Such events may be related to professional practice, health
care products, procedures, and systems including prescribing, order communication, product
labeling, packaging, and nomenclature, compounding, dispensing, distribution,
administration, education; monitoring, and use." Medication errors in the Middle East are
high, ranging between 7.1 % to 90.5 %.
Medication errors are classified into five stages according to where they occur in the
medication use process: prescribing, transcription, dispensing, administration, and
monitoring.
It is important to classify medication errors. It helps the health care system to determine the
occurrence and severity of errors, and to develop measures that improve the medication use
process and minimize the incidence of medication errors.
This workshop will provide knowledge and skills on how to identify, classify and prevent
medication errors happening in Jordanian hospitals
41
Workshops
Workshop 4
Professional Ethics: Basic Principles and a Tool Kit to Practice Ethically
Hosted by Dr. Nadir Kheir, Qatar University, Qatar
Venue: Faculty of Pharmacy/ASU
Date: 13th March 2016
Time: 2:30-4:30
Aim:
To provide participants with the foundational knowledge that would allow them to
demonstrate understanding of the ethical principles in general, recognize ethical dilemmas,
and apply a structured decision‐making process to resolve ethical dilemmas.
Learning Outcomes:
By the conclusion of this workshop, participants will be able to:
1. Explain some ethical terms and provide example to demonstrate.
2. Discuss a number of ethical decision‐making systems and provide critical views about each
of them.
3. Explain the steps involved in ethical reasoning and the ethical decision‐making process.
4. Apply the steps of the ethical decision‐making process in situations involving ethical
dilemmas.
Workshop style: Interactive and hands on
Workshop content:
1. Background information about ethics: definitions; relevance, why learn ethics
2. Ethical principles
3. Professional Ethics
4. Resolving ethical dilemmas
5. Discussing cases involving ethical dilemmas
42
Workshops
Workshop 5
Application in Pharmacy Education
Hosted by Dr. Betty Chaar, Dr. Rebeka Moles and Dr. Dalia Bajes, Sydney
University, Australia
Venue: Faculty of Pharmacy/ASU
Date: 13th March 2016
Time: 1:30-4:30
In the Arab region, asthma prevalence is increasing at an alarming rate and remains a major
challenge. In managing asthma optimally, healthcare providers including pharmacists must
optimize therapy and advice on lifestyle changes to reduce morbidity and mortality. In
Jordan, prevalence of asthma has doubled over the past decade and is on the rise.
As pharmacy students and pharmacists, we are educated on asthma medications and asthma
management protocols. However, are we able to put our knowledge to practice and perform
asthma first aid on an adult or child if experiencing a severe asthma attack?
In this comprehensive workshop, students will learn how to manage a severe asthma attack
following Asthma Australia guidelines. They will be able to put their knowledge to practice
by applying what they have learned to “simulated” patient case scenarios followed by
feedback and group-based discussion.
Objectives:
At the completion of this workshop, students will:
Receive up to date asthma first aid training.
Be exposed to two different methods of learning and given an opportunity to ascertain
which way they like to be taught.
43
Posters Abstracts
Posters Abstracts
44
Posters Abstracts
Poster Evaluation Committee
45
Posters Abstracts
Overuse of Proton Pump Inhibitors among Medically Hospitalized and
Intensive Care Unit Patients
Author: Needa Zalloum
Co-Authors: Rana Abu Farha, Oriana Awwad, Nabil Samara
Author’s Organization: The University of Jordan, Amman, Jordan.
Abstract
Background: The main Purpose of this study was to evaluate the current prescription
patterns and appropriateness of proton pump inhibitors (PPIs) to determine their overuse rate
among Jordanian population admitted to hospitals.
Methods: One hundred ninety three patients (ICU and non-ICU patients) who were receiving
PPIs prescriptions as part of their drug regimen during their hospitalization have been
recruited. The appropriateness of PPIs and the rationale for their prescription as a treatment
or prevention therapy was evaluated according to the recent treatment guidelines.
Results: Results showed that PPIs are currently being overused; only 53 patients (27.5%)
have been received PPIs for correct valid indication while the remaining 140 patients (72.5%)
have been prescribed and overused PPIs without a documented valid indications. By
comparing patients according to their site of care, 52.4% (43/82) of ICU patients compared to
87.4% (97/111) of medically hospitalized patient (non-ICU) were found to receive PPIs for
no valid medical indication (P-value = 0.000).
Conclusion: Adherence tocurrent practice guidelines for safe prescription of PPIs was poor.
Thus updating physicians on practice guidelines, inclusion of a clinical pharmacist in making
therapy decisions and modifying hospital formularies are the most urgent recommendations
to improve healthcare systems in the region.
46
Posters Abstracts
Medication Errors in Voluntary Reported Incidents at Jordan University
Hospital
Author: Khawla Abu Hammour
Co-Author: Mariam Abdel Jalil
Author’s Organization: The University of Jordan, Amman, Jordan.
Abstract
Background: Appropriate error reporting systems are the cornerstone of any plan designed
to enhance patient safety*. This study will assess the prevalence, origin, type, and severity of
reported medication incidents at Jordan University Hospital, utilizing a voluntary non-
punitive reporting system.
Methods: The present study is of a retrospective design. All voluntary non-punitive incident
reports that occurred between January/2014 to March/2015 at Jordan University Hospital
were retrieved from the quality department of the hospital. Detailed content analysis was
conducted to obtain all relevant information. Data were coded anonymously and analyzed
using SPSS version 20.
Results: There was an increase in reporting of medication errors overtime and almost all of
the reporters were nurses. A total of 58 medication error reports including 86 medications
were related to errors in medication management process starting from prescribing,
dispensing to administration of medications. Two-thirds of those reports originated from the
internal medicine department and the neonatal intensive care unit. The most common drug
classes associated with those reports, anti-infectives, cardiovascular and chemotherapy
agents. The majority of errors occurred during the administration phase where missed doses
and wrong time accounted for more than 52% of the reported incidents. Around 98.8% of
reported incidents did not cause major harm to patients.
Conclusion: A low number of medication errors were reported in multiple hospital
departments that increased overtime utilizing the non-punitive system of reporting.
Additional research is required to identify possible improvements to optimize and encourage
reporting in addition to enhancing the response to each report.
47
Posters Abstracts
The Use and Safety of Medications Known to Affect Driving in Jordan: A
Cross-Sectional Study
Author: Eman Elayeh
Co-Authors: Nailya Bulatova, Iman Basheti, Rana AbuFarha, Nasser Al-Rawi, Ahmad
Abu Snaineh, Ibrahim Alahwal
Author’s Organization: University of Jordan, Amman, Jordan
Abstract
Background: The aim of this study was to estimate the main driving-impairing medications
used by drivers in Jordan, the reported frequency of medication side effects, the frequency of
motor vehicle crashes (MVCs) while using driving-impairing medicines, as well as factors
associated with MVCs.
Methods: A cross-sectional study involving 1,049 individuals (age 18-75 years) who are
actively driving vehicles and taking at least one medication known to
affect driving (anxiolytics, antidepressants, hypnotics, antiepileptics, opioids, sedating
antihistamines, hypoglycemic agents, antihypertensives, central nervous system [CNS]
stimulants, and herbals with CNS-related effects) was conducted in Amman, Jordan, over a
period of 8 months (September 2013-May 2014) using a structured validated questionnaire.
Results: Sixty-three percent of participants noticed a link between a medicine taken and
feeling sleepy and 57% stated that they experience at least one adverse effect other than
sleepiness from their medication. About 22% of the participants reported having a MVC
while on medication. Multiple logistic regression analysis showed that among the
participants who reported having a crash while taking a driving-impairing medication, the
odds ratios were significantly higher for the use of inhalant substance (odds ratio [OR] =
2.787, P = .014), having chronic conditions (OR = 1.869, P = .001), and use of antiepileptic
medications (OR = 2.348, P = .008) and significantly lower for the use of antihypertensives
(OR = 0.533, P = .008).
Conclusion: The study results show high prevalence of adverse effects of medications with
potential for driving impairment, including involvement in MVCs. Our findings highlight the
types of patient-related and medication-related factors associated with MVCs in Jordan, such
as inhalant use, presence of chronic conditions, and use of antiepileptics.
48
Posters Abstracts
Terminalia bellirica Stimulates the Secretion and Action of Insulin and
Inhibits Starch Digestion and Protein Glycation in vitro
Author: Kasabri V
Co-Authors: Flatt PR, Abdel-Wahab YH
Author’s Organization: University of Jordan, Amman, Jordan
Abstract
Background: Traditional plant treatments have been used throughout the world for the
therapy of diabetes mellitus. The aim of the present study was to investigate the efficacy and
mode of action of Terminalia bellirica used traditionally for the treatment of diabetes in
India.
Methods: In vitro cellular, enzymatic and cell-free based bioassays were recruited.
Results: T. bellirica aqueous extract stimulated basal insulin output and potentiated glucose-
stimulated insulin secretion concentration-dependently in the clonal pancreatic beta-cell line,
BRIN-BD11 (P < 0.001). The insulin-secretory activity of the plant extract was abolished in
the absence of extracellular Ca2+ and by inhibitors of cellular Ca2+ uptake, diazoxide and
verapamil (P < 0.001; n 8). Furthermore, the extract did not increase insulin secretion in
depolarized cells and did not further augment insulin secretion triggered by tolbutamide or
glibenclamide. T. bellirica extract also displayed insulin-mimetic activity and enhanced
insulin-stimulated glucose uptake in 3T3-L1 adipocytes by 300 %. At higher concentrations,
the extract also produced a 10-50 % (P < 0.001) decrease in starch digestion in vitro and
inhibited protein glycation (P < 0.001).
Conclusions: The present study has revealed that water soluble components in T. bellirica
extract stimulate insulin secretion, enhance insulin action and inhibit both protein glycation
and starch digestion. The former actions are dependent on the active principle(s) in the plant
being absorbed intact. Future work assessing the use of T. bellirica as a dietary adjunct or as
a source of active anti-diabetic agents may provide new opportunities for the treatment of
diabetes.
49
Posters Abstracts
Hospital Based Pharmacists’ Attitudes towards off-label Pediatric
Prescribing in Jordan
Author: Amani Aburjei
Co-Authors: Karem Zoubi, Tareq Mukattash
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
With growing responsibility of the pharmacists in ensuring public health and safe medicine
use, an understanding of the issues surrounding off-label prescribing is crucial to allow
pharmacists to make informed decisions about such practice. The aim of this study is to
assess the experience with and attitudes, concerns towards pediatric off-label prescribing of
hospital based pharmacists.
A questionnaire survey was administered to 250 randomly selected hospital pharmacists. One
hundred and fifty (150) completed questionnaires were returned.
Less than half the respondents (44%, n=66) admitted to being familiar with the concept of
off-label prescribing, primarily through dispensing experience rather than education. The
most common reasons given by respondents for a dispensed prescription being off label were
younger age than recommended (86.6%, n= 130), and higher than (64%, n=96) or lower than
(38%, n=57) recommended dose. Lack of dosage data (74%, n= 111), risk of side-effect
(40%, n=60) and lack of clinical trials data (32%, n= 48) were recognized as major areas of
concern for pharmacists when dispensing pediatric off-label medicines. More than half of
respondents (58%, n=87) believed that the lack of appropriate formulations or the lack of
efficacy data were of concern.
50
Posters Abstracts
Integrative Literature Review: Prevention of Oral Mucositis among
Pediatric Patients with Cancer
Author: Nijmeh al-atiyyat
Co-Authors: Aseel Aljundi
Author’s Organization: The Hashemite University, Azarqa, Jordan
Abstract
Background: oral mucositis among pediatric oncology patients with cancer still to be
one of the most common side effect of chemotherapy, affecting many of the child life
aspects. Purpose: to clarify the importance of regular nurses assessment role in
improving outcome within cancer pediatric patients suffering from oral mucositis.
Methods: articles used were identified in the electronic database CINAHIL- EBISCO
published between 2008 – 2015, using the following key words or combination terms
such as: oral, mucositis, oral mucositis in pediatric, pediatric cancer, pediatric oncology,
pediatric chemotherapy, prevention of oral mucositis, stomatitis. The sample size ranges
between 26 up to 337 pediatric patients, ages ranges between 1 to 18 years old. All of
the sample participants have received chemotherapy as a treatment.
Results: there was a general senses that the oral mucositis among pediatric patient is a
common complication caused by chemotherapy that differs in severity, it is painful,
annoying, affecting the life quality. Frequent assessment and following up is the
bottom line to prevent and to reduce the incidence of oral mucositis.
Conclusion: we can inferred from the reviewed literature that oral mucositis is
inevitable complication among pediatric patient who receiving the chemotherapy as a
part of their treatment plan. In the contrary there is a good inverse relationship
between the onset of oral mucositis and frequent oral assessment. Nursing in the
different clinical sittings are highly recommended to make oral assessment as an
essential part of their daily physical assessment. Researchers are highly recommended
also to investigate more about any potential benefits or interventions that might be
provided through nursing practicing.
51
Posters Abstracts
Parental Attitudes toward Medicine Use in Children in Jordan
Author: Nuha Al.Ghzawi
Co-Authors: Khawla Nuseir, Tareq Mukattash
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
Recently, there have been growing concerns regarding the use of medicines in children
among both researchers and parents; who are considered the children’s responsible
caregivers. Therefore, many strategies were implemented to improve such use and make safe
and effective medicines more available for children. Among these strategies, enhancing the
interaction between parents and health care providers plays an important role in insuring the
proper use of medicines. In order to optimize such interaction, the attitudes, beliefs and
practices of parents toward medicine use in children need to be explored, which is the main
objective of this study. In addition to exploring parental attitudes, this study also aims to
increase the awareness of Jordanian parents about the appropriate use of medicines in
children. A questionnaire was administered through face to face interviews to 1000 parents
attending with their children pediatric outpatient clinics in Amman and Irbid in order to
investigate their attitudes toward children's medicines. Results have shown that 83.2% of the
participants were mothers. The majority of the participants fall in the age category 30 to 39
years and had either a college or a university degree. Of the participants, 84.4% agreed that
medicines are necessary in treating illnesses, 80% of the parents had worries about the side
effects and interactions of medicines, and 60% of the parents try to avoid giving medicines to
their children. Moreover, parents in this study varied considerably in their views toward
prescription and over-the-counter medicines and a large proportion of the parents had
negative attitudes toward analgesics. More than half of the participants (55.2%) declared that
doctors in Jordan prescribe antibiotics to children too easily.
52
Posters Abstracts
Epidural Analgesia and its Impact on Maternal and Neonatal Outcomes: A
Jordanian
Author: Reem Ahmad Ali
Co-Authors: Reem Hatamleh, Amira Elian
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
Background: Epidural Analgesia (EA) is a central nerve block technique that blocks the
transmission of painful stimuli from the contracting uterus and birth canal to control labour
pain. It’s generally a safe method, though evidence shows that it's not as safe as it was
thought to be and it has negative impact on mothers and babies.
Methods: A descriptive-comparative design was used to assess the rate of using EA during
birth in the north of Jordan and to examine maternal and neonatal outcomes when EA is
used. These outcomes including method of delivery, length of second stage of labour,
maternal complications, newborn’s Apgar scores, Naloxone administration, meconium
staining of liquor, and newborn’s admissions to neonatal intensive care unit. Medical files
were reviewed for all primigravida & primipara mothers with low risk pregnancies (N=414)
who gave births in King Abdullah University Hospital between October 2013 to the end of
September 2014.
Results: EA use was 35.8% for all deliveries (3228 women) during study period, and for the
study subjects was 52%. Significant associations were found between EA use and the
increased rate of instrumental deliveries, prolonged second stage of labour, & maternal
complication. Using Fentanyl & Marcaine was associated with maternal hypotension, fever
and post-partum hemorrhage.
Conclusion: The rate of EA use is high comparing to rates in the Middle East and
worldwide. It is recommended to weigh benefits and indications against risks when using EA
to ensure safety of mothers and their babies.
53
Posters Abstracts
Measuring the activity of platelet agonists using Multiplate®
Author: Ali Almuqdadi
Co-Authors: Nailya Bulatova, Al-Motassem Yousef
Author’s Organization: The University of Jordan, Amman, Jordan
Abstract
Background: Platelets are responsible for pathogenic thrombi formation in patients with
atherothrombotic disease (Rivera et al., 2009). Platelet aggregation is the most frequent
parameter used to measure platelet function (Yao et al., 1994).
Physiologically, platelet aggregation agonists act in combination, and the use of more than
one agonist simultaneously better reflects the pharmacodynamic effect of compounds that
affect platelets aggregation.
This study was conducted in order to measure the efficacy of several platelets agonists using
Multiplate® that, along with other instruments that use whole blood to measure platelet
aggregation, has not been used before to investigate the effect of weak platelet agonists such
as epinephrine and serotonin.
Methods: Blood was drawn from adult healthy volunteers. Whole blood aggregation was
measured using Multiplate® analyzer that detects platelets aggregation based on impedance
aggregometry principle.
Results: Among platelet agonists, collagen produced the highest (112 U), whereas serotonin
and epinephrine produced the lowest (11 U and 23 U, respectively) platelet aggregation
AUC. Significantly amplified platelet aggregation AUC was observed between serotonin and
epinephrine.
Conclusion: Our study established new practice of using Multiplate® method for
investigating weak platelet agonists such as serotonin and epinephrine. The platelet
aggregation amplification reaction between serotonin and epinephrine could have an
important clinical value.
54
Posters Abstracts
Evaluating Perceptions and Knowledge of Public about Local Generic
Medications in Jordan
Author: Samer Abdeljalil
Tareq Mukattash Author:-Co
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
Background: In recent years the use of generics has markedly improved. Because of lower
manufacturing cost, generics offer a great chance for financial saving in drug expenditure
with maintaining the quality, efficacy and safety. In developing countries, health insurance
companies, health authorities and governments have suffered from pharmaceutical
expenditures that has risen rapidly especially in the Last two decades. Improper or lacking
knowledge about local generics may lead to ineffective and unsafe treatment. This situation
could increase the costs, contrary to expectations; the lack of awareness about generic
medicines was a barrier for using them. The aim of this study is to evaluate awareness and
attitude of Jordanian society toward local generics; in particular, their preferences regarding
the use of generics vs. brand medication, and the reasons for their choices and opinions.
Methods: A cross-sectional survey was conducted, and an adult consumers (aged >18 years)
were recruited. The public opinion questionnaire was “administered” using a structured
interview technique (face to face) in which members of the public were asked questions by a
trained researcher (author). The target sample size was 1,000. This sample size has been
shown in previous surveys of the general public, carried out by the Faculty of Pharmacy at
the Jordan University of Science and Technology, to yield statistically reliable results.
Results: The majority of respondents were confused regarding the quality and safety of local
generics.
Conclusions: The results showed general unawareness on generic medicines. No single
variable was found to be associated with consumers’ knowledge on generic medicines.
55
Posters Abstracts
Students’ Perceptions of Pharmacy as a Specialization and their Future
Career, a Cross Sectional Study of Final Year Pharmacy Students in
Jordan
Author: Tareq Mukattash
Co-Author: Khawla Nuseir, Eman Biltaji
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
Background: This study aimed to establish a baseline understanding of the career
aspirations, motivations and expectations of students within undergraduate pharmacy
education in Jordan and to examine students’ incentives to select pharmacy and how they feel
about their choice as they are approaching graduation.
Methods: A draft survey instrument was designed to collect the required information. The
questionnaire was administered to final year pharmacy students (B.Sc. Pharmacy and
PharmD) at the University of Jordan and the Jordan University of science and Technology.
The questionnaire was administered at the end of all lectures at both universities. Following
data collection, responses were coded and entered into a customized database in SPSS,
version 17, for statistical analyses. Chi-square and Fisher exact tests were used to test for
significant differences between groups
Results: A total of 240 final-year pharmacy students took part in the present study. The
majority of respondents (n=147, 61.3%) indicated that pharmacy was not their first choice of
study at the time of application to universities. More than half (n=138, 57.5%) the
respondents claimed that they were optimistic regarding the future of pharmacy as a
profession. When asked to rank pharmacy among different suggested professions, the
majority of respondents (n=95, 39.58%) ranked pharmacy second after medicine and before
dentistry. The majority of respondents (n=202, 84.17%) thought they had a positive self
image.
Conclusion: Students studying pharmacy seem to have optimistic aspirations of their future
career and a positive image. Further qualitative research is needed to gain more in-depth
understanding of this issue and to create a realistic connection between market needs and
pharmacy education outputs.
56
Posters Abstracts
Off-label antibiotic use in children in Jordan: A descriptive study
Author: Tareq Mukattash
Author’s Organization: Jordan University of Science and Technology, Irbid, Jordan
Abstract
Background: The majority of medicines prescribed for children are prescribed in an off-label
manner. Among all drugs, antibiotics are most frequently prescribed for paediatric patients.
The aim of the present study was to evaluate the use of off-label antibiotics in neonatal
intensive care units (NICUs) and paediatric wards in Jordan.
Methods: Data of patients admitted to the neonatal intensive care units and paediatric wards
in King Abdulla University Hospital were collected over an 8-week survey between May and
July 2012. Data collected in this study included patients’ age, weight, medical history,
diagnosis and the details of antibiotics prescribed to each patient.
Results: The study involved a total of 250 children (80 admitted to the NICU and 170
admitted to the wards). A total of 596 antibiotic prescriptions were issued for these patients
(244 in NICUs and 354 in paediatric wards). The results of the present study showed that off-
label antibiotic prescribing to paediatric patients is very common. Off-label antibiotic
prescribing to paediatric patients is related mostly to doses and indications, and rarely to age.
The majority of admitted patients received at least one off-label antibiotic during their
hospital stay.
Conclusion: This study reveals the high prevalence of off-label use of antibiotic among
paediatric children in Jordan. There is a serious need for robust and continuous educational
programs to improve the awareness of paediatricians of guidelines surrounding the use of
antibiotics in paediatric patients. Furthermore, true collaboration between paediatricians and
clinical pharmacists towards safe and effective antibiotic prescribing in paediatric patients is
crucial.
57
Posters Abstracts
Birth Control Risks for Deep Vein Thrombosis
Author: Sajid Majeed Hameed
Co-Author: Wafa Attoof
Author’s Organization: Iraqi Society of Clinical Oncology, Iraq
Abstract
Background: DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in
body, usually in legs. Deep vein thrombosis can cause leg pain or swelling, but may occur without
any symptoms. Many factors can increase risk (DVT), Birth control pills (oral contraceptives) and
hormone replacement therapy both can increase blood ability to clot. Ultrasound, A wand-like device
(transducer) placed over the part of body where there a clot sends sound waves into the area. Deep
vein thrombosis treatment is aimed at preventing the clot from getting any bigger, as well as
preventing the clot from breaking loose and causing a pulmonary embolism. After that, the goal
becomes reducing chances of deep vein thrombosis happening again. Medications used to treat deep
vein thrombosis include the use of anticoagulants, also sometimes called blood thinners, whenever
possible. These are drugs that decrease blood ability to clot. While they don't break up existing blood
clots, they can prevent clots from getting bigger or reduce risk of developing additional clots. Usually,
first be given a shot or infusion of the blood thinner heparin for a few days. After starting heparin
injections, treatment may be followed by another injectable blood thinner, such as enoxaparin
(Lovenox), Other blood thinners can be given in pill form, such as warfarin (Coumadin).
Case Report: The condition started on 7th of May 2014 where 24 years female patient presented in
emergency department in Baghdad teaching hospital (medical city teaching complex). patient exposed
to the car accident, all investigation done at moment of patient, where within normal limit, abdominal
discomfort, abdominal distention, and infrequent vomiting, ultrasound and Plain abdominal X-ray
show spleen damage, X-Ray and MRI imaging show fractured in tibia eminence, necessitating
immobilization of the right knee, as well as her spleen removed, patient a good recovery from the
surgery, patient no longer taking pain medication but has continued her oral contraceptives. Two
weeks later he started to complain right calf is reddish in color (erythematous) and warm to the touch.
It is visibly swollen. The left calf is normal in appearance and without pain. An Doppler ultrasound is
request to determination problems, diagnosed as deep venous thrombosis (DVT), and start heparin
therapy.
Conclusions: Birth control pills (oral contraceptives) and hormone replacement therapy both can
increase blood ability to clot, also bed rest in long time period risk factor increase incidence DVT
58
Posters Abstracts
The Correlation between Serum Levels of Oxytocin (OXT) and
Betatrophin in Type 2 Diabetes Mellitus (T2DM) Patients with Metabolic
Syndrome (MS) in Jordan: a Cross Sectional Study
Author: Amani Al-Rawashdeh
Co-Authors: Violet Kasabri, Nailya Bulatova
Author’s Organization: The University of Jordan, Amman, Jordan
Abstract
Background: Oxytocin (OXT) has been implicated as a novel therapeutic strategy of diabetes and
obesity, reversing and/or preventing their complications. It could as well regulate appetite and energy
intake. Also, betatrophin is an adipokine/hepatokine that regulates lipid metabolism and promotes
pancreatic β-cell proliferation. However, it is not investigated yet whether OXT is correlated with
circulating levels of betatrophin in metabolic syndrome-type 2 diabetes (MS-T2DM) patients.
Methods: The aim of current study was to assess correlations between plasma betatrophin and OXT
levels in MS-diabetic (N=89) as compared to MS-non-diabetic (BMI- and age-matched; N=69)
patients. Competitive binding enzyme-linked immunosorbent assay was recruited to evaluate
betatrophin and OXT plasma concentrations. Correlations of the above biomarkers and patient clinical
characteristics such as fasting glycemia, HbA1c, blood lipids, blood pressure, body mass index and
waist circumference were also detected.
Results: As compared to the control MS participants (mean±SD; 0.32±0.25 ng/mL); betatrophin
plasma levels were increased (P<0.001) by more than four folds (P<0.001) in the MS-T2DM patients
(1.23±0.68 ng/mL). OXT concentrations, nevertheless, were decreased (P<0.001) in the MS-T2DM
patients (1222.46±514.55 pg/mL) as compared to the MS control subjects (2323.42±848.68 pg/mL).
OXT secretion was negatively correlated with betatrophin levels in the total sample (Spearman
correlation coefficient rs= -0.492, P=0.000). In the total sample, betatrophin plasma levels were
positively correlated with HbA1c and fasting glycemia (P<0.001 for both), but OXT levels were
inversely correlated with HbA1c and fasting plasma sugar (P<0.001 for both). Highly unlikely but
still, no such correlations were found in either study arm.
Conclusion: Betatrophin, is increased in MS-T2DM; unlike the OXT that is decreased in MS-T2DM.
We found an inverse correlation between the levels of the two biomarkers in addition to correlation
between their levels and the degree of glycemic control. Our data may have potential implementation
in the development of new agents for the management of MS.
59
Posters Abstracts
Baseline Characteristics and Response to Ticagrelor among Jordanian
Patients with Acute Coronary Syndrome: A Cross Sectional Study
Author: Mohammad Matarneh
Co-Author: Al-Motassem Yousef
Author’s Organization: The University of Jordan, Amman, Jordan
Abstract
Background: Ticagrelor is a representative of a new chemical drug class which inhibits
P2Y12 receptors of platelets in reversiblenon competitively way. “Variability of response” or
“resistance” to antiplatelet drugs is of remarkable importance. This study aimed to examine
the variability in anti-platelet effect of ticagrelor in Acute Coronary Syndrome (ACS)
patients.
Methods: A cross sectional study included 34 individuals aimed to quantify the extent of
variability in platelet aggregation response after 6 weeks of starting ticagrelor, platelet
aggregation inhibition was tested using (Multiplate®) whole blood was measured using
different ADP concentrations (5 µM, 20 µM). Parameters calculated were aggregation,
velocity, and area under the curve (AUC).
Results: There were 2 patients considered to have high on treatment platelet reactivity
(HTPR), 6 patients were at risk of bleeding, and 24 patients had optimum response at 20 µM
ADP where at 5 µM ADP 15 patients were considered at higher risk for bleeding, 18 patients
were having optimum response, and no patient were considered at HTPR. For hypertension
patients AUC reading was almost significantly higher at 5 µM ADP (22.4 + 8.1 vs. 15.5 +
10.6, P=0.07), and significantly higher compared to non-hypertensive patients at 20 µM ADP
(30.4 + 9 vs. 20.6 + 9.6, P= 0.008).
Conclusion: Ticagrelor decrease platelet aggregation effectively, which is reflected by low
on-treatment platelet reactivity, increases the risk of major bleeding events. Therefore,
cardiologists might be facing a new challenge in the future: to individualize the level of
platelet inhibition in order to decrease thrombotic events without increasing bleeding.
60
Posters Abstracts
Cost of Antimicrobial Therapy: Review of Price of Antimicrobial Therapy
Obtained Through Different Methods of Purchase in Royal Medical
Services (Years 2010, 2012)
Author: Mohamad Al-Ali
Co-Author: Abla Albsoul-Younes, Mayyada Wazaify
Author’s Organization: The University of Jordan, Amman, Jordan
Abstract
Background: Jordan Royal Medical Services (JRMS) along with the Ministry of Health
(MoH) are considered as the two major public health authorities that finance as well as
deliver health care in Jordan. This study aimed to compare prices of antimicrobial therapy at
JRMS main tenders for the years (2010 and 2012) and between each main tender with its
related sub procures, as well as to compare delay of delivery times between the two main
tenders.
Methods: Defined daily dose (DDD) methodology was used for all price comparisons, and
the percentage of delayed items, average delay times were used in delivery time comparisons.
Results: Assuming that the same quantities purchased in 2010 will be purchased in 2012,
estimated saving achieved by 2012 main tender was 30%. In the case of 2010 tender , the
related sub procures resulted in saving more than 30 thousands JD, but in case of 2012 tender,
it resulted in an extra cost of more than 31 thousand JD.
For 2010 tender, the percentage of delayed items was (28.74%) and the average delay time
was (58.92 days), but for 2012 tender they were (43.18%) and (77.289 days) respectively.
Conclusion: The study concluded that JRMS procurement system for antimicrobial therapy
is satisfactory, but it recommends to restrict this type of purchase through the central
procurement branch, decrease the extra tenders, decrease period for achieving main tenders,
encourage estimating the needed quantities carefully, the negotiations on prices and finally
the participation of local manufacturing companies.
61
Posters Abstracts
Technology and the Prevention of Medication Errors
Author: Ruba Haddadin
Co-Authors: Mohammad Alsadi, Zeid Abu Ghosh
Author’s Organization: Electronic Health Solutions, Amman, Jordan
Abstract
Introduction: A medication error is “any preventable event that may cause or lead to
inappropriate medication use or patient harm while the medication is in the control of the
health care professional, patient, or consumer”. As part of the report “To Err Is Human”, the
Institute of Medicine (IOM) estimated that in the United States, 7,000 deaths a year are due to
preventable medication errors. The high cost of medication errors is alarming. In the United
States alone, it is estimated that inpatient preventable medication errors cost approximately
$16.4 billion annually while outpatient preventable medication errors cost approximately $4.2
billion annually.
Why Do Medication Errors Occur? Medication errors occur for a number of reasons.
(33%) of preventable medication errors result from dosing errors, while (11%) result from
drug allergies or harmful drug interactions. Medication errors may occur at any stage of a
patient’s journey through a healthcare system. Errors may occur during admissions (22%),
transitions in care (66%), and even during discharge (12%). In pharmacies where the majority
of medications are dispensed, the high volume of medication transactions leads to medication
errors. It is estimated that approximately 100 undetected dispensing errors can occur each day
at any one pharmacy location. Fragmentation of care is considered to be one of the main
reasons for medication errors.
Technology as a Proposed Solution: EHRs offer an excellent platform to allow such
multidisciplinary collaborative efforts, ultimately reducing medication errors. These systems
often have built-in decision support tools that automatically check for duplicate orders or
incorrect medication doses. They also provide alerts to let the prescriber know that a dose is
too high or may interact with other medications, or highlight the latest clinical guidelines to
improve evidence-based treatment. One study reported that the use of EHR systems reduced
medication errors by up to 85%.
In Jordan: Jordan’s nationwide EHR ‘Hakeem®’ is currently implemented at more than 15
hospitals, 21 comprehensive clinics and 49 primary clinics. At the sites where Hakeem
® is
implemented, physicians are able to order medications and various patient care orders
electronically. Pharmacists are also supported with a system that provides alerts in case of
drug duplication, interaction or allergy. A study of BCMA implementation in an academic
medical center demonstrated a 41.1% relative reduction in non-timing errors in medication
administration, resulting in a 50.8% relative reduction in potential adverse drug events due to
such errors.
Conclusion: The use of electronic health record systems offers a promising solution to
reduce medication errors locally and internationally, ultimately improving patient safety as
patients’ transition through the multiple parts of a healthcare system.
62
Posters Abstracts
Medication Reconciliation and Patient Counseling “An Evidence-Based
Approach to Counseling Helps Patients to Adhere to their Medications”
Author: Lama A. Al-Rashdan
Co-Author: Abdulla Malkawi
Author’s Organization: Princess Badee’a Hospital, Irbid, Jordan.
Abstract
Background: This improvement work was done in Princess Badee’a Hospital. The whole
medical staff was involved in this work; physicians, nurses and pharmacists, discharge
planners, and others representing areas of focus. Our aim is to enhance patient care and
improve medication utilization.
Methods: Once medication lists have been obtained, verified with patients and other sources
if needed, and documented within the medical record, this information can then be compared
with medications ordered during the episode of care to identify unintended discrepancies,
potential drug interactions, and contraindications. Upon discharge, medications administered
during the episode of care are then compared to the patient’s pre-admission list, and the
patient’s list is then updated to reflect any changes.
Results: The effects of our changes were significant. Patients were involved effectively in the
health care process, the patient’s compliance increased, patients feel as partners to medical
practitioners, risks of medication omission, duplication and interaction were reduced
significantly.
Maintaining an efficient medication reconciliation process for patient safety in every facility
is at the forefront of national patient safety goals and initiatives.
Conclusions: Medication errors are common and often occur when patients move between
healthcare settings. At least one in six patients may have a clinically significant medication
discrepancy on transfer within a hospital. A sound medication reconciliation process must
involve all caregiver disciplines, must be integrated into their daily workflow, and must have
the support of facility leadership to be successful. The process of medication reconciliation
can significantly decrease errors. It involves obtaining, verifying and documenting a list of
the patient's current medicines and comparing this list to the medication orders and the
patient's condition to identify and resolve any discrepancies. Medication reconciliation is an
important element of patient safety.
63
Posters Abstracts
Associations between Patient Factors and Medication Adherence: A
Jordanian Experience
Author: Iman Basheti
Co-Authors: Saqf el Hait S, Qunaibi EA, Aburuz S, Nailya Bulatova
Author’s Organization: Applied Science University, Amman, Jordan.
Abstract
Background: To explore the effect of patient characteristics and health beliefs on their
medication adherence.
Methods: Patients (n=167) with chronic conditions (mean age 58.9 ± 13.54, 53 % males)
were recruited from March 2009- to March 2010 using a cross sectional study design. Data
collected included patients’ demographics, medical conditions, medications therapeutic
regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to
medications was assessed by the researcher using a validated and published scale. Treatment
related problems (TRPs) were evaluated for each patient by competent clinical pharmacists.
Associations between patient characteristics/health beliefs with adherence were explored.
Results: About half of the patients (46.1%) were non-adherent. A significant association was
found between lower adherence and higher number of disease states (p<0.001), higher
number of medications (p=0.001), and higher number of identified TRPs (p = 0.003). Patient
adherence was positively affected by older age, higher educational level, and higher number
of physician visits per month, while it was negatively affected by reporting difficulties with
getting prescription refills on time.
Conclusion: This study identified different factors that may negatively affect adherence,
including higher number of medications and disease states, higher number of identified TRPs
and inability to getting prescription refills on time. Hence, more care needs to be provided to
patients with complex therapeutic regimens in order to enhance adherence.
64
Posters Abstracts
Associations between Inhaler Technique and Asthma Control amongst
Asthmatics Using pMDIs and DPIs
Author: Iman Basheti
Co-Authors: Obeidat NM, Ammari WG, Reddel HK
Author’s Organization: Applied Science University, Amman, Jordan.
Abstract
Background: To investigate associations between technique with pressurized metered-dose
inhalers (pMDI) and dry powder inhalers (DPI) used as controller medication and asthma
control variables (Asthma Control Test (ACT) scores).
Methods: In this cross-sectional study, inhaler technique of asthmatics using pMDIs or DPIs
(Turbuhaler (TH) and Accuhaler [Diskus] (ACC)), were assessed against published inhaler
technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma
control) were assessed.
Results: 130 subjects were enrolled into the study (41 TH, 54 ACC, and 35 pMDI). Inhaler
technique scores (out of 9 for all devices) were low for TH (4.4±0.9) and ACC (5.4±1.0)
compared with pMDI (8.1±0.9) (p<0.001, One way ANOVA). Older age and use of pMDI
were associated with better inhaler technique. ACT scores (mean±SD) were low, consistent
with very poorly-controlled asthma (TH:13.1±3.9, ACC:13.3±3.9 and pMDI:12.8±4.2). No
significant association between inhaler technique scores and ACT scores was found. More
recent asthma diagnosis, and a higher level of education were associated with higher ACT
scores (better asthma control).
Conclusion: Asthma control was poor in this population. Lack of a significant association
between inhaler technique score and asthma control may reflect the multiple factors
contributing to poor asthma control in the Jordanian population.
65
Advertisement
66
Advertisements
www.asuconf.org
Recommended