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  1. Kubas MA, Halboup AM
    Int J Clin Pharm, 2020 Feb;42(1):51-56.
    PMID: 31713107 DOI: 10.1007/s11096-019-00936-x
    Background Studies have revealed that the inclusion of a clinical pharmacist as a member in multidisciplinary medical team has been associated with improved medication use, reduced adverse drug reaction, reduced cost of treatment, and improved health outcomes. Objective The objectives of this study were to evaluate the implementation of clinical pharmacy recommendations and services, the acceptance rate by the physicians, and the anticipated outcomes of the recommendations at a hospital in Yemen. Methods Different units of the University of Science and Technology Hospital, Sana'a were included in this study. All the recommendations and services provided by the clinical pharmacist during daily activities were documented between June 2013 and November 2015. The provided recommendations were classified based on the type, acceptance rate, and the anticipated outcomes. Main outcome measure Type and quality of clinical pharmacists' recommendations, anticipated impact of the recommendations on health outcomes, and their acceptance rate. Results Throughout the study period, a total of 957 patients in different hospital units were visited and provided with a total of 3307 interventions and services. The most frequent types of clinical pharmacist's interventions were drug discontinuation (23.6%, n = 782), inappropriate dose interval or time (n = 735, 22.2%), and add medication (18.9%, n = 626). Overall, 61.8% (n = 2044) of the provided recommendations were accepted by the physicians. The most anticipated outcomes were improved the effectiveness of therapy (45.1%, n = 1909), avoid adverse drug reactions (29%, n = 1228), and decrease the cost of medications (18.8%, n = 797). Conclusion Clinical pharmacist's recommendations resulted in improving drug therapy and decreasing adverse effects for inpatients at the University of Science and Technology Hospital. This suggests that the implementation of clinical pharmacy services is essential and has a positive outcome on patient care.
  2. Sallom H, Abdi A, Halboup AM, Başgut B
    BMC Public Health, 2023 Jul 17;23(1):1364.
    PMID: 37461105 DOI: 10.1186/s12889-023-16199-1
    INTRODUCTION: Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient's safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe.

    OBJECTIVE: The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations.

    METHOD: The Arkesy and O'Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research.

    RESULTS: There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year.

    CONCLUSION: Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.

  3. Abu-Farha R, Alzoubi KH, Abu Assab M, Awwad O, Gharaibeh L, Mukattash TL, et al.
    Patient Prefer Adherence, 2023;17:2131-2140.
    PMID: 37650044 DOI: 10.2147/PPA.S428470
    OBJECTIVE: This research aimed to explore how telepharmacy is perceived, whether it would be willingly used by the overall population in Jordan, and the associated socioeconomic disparities that might affect its acceptance.

    METHODS: This is a survey-based cross-sectional study involving the general public of Jordan. The study took place in various Jordanian cities from May 2nd to June 1st, 2023. Using Google forms, the questionnaire was shared through various social media channels (such as Facebook and WhatsApp).

    RESULTS: The questionnaire received responses from 800 participants. The data showed that a sizable portion of the Jordanian population were unaware of telepharmacy (n= 343, 42.9%), and a majority had never utilized it (n= 131, 16.4%). The participants viewed the main advantage of telepharmacy as minimizing unnecessary trips to pharmacies (n= 668, 83.5%) and reducing travel time and expenses (n= 632, 79.0%). However, the primary concern was the mental effort required to use this service (n= 465, 58.1%). Of the respondents, 61.3% (n= 490) indicated a willingness to adopt telepharmacy services in the future. Regression analysis indicated that men were more likely to use this service compared to women (OR= 1.947, p<0.001), and people living in northern and southern Jordan exhibited a greater willingness compared to those inhabiting the central region (OR= 2.168, p<0.001).

    CONCLUSION: The results reveal a positive attitude towards and a significant readiness to embrace telepharmacy among the Jordanian population. However, for broader acceptance and utilization, apprehensions regarding the service need to be addressed. Doing so could improve access to pharmaceutical care, particularly for patients living in far-flung areas of Jordan.

  4. Ahmed WS, Halboup AM, Alshargabi A, Al-Mohamadi A, Al-Ashbat YK, Al-Jamei S
    Confl Health, 2024 Apr 03;18(1):26.
    PMID: 38566200 DOI: 10.1186/s13031-024-00590-9
    BACKGROUND: Despite the increased recommendations for influenza vaccination, particularly among high-risk groups such as young children, Yemen lacks an influenza vaccination program, and the influenza vaccine is not included in the national immunization regime. This is exacerbated by the country's fragile infrastructure, as well as the devastating consequences of the ongoing conflict, which include child undernutrition and strained healthcare resources. Thus, the objective of the current study is to assess the public attitudes and perceptions toward vaccinating children against influenza in Yemen.

    METHODS: A cross-sectional study was conducted by distributing a validated survey questionnaire to potential participants using convenience sampling. Descriptive statistics were used to summarize sociodemographic data, knowledge of influenza vaccines, and attitudes and perceptions regarding vaccinating children against influenza. Logistic regression analysis was employed to identify associations between independent variables and the acceptance of vaccines for children.

    RESULTS: A total of 853 eligible individuals, parents and non-parents, successfully completed the survey. The uptake of the influenza vaccine among the participants was notably low as the majority (69.2%) had not previously received the vaccine, although the majority expressed a willingness to get vaccinated in the future (59.4%). The majority (68.5%) were willing to vaccinate children. The largest percentage of the participants who expressed hesitancy toward children's vaccination cited multiple reasons to reject the vaccine (39.7%), with concerns regarding the safety of the vaccine being the predominant barrier to its acceptance for children (29.6%). On the other hand, motivating factors for vaccinating children included the validation of the vaccine's safety and efficacy, endorsement of the vaccine by the government and physicians, integration of the vaccine into the national immunization program, and the provision of the vaccine free of charge and through schools. Significant predictors for vaccine acceptance in children included male gender, knowledge of the protective effect of the influenza vaccine, previous receipt of the vaccine, and a willingness to receive the vaccine in the future.

    CONCLUSIONS: The study highlights the need for educational health campaigns to raise awareness and remove misconceptions regarding influenza and the role, benefits, and availability of its vaccine. These findings can serve as a robust foundation for the future design and implementation of an influenza vaccination program for children in Yemen.

  5. Halboup AM, Alzoubi KH, Khabour OF, Alomari MA, Refat M, Al-Khazzan AY, et al.
    J Multidiscip Healthc, 2023;16:707-716.
    PMID: 36938485 DOI: 10.2147/JMDH.S399405
    BACKGROUND: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen.

    METHODS: This was a cross-sectional study of the public in Yemen. The relationship between participants' sociodemographic factors and their responses was assessed by the chi-square test.

    RESULTS: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants' perceptions regarding the nature of the virus and susceptibility to severe disease.

    CONCLUSION: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.

  6. Alkubati SA, Al-Sayaghi KM, Salameh B, Halboup AM, Ahmed WAM, J Alkuwaisi M, et al.
    J Multidiscip Healthc, 2024;17:689-699.
    PMID: 38370607 DOI: 10.2147/JMDH.S452935
    BACKGROUND: Depression has a negative impact on the health outcomes of hemodialysis (HD) patients, including decreased quality of life and increased morbidity and mortality rates. Therefore, this study aimed to determine the prevalence of depression and its associated factors among HD patients in Hodeida city, Yemen.

    METHODS: A cross-sectional study involving 200 HD patients at the Dialysis Center in Hodeida was conducted from February to May 2022. Data on depression were collected using the 9-item Patient Health Questionnaire (PHQ-9). Association of sociodemographic characteristics of patients with depression were assessed using chi-square, subsequently by multivariable logistic regression. Statistical significance was set at P-values <0.05.

    RESULTS: The response rate was 98% (200/204). Depression was prevalent among 63% of HD patients at the Dialysis Center in Hodeida city. Sex was significantly associated with depression, where female patients were more frequently depressed than males (82.4% vs 56.4%, P < 0.001). In addition, employment status and medical insurance were significantly associated with depression, where unemployed patients were more frequently depressed than employed patients (67.6% vs 52.5%, P = 0.041) and patients with medical insurance were less frequently depressed than their counterparts (47.1% vs 66.3%, P = 0.035).

    CONCLUSION: Depression is highly prevalent among HD patients in Hodeida city. Female sex, unemployment and lack of medical insurance are predictors of depression among HD patients. These findings emphasize the urgent need for targeted interventions.

    IMPLICATIONS FOR PRACTICE: Depression is common among HD patients, so that, psychiatric physicians and nurses are increasingly needed in HD centers to implement mental health assessment of patients for depression signs and symptoms to help in early diagnosis and management of depression in order to improve patients' quality of life and preventing negative outcomes.

  7. Abu-Farha R, Gharaibeh L, Alzoubi KH, Ahmad RE, Binsaleh AY, Shilbayeh SAR, et al.
    J Pharm Policy Pract, 2024;17(1):2430445.
    PMID: 39605986 DOI: 10.1080/20523211.2024.2430445
    BACKGROUND: Gabapentin is increasingly recognised for its potential for abuse, raising concerns within healthcare communities. Community pharmacists are on the front lines in identifying and addressing instances of gabapentin abuse, making their insights invaluable. This study aims to assess community pharmacists' experiences and perceptions regarding gabapentin abuse in Jordan.

    METHODS: A cross-sectional study was conducted from April to June 2024 using a questionnaire-based approach. The questionnaire, developed in English, was uploaded to Google Forms and distributed through social networking platforms. It consisted of four sections: demographic information, pharmacists' experiences with gabapentin abusers, strategies to limit access to gabapentin, and perceptions of gabapentin abuse, which were assessed using a 5-point Likert scale. A Chi-square test was employed to analyze the association between categorical variables.

    RESULTS: The study included 209 pharmacists (median age 29.0 years, IQR 8.0 years). Concerning gabapentin, 72.7% of pharmacists received requests to sell it in the past 6 months. Of these, about 75.7% encountered suspected gabapentin abusers, noting behavioural changes (95.9%), frequent refill requests (90.4%), and inconsistent medical histories (87.8%) as key indicators. Most suspected abusers were male (81.7%) and aged 21-30 years (74.8%).Common reasons cited by suspected abusers for requesting gabapentin included neuropathic pain (93.0%), low back pain (89.6%), and mood instability (73.0%). Pharmacists perceived an increase in gabapentin abuse (74.5%) and expressed a need for additional training (83.3%). Additionally, 83.7% recognised their pivotal role in identifying and addressing gabapentin abuse. Finally, significant associations were found between working in chain pharmacies and receiving gabapentin requests (χ² = 9.159, p = 0.002).

    CONCLUSION: Pharmacists have an important role in detecting gabapentin abuse which necessitates adequate education. Pharmacists have concerns regarding this issue and believe stricter regulations are needed.

  8. Ahmed WS, Abu Farha R, Halboup AM, Alshargabi A, Al-Mohamadi A, Abu-Rish EY, et al.
    Front Public Health, 2023;11:1030391.
    PMID: 36860400 DOI: 10.3389/fpubh.2023.1030391
    BACKGROUND: The seasonal influenza vaccine is an important preventive measure against influenza and its associated complications. In Yemen, there is no seasonal influenza vaccination policy, and the influenza vaccine is excluded from the national immunization program. Data on vaccination coverage remain scarce with no previous surveillance programs or awareness campaigns implemented in the country. The current study aims to assess the awareness, knowledge, and attitudes of the public in Yemen toward seasonal influenza and their motivators and perceived barriers to receiving its vaccine.

    METHODS: A cross-sectional survey was carried out using a self-administered questionnaire that was distributed to eligible participants using convenience sampling.

    RESULTS: A total of 1,396 participants completed the questionnaire. The respondents showed a median knowledge score of influenza of 11.0/15.0, and most of them (70%) were able to recognize its modes of transmission. However, only 11.3% of the participants reported receiving the seasonal influenza vaccine. Physicians were the respondents' most preferred information source for influenza (35.2%), and their recommendation (44.3%) was the most cited reason for taking its vaccine. On the contrary, not knowing about the vaccine's availability (50.1%), concerns regarding the safety of the vaccine (17%), and not considering influenza as a threat (15.9%) were the main reported barriers to getting vaccinated.

    CONCLUSION: The current study showed a low uptake of influenza vaccines in Yemen. The physician's role in promoting influenza vaccination seems to be essential. Extensive and sustained awareness campaigns would likely increase the awareness of influenza and remove misconceptions and negative attitudes toward its vaccine. Equitable access to the vaccine can be promoted by providing it free of charge to the public.

  9. Halboup AM, Alzoubi KH, Abu-Farha RK, Harun SN, Al-Mohamadi A, Battah MM, et al.
    J Multidiscip Healthc, 2023;16:3689-3701.
    PMID: 38058461 DOI: 10.2147/JMDH.S442296
    BACKGROUND: The spread of monkeypox (mpox) worldwide poses a severe threat to human life. This virus leads to a disease with symptoms similar to smallpox in humans. To combat this threat, improving public knowledge and perception toward mpox is vital for public health preventive measures.

    METHODS: A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables.

    RESULTS: A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351).

    CONCLUSION: The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.

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