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Razan Nassar

Research

​​​​​​​​​The Impact of the Coronavirus Pandemic on the Learning Process among Students: A Comparison between Jordan and Turkey

Authors : ​Iman A. Basheti, Razan I. Nassar, İbrahim Halalşah

Abstract : COVID-19 was declared by the WHO as a pandemic affecting several aspects of human lives. Follow-up investigations showed that the pandemic affected tertiary education. This study was designed to assess the online learning process among students living in Turkey and Jordan during the COVID-19 pandemic. This descriptive cross-sectional study was conducted via an online survey. The survey was followed by a focus group. Data were analyzed using the Statistical Package for Social Science (SPSS). A total number of 214 students participated in this study. Most of the participants were female, single, and undergraduates. Regarding the theory courses, the percentage of Turkish and Jordanian students who evaluated the online learning as ‘excellent’or ‘very good’or ‘good’was greater than that for the practical courses. With regards to the practical training, more than half of the Turkish students (57.5%) ranked their experience in practical training as ‘excellent’or ‘very good’or ‘good’, while a lower proportion was reported by Jordanian students (47.7%). During the focus group, the cons of online learning were m​ore numerous than the pros. The tertiary education in Turkey and Jordan was affected during the pandemic.

Keywords : coronavirus; COVID-19; learning; education; Turkey; Jordan

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​​​​​COVID-19 infected patients' experiences in Syria, and the role of the pharmacists during their infection

Authors : Razan I Nassar, Samar Thiab, Kinda T Alkoudsi, Iman A Bashet​i​

Abstract : Background: Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. Objective: To assess the experience of individuals who have been infected with coronavirus and the roles played by pharmacists to meet their new needs. Methods: This descriptive cross-sectional survey was developed based on previous literature, validated, and conducted in Syria. The survey included items related to participants’ COVID-19 experiences, and items concerning the roles played by pharmacists when participants were infected. Items were tested for face validity. Data collection was conducted in May and June 2021. Data was analyzed using the Statistical Package for the Social Sciences (SPSS). Results: The study participants (n=576) had a mean age of 37.99 years. Fatigue was the most reported symptom by the participants. Vitamin C was the most used supplement (76.4%), and 66.5% of the participants used herbs during their infection. More than 60.0% of the participants stated that their anxiety and stress levels increased during their infection. Around 40.0% of the participants needed to visit a specialist doctor. Only 5.4% needed to use an artificial respiration apparatus. The mean of the participants’ infection severity was 4.97 (SD=2.30) out of 10. The severity of the infection was significantly affected by being older, female, smoking, and having a chronic condition. Doctors followed by pharmacists were the healthcare providers who advised participants to take certain medications/herbs. More than one-third of the participants strongly agreed/agreed that the pharmacist played important and effective roles during their infection. Conclusion: Patients’ experiences indicated that fatigue was the most reported symptom by the participants diagnosed with coronavirus infection, while vitamin C was the most used supplement. Pharmacists have a major role in helping participants manage their infection and are considered a vital pillar in patients’ experiences since they provided patients with the needed medications

Keywords : Coronavirus; COVID-19; Pandemics; Pharmacists; Patient experience; Syria

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COVID-19 and role of pharmacists: Knowledge and perceptions of pharmacists from Iraq and Syria

Authors : Iman A Basheti, Razan Nassar, Feras El-Hajji, Bayan Othman, Kinda T Alkoudsi, Zaid Al-Ani​

Abstract : Objectives: To assess pharmacists from Syria and Iraq on their knowledge, readiness, and perspectives on their roles during the COVID-19 pandemic. In addition to investigate pharmacists’ perceived barriers towards delivering their emergency roles during the COVID-19 pandemic and perceived policymakers’ responsibilities. Methods: This cross-sectional study design was conducted in Iraq and Syria during COVID-19 outbreak over one month (April 2020). The study objectives were addressed through a validated online questionnaire. Data was analyzed using statistical package for social science (SPSS). Results: A total of 916 individuals participated in this study (447 from Iraq and 439 from Syria). Most of Iraqi participants were students while most of Syrian participants were graduates and technicians. The mean age for the Iraqi participants was 22.5 (SD= 4.1) while the mean age for the Syrian participants was 28.7 (SD= 9.1). A significant difference (p< 0.001) was found in following the latest coronavirus updates on management among pharmacy graduates and technicians and undergraduate students. Media was reported as the most used source for knowledge about epidemics/ pandemics among the Iraqi and the Syrian participants. Around 72% strongly agreed/agreed that the faculties of pharmacy have a role in preparing them to deal with epidemics/pandemics. In addition, 64.3% strongly agreed/agreed that pharmacist associations and societies have a role in preparing them to deal with epidemics/pandemics such as the coronavirus. Moreover, 82.9% believed that pharmacists should receive training programs on how to provide mental health support for people during epidemic and pandemic outbreaks. Conclusion: Tertiary pharmacy education providers and pharmacy professional bodies have a strong role in preparing pharmacists to deal with pandemics. Therefore, the importance of providing beforehand training programs on epidemics/pandemics management, workshops, lectures, and online information resources for such circumstances is crucial for pharmacists.

Keywords : Coronavirus; Pandemics; Pharmacists; Pharmaceutical associations; Syria; Iraq

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​​​​​Medications and natural products used in Jordan for prevention or treatment of COVID-19 infection during the second wave of the pandemic: A cross-sectional online survey

Authors : ​Samar H Thiab, Razan I Nassar, Sara Thiab, Iman A Basheti

Abstract : Worldwide, during the COVID-19 pandemic in 2019, there was an increase in the tendency of misusing prescription drugs as well as self-medicating with over-the-counters. Additionally, an increase in the use of herbs and natural products was reported. A descriptive cross-sectional survey was conducted in Jordan from May 19th to July 29th, 2021, to assess the medications and natural products used in Jordan during the second wave of the pandemic. The survey was developed and validated, then distributed using Google Forms via social media platforms. Data was analyzed using Statistical Package for Social Sciences-24. The study participants (n = 386) had a mean age of 29.35 (SD = 11.90) years. Most of participants were females (72.8%), not married (64.5%), non-smoker (69.2%), have a Jordanian nationality (80.6%), hold a bachelor’s degree (73.1%), and living in the middle of Jordan (74.1%). More than 70% of the participants used vitamin C, D and pain relievers. The most used natural products were citrus fruits (78.8%), honey (63.0%) and ginger (53.1%). The participants reported that family and friends (55.4%) played a major role in advising them to use medications and dietary supplements. Pharmacists ranked second (54.1%), followed by social media platforms (43.3%). Multiple logistic regression analysis highlighted that only the age significantly affected the participants’ use of medications and natural products (P < 0.001). The results of this study warrant the need of conducting awareness campaigns guided by trained healthcare providers to educate people and minimize the risk of side effects that may arise from unsupervised use of medications and natural products

Keywords : COVID-19, Coronavirus, Medication, Supplement, Natural products, Jordan

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​​​​​Exploring Validated Self-Reported Instruments to Assess Adherence to Medications Used: A Review Comparing Existing Instruments

Authors : Razan Nassar, Iman Basheti, Bandana Saini ​

Abstract : Objective: To provide an overview of instruments that measure adherence to medications to facilitate selection of an instrument and to provide a summary of some published adherence assessment tools tailored to be used by the healthcare team, especially the pharmacists. Data Sources: Studies were identified via PubMed, Medline, Embase, and Google Scholar using the search terms medication adherence, compliance, persistence, combined with the terms questionnaire, scale, survey, self-report, and instrument. Study Selection: Articles written in English, describing questionnaire instruments that were psychometrically evaluated (reporting a good coefficient of internal consistency, reliability assessed through Cronbach’s alpha, and had been validated against a subjective or objective measure), and containing 30 or fewer items were included. Data Synthesis: Twelve instruments were identified and included in this review. Instruments were reviewed by evaluating specific characteristics (number of items, sample size, reliability, sensitivity, specificity, questionnaire completion time, criterion validity, and component analysis). Conclusion: Various instruments are used to assess patient adherence to medications; however, no single one performs well on all criteria. Every instrument has different advantages and unique properties. A particular instrument can be chosen after considering certain factors, such as the specific requirements, population, the needed time to complete the questionnaire, the sensitivity, and the specificity of the questionnaire. Moreover, there is a recognized need to provide primary care medication adherence services customized to patient’s needs. A link for teamwork between healthcare providers such as pharmacists and patients is needed. This link can be a validated instrument to assess patient’s adherence to medication

Keywords : adherence to medications, compliance, questionnaire, self-report, scale, survey, instrument

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​​​​​Knowledge and perceptions of pharmacists' readiness during coronavirus pandemic: the case of United Arab Emirates

Authors : Iman A Basheti, Nizar M Mhaidat, Sayer Al-Azzam, Rajaa Alqudah, Razan I. Nassar, Hamzah Alzubaidi, Mahmoud S Abu-Samak, Eman Abu-Gharbieh​

Abstract : Background: With the outbreak of Coronavirus infection (COVID-19), pharmacists play an important role in supporting local health during this emergency. Aim: To assess the knowledge and to identify information sources regarding COVID-19 used by pharmacists, to investigate the active and public perceived roles of pharmacists, to explore the role of the pharmacy facilities and health authorities, and to identify barriers that would hinder pharmacists from performing their duties optimally in the United Arab Emirates. Methods: This descriptive cross-sectional online study was conducted in the UAE during the COVID-19 outbreak, from 18 May to 20 June 2020. A validated online questionnaire addressing participants’ current knowledge about pandemics and COVID-19, source of information, and their perspectives of their role was used. Participants were licensed pharmacists practising in community and hospital pharmacies in UAE, academics, and pharmacy students. Results: Almost two-thirds of the participants (71.2%) were aged 18–30 years, with 76.2% females. Only 57.5% of participants believed that they got enough education about pandemics, and 88.3% of them followed on the latest coronavirus updates regarding treatments, and that is mainly from the World Health Organization reports (53.9%), followed by health authorities (44.8%). Two-thirds of participants (69.7%) had good/very good current knowledge regarding COVID-19. Knowledge of pharmacy students compared to pharmacists was significantly higher (p < 0.001). Conclusion: The majority of pharmacists and pharmacy students reported that they have a major role in managing pandemics executed through the community pharmacies and that it is their role to ensure the availability of key medications. Policymakers and health authorities are called upon to train pharmacists in advance of emerging situations, supporting and helping them to optimally fulfill their role."​

Keywords : Coronavirus, Pandemics, Pharmacists, United Arab Emirates

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Pharmacists’ awareness of COVID‐19 and perceptions of their roles, barriers, and roles of policymakers: Exploring the Middle East and North Africa (MENA)

Authors : Iman A Basheti, Feras El‐hajji, Razan Nassar, Samar Thiab, Muna Barakat, Mariam Basheti, Alberto Berardi, Bandana Saini​

Abstract : Background: The coronavirus infection (COVID-19) was declared in January 2020 as a public health emergency of international concern. The Middle East and North Africa (MENA), like other parts of the world, suffered from several epidemics over the years. Pharmacists have vital roles to play to prevent the spread of this virus. Objectives: To assess the awareness of COVID-19 amongst pharmacists from countries located in the MENA countries, and to assess their perspectives of their role, barriers, and roles of the educational institutions and pharmaceutical associations in preparing them for their roles during the pandemic. Methods: An online survey was conducted to run a descriptive cross-sectional study in Jordan from 12th to 22th April 2020. The questionnaire was validated and put on Facebook for pharmacists’ recruitment and assessment of their awareness (20 questions with a score out of 20) about epidemics/pandemics and COVID-19, their perceived roles and barriers, and roles of the educational institutions and pharmaceutical associations. Data were analyzed using Statistical Package for the Social Science (SPSS). Results: Study participants (n= 2589) had a mean age of 29.3 (8.2) years and 1329 (51.5%) were females. Most of the participants were from Egypt 819 (40.8%), Followed by Jordan, Algeria, and Syria. As for the sources of information about coronavirus treatment among the study participants, 60.8% got their information from the social media. Fear as a consequence was identified by the majority of participants (87.7%). The majority of pharmacists identified positive roles for the pharmaceutical association and pharmaceutical associations. Conclusion: Pharmacists from the MENA countries believe they got enough education previously about epidemics/pandemics, and the majority follow on the latest coronavirus updates from social media. Fear was reported as the major barrier that requires resolution by the policymakers. Certain gaps in the awareness about COVID-19 were identified

Keywords : coronavirus; pandemics; pharmacists; educational institutions; Pharmaceutical association; Middle East; North Africa; MENA

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Primary health care policy and vision for community pharmacy and pharmacists in Jordan

Authors : ​Iman A Basheti, Nizar M Mhaidat, Rajaa Al-Qudah, Razan Nassar, Bayan Othman, Tareq L. Mukattash​

Abstract : Jordan is considered a low middle-income country with a population of 9.956 million in 2018. It is considered the training center for healthcare professions in the region, as the Jordanian healthcare sector has seen remarkable development. In 2017, the expenditure on health as a percentage of Gross Domestic Product (GDP) was estimated to be around 8%. The healthcare sector is divided into two main sectors; the public and the private sector with both including hospitals, primary care clinics and pharmacies. The Jordanian government has a strong commitment to health and educational programs; hence, an increase in the number of pharmacy schools and pharmacy graduates has occurred in the past few years. Health authorities, such as the Jordan Food and Drug Association (JFDA) and the Jordan Pharmaceutical Association (JPA) have played an important role in ensuring the availability and affordability of medications, and has influenced the practice of pharmacists. Protecting the pharmaceutical market and professional interests, preserving pharmacists' rights, building needed cooperation with the internal federation, and maintaining professional ethics are some of the objectives for the JPA. Hence, the integration of community pharmacists into the primary healthcare system is considered vital to the different health authorities in Jordan, emphasizing the fact that community pharmacists are the most trusted, accessible, and affordable healthcare providers in the country. There have been many developments in the pharmacy practice in the past recent years, including the establishment of ‘Good Pharmacy Practice’, new curricular development based on the international accreditation (the ACPE), a new immunization program, and health services research aimed to save patients’ lives, influence expenses, and improve patients’ quality of life. Although these developments in pharmacy practice are promising, challenges continue to exist, specifically the establishment of an evidence base for pharmaceutical care services such as the medication management review service

Keywords : Pharmacies; Primary Health Care; Delivery of Health Care, Integrated; Ambulatory Care; Community Health Services; Pharmacists; Community Pharmacy Services; Professional Practice; Jordan

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​​​​​Pharmacists’ perceived barriers towards delivering their emergency roles during the COVID-19 pandemic and perceived policymakers’ responsibilities

Authors : Iman A Basheti, Razan Nassar, Muna Barakat, Rajaa Alqudah, Rana Abu Farha, Tareq Muqatash, Samar Thiab, Bandana Saini​

Abstract : Rational: In March 2020, the World Health Organization (WHO) declared the coronavirus infectious disease as a pandemic referred to as COVID-19. As an essential service, community pharmacists have been enacting a key role in patient counseling and supply of essential medicines and protective equipment. Objectives: To investigate pharmacists’ perspectives of the role of educational institutes and professional pharmacy organizations in supporting them to take on roles during COVID-19 pandemic and to identify barriers to be able to support themselves and their patients. Methods: This descriptive mixed-method study was conducted via a cross-sectional online survey distributed to pharmacists/pharmacy students in Jordan during the COVID-19 outbreak (15–30 March 2020) using an online questionnaire, followed by an online focus group. Questionnaire items related to participants’ perspectives in being prepared for and supported in their roles during the COVID-19 pandemic, and items were tested for face validity. Data were descriptively analyzed using the Statistical Package for the Social Sciences and triangulated with focus group findings. Results: Considering that fear and anxiety are a consequence of mass social distancing/quarantine, study participants (n = 726, age = 26.9 (SD = 8.0) years, 71.9% females), reported needing training on mental healthcare to be able to support themselves and people during pandemics (90.2%). Most respondents agreed/strongly agreed (59.7%) with the statement around pharmacy educators/educational institutes having a key role in preparing pharmacists for practice during epidemics/pandemics and agreed that their faculties should add a course regarding pandemic preparedness in their curriculum (89.9%). Results were similar regarding roles for the pharmaceutical associations. Focus group findings (n = 7) mirrored the survey findings to a large extent. Conclusions: Most participants believed that pharmacy educators and pharmaceutical associations have a role in preparing them to deal with the COVID-19 pandemic through online educational workshops/webinars. Online education on mental healthcare is specifically needed

Keywords : Coronavirus, Pandemics, Pharmacy educators, Educational institutes, Faculty of Pharmacy, Pharmaceutical association, Jordan

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​​​​​Pharmacists’ readiness to deal with the coronavirus pandemic: Assessing awareness and perception of roles

Authors : Iman A Basheti, Razan Nassar, Muna Barakat, Rajaa Alqudah, Rana Abufarha, Tareq L Mukattash, Bandana Saini​

Abstract : Background: The 2019 Coronavirus infection (COVID-19) caused by a novel strain of coronavirus was detected in China in December 2019, and declared a public health emergency of international concern on January 30, 2020. Community pharmacists have an important role in supporting the local health emergency preparedness and response arrangements. Objectives: To investigate pharmacists and pharmacy students’ awareness and source of their information regard the management of the coronavirus pandemic, and their perspective of their role during this emergent situation. Methods: This descriptive cross-sectional online survey study was conducted in Jordan during the COVID-19 outbreak (from 15 to 30 March 2020). A validated online questionnaire addressing participants' current awareness about epidemics/pandemics and COVID-19, source of information and their perspectives of their role. Data were analyzed using statistical package for social science (SPSS). Results: Participants (n = 726) had a mean age of 26.9 (8.0) years with 71.9% females. Pharmacy students made 35.3% of the sample while the rest were pharmacists. Only 54.3% of participants believed that they got enough education about epidemics/pandemics, and 94.6% of them follow on the latest coronavirus updates on treatments, and that is mainly from the media (59.5%) followed by the World Health Organization reports (58.7%) and then the published researches (57%). Awareness score (out of 20) of pharmacists (n = 470) was significantly higher (p < 0.001) than that of students (n = 256). Better Awareness scores were also associated with higher age of participants, graduating from a public versus a private university, and attending more educational workshops. Conclusion: The majority of pharmacists and pharmacy students reported that they have a major role in the management of epidemics/pandemics through the community pharmacies but the majority follow on the latest coronavirus updates from the media. This fact rings bills considering the numerous conflicting messages publicized during the pandemic through the media.

Keywords : Coronavirus, Pandemics, Pharmacists, Faculty of pharmacy, Pharmaceutical association, Jordan

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Development and validation of the Adherence to Asthma Medication Questionnaire (AAMQ)

Authors : Razan I. Nassar, Bandana Saini, Nathir M. Obeidat, Iman A. Basheti ​

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

Keywords : Asthma; Adherence to medication; Compliance; Questionnaire; Self-report; Scale; Survey

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​​​​​Short-term Side Effects of COVID-19 Vaccines: A Cross-Sectional Study in Jordan

Authors : Razan I. Nassar, Dalal Alnatour, Samar Thiab, Ayman Nassar, Feras El-hajji, Iman A. Basheti​

Abstract : The rapid creation of vaccinations has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This study aims to collect data on the short-term side effects of the COVID-19 vaccines among the Jordanian population. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and side effects). Data were analyzed using the Statistical Package for Social Science. A total of 1,044 participants were enrolled in the study. The most commonly received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the site of injection (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p=0.046), having an allergy (p=0.024), or rheumatoid arthritis (p=0.023), and participants who take NSAIDs regularly (p=0.029). This study is one of the studies that aimed to improve our emerging knowledge regarding the COVID-19 vaccines’ side effects.

Keywords : COVID-19; Pandemics; Side effects; Vaccine; Immunization; Jordan.

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​​​​​A qualitative assessment of the adverse effects associated with COVID‑19 vaccines: a study from Jordan

Authors :Rawan Al‑Bawab, Rana Abu‑Farha, Faris El‑Dahiyat, Razan I. Nassar, and Mohammed Zawiah ​

Abstract : Objectives The current study aimed to qualitatively explore the side effects reported by participants who received the COVID-19 vaccine among the Jordanian population. Methods Between April 18th and May 12th, 2022, an in-depth interview was conducted with a purposive sample of vaccinated individuals to assess the side effects of the COVID-19 vaccine in this study. Thematic analysis was used to identify themes and sub-themes within the current qualitative data. Results A total of 20 participants were interviewed. They had a mean age of 41.3 (SD=14.3) years. Half of the participants were females (n=10, 50.0%). The study revealed six main themes: first, most of the respondents believed that COVID-19 vaccines were safe. Second, the vaccines are not equivalent in their safety. The third there showed that participants follow preventive measures to decrease the possibility of experiencing side effects. The fourth theme showed that reporting of side effects by the participants is dependent on the experienced side effects. Moreover, the next theme revealed that participants showed hesitancy to take more than one type of vaccine. Finally, participants were willing to take the vaccine annually, because they believed that the vaccine is better than the disease itself and decreases the aggressive effects of the disease. Conclusions This study found that the majority of participants believed in the safety of the COVID-19 vaccines and emphasized the responsibility of the healthcare providers in increasing awareness among the population about the importance of the vaccines. Enhancing such awareness is essential to improve the acceptance of receiving different types of vaccines

Keywords :Side effects, COVID-19, Vaccine, Immunization, Jordan

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​​​​​Perception and attitudes toward COVID- 19 vaccines in Jordan: lessons for future pandemics

Authors :Dalal Alnatour, Razan I. Nassar, Yara Salhi, Samar Thiab, Ahmad R. Alsayed ​

Abstract : Objective: This study aimed to assess Jordanians’ perception and attitudes toward COVID-19 vaccines authorized for use in Jordan. Another objective was to evaluate the population’s confidence in vaccine efficacy, their fears of the vaccines, and their perceptions and attitudes after vaccination. Methods: This cross-sectional study was conducted over four months (August 2021- December 2021) and included the general Jordanian population above 18 years old. Results: A total of 398 participants were included in the study, with the majority (around 81.0%) received at least one dose of any of COVID-19 vaccines approved for use in Jordan. Most non-vaccinated participants (67.4%) were either unwilling to receive the COVID-19 vaccine or unsure. The main reasons for receiving the vaccine were: family protection, self-protection, global efforts to fight the virus and local restrictions, with some variability between vaccinated and non-vaccinated. The major reasons for fear of COVID-19 vaccines were limited research, vaccine effectiveness, and vaccine side effects. Pfizer-BioNTech vaccine was the most trusted vaccine by vaccinated and non-vaccinated participants (47.8% and 57.9%, respectively), and OxfordAstraZeneca was the most feared by them (42.2% and 57.9%, respectively). Internet websites (>85.0%), social media platforms (>70.0%), relatives and friends (>69.0%), and news applications (>60.0%) were the major sources of information about the COVID-19 vaccines among participants. Conclusion: Our results revealed that hesitation in receiving the vaccine remains a challenge in Jordan, as in other countries. The findings also show that participants, regardless of their vaccination status, had many concerns about the four types of vaccines approved for use in Jordan during the study conduction period. Moreover, the participants’ perceptions and attitudes towards the vaccines were variable between vaccinated and non-vaccinated participants and were variable for the four types of vaccines.

Keywords : COVID-19; Jordan; vaccine; attitude; perception

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​​​​​The battle against COVID-19 in Jordan: A cross-sectional study assessing the experience of Jordanians who have been infected with COVID-19

Authors :Razan I. Nassar, Samar Thiab, Iman A. Bashet ​

Abstract : Background: Patients infected with coronavirus have new experiences and hence needs from the healthcare sector. Pharmacists can play vital roles in adopting innovative strategies to meet such needs. Objectives: To assess the experience of people who have been infected with coronavirus, and to assess the roles played by pharmacists to meet their new needs. Methods: This descriptive cross- sectional online survey was developed based on previous literature, validated, and conducted in Jordan (3-13 May 2021). Results: The mean age of the study participants (n=470) was 34.31 years (SD=11.75). About three-quarters were females. Out of the study participants, 24.0% reported to having been infected with the coronavirus previously, and 48.9% of them were infected after contacting an infected family member/friend. Only 36.0% ranked their commitment to the preventative measures as “very committed” before getting infected. The most reported symptom was fatigue (77.1%). The most used medicine/supplement was vitamin C (85.3%), followed by pain relievers (77.7%), and zinc tablets (75.3%). More than half of the participants (66.4%) documented that their anxiety and stress levels increased during their infection. More than half of the participants (53.7%) strongly agreed/agreed that pharmacists had an important and effective role during their infection. Conclusion: The experience of individuals who contracted the coronavirus indicated that few were very committed to preventative measures before getting infected. Fatigue was the main experienced symptom, while vitamin C was the supplement used the most. About half of the participants believed that pharmacists have an important role in managing their needs during their COVID-19 infection

Keywords : coronavirus; COVID-19; pandemics; pharmacists; Jordan

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Short-term Side Effects of mRNA-based COVID-19 Vaccine Among Jordanian Population; a Cross- sectional Study

Authors : Razan I. Nassar​

Abstract : Introduction: One type of the developed COVID-19 vaccines that received emergency permission and was approved by the food and drug administration (FDA) is the mRNA-based vaccine. The aim of this study is to gather information on the Jordanian population’s experience with the vaccine’s side effects. Methods: The study objectives were addressed through a cross-sectional study, which collected information regarding the short-term side effects experienced by the vaccinated individuals within one month following the injection of an mRNA-based COVID-19 vaccine. Data collection was carried out in August 2021. Participants were invited to take part in a self-administered web-based survey created using Google Forms. Results: Among the study’s participants (n= 533), about 56% experienced side effects after the first dose of the mRNA-based COVID-19 vaccine. The most commonly reported side effects after the first dose were sore arm at the injection site (91.6%), and fatigue (83.06%). The female gender was significantly associated with experiencing fatigue, discomfort, chills, and hair loss. Being over 30 years old was significantly associated with experiencing cough. Being a smoker was significantly associated with experiencing shortness of breath and gastrointestinal symptoms. Conclusion: The mRNA-based COVID-19 vaccine side effects were common, yet, mild, local, and self-limited. The local pain at the injection site was the most commonly reported side effect. Hopefully, the study’s findings will aid in lowering resistance to vaccination.

Keywords : Coronavirus; COVID-19; adverse effects; vaccines; mRNA vaccine; COVID-19 vaccines; Jordan

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​​​​​The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Authors : ​Iman A. Basheti, Hiba Barqawi, Razan I. Nassar, Samar Thiab, Noor Atatreh, and Eman Abu-Gharbieh

Abstract :Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19- infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

Keywords : coronavirus; COVID-19; pandemics; pharmacists; United Arab Emirate

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The combined effect of omega-3 fatty acid and vitamin D3 on oxidized LDL-C 3 and non-HDL-C levels in people with vitamin D deficiency: A randomized 4 controlled trial

Authors :Amani Mehdawi, Beisan A Mohammad, Ibrahim Mosleh, Heba A. Khader, Maha Habbash, Razan I. Nassar, Shady Awwad, Luai Hasoun, Mahmoud S. Abu-Samak ​

Abstract :The present randomized clinical trial (RCT) was conducted on Jordanian participants with vitamin D deficiency (VDD) with no other medical conditions, to evaluate the combined effect of 1,25-dihydroxy vitamin D3 (Vit.D3) and omega-3 fatty acid (n-3FA) supplements (D+) on oxidized low-density lipoprotein (Ox-LDL) and non–high-density lipoprotein cholesterol (non–HDL-C) levels as common predictors of cardiovascular diseases (CVDs). Participants were randomized into 4 groups as follows: a control group (C) that received no supplementations, a Vit.D3 group that received 50,000 IU of Vit.D3 every week, an n-3FA group that received 300 mg of omega-3 fatty acid every day, and a D+ group that received a combination of both supplements, with the same dosage administered by the previous groups but with a 4–6-hour time interval between Vit.D3 and n-3FA administration to avoid any possible interaction. All supplementations were administered orally for 8 weeks. Forty-seven participants were allocated to each group. Twenty-six in the control group, 37 participants in the Vit.D3 group, 37 participants in the n-3FA group, and 46 participants in the D+ group completed the study to the end. The D+ supplementations significantly increased non–HDL-C (118.99 ± 60.98 to 155.26 ± 43.36 mg/dL, P << 0.05) but decreased Ox–LDL-C levels (69.29 ± 37.69 to 52.81 ± 17.30 pg/mL, P = 0.03). The stepwise regression showed that the serum LDL-C level was the main independent variable involved in the elevation of non-HDL levels (R2 = 0.837) observed at the end of the trial in the D+ group. The groups that were supplemented with either Vit.D3 alone or n-3FA alone had an insignificant decrease in the level of Ox–LDL-C. In conclusion, despite the observed hyperlipidemic effect, the combination treatment is recommended by the research team because the decrease in Ox-LDL may offset the hyperlipidemic effect.

Keywords : vitamin D deficiency; vitamin D3; omega-3 fatty acids; non-HDL; oxidized-LDL cholesterol; LDL-C, TG

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​​​​​Web-Based Reporting of Post-Vaccination Symptoms for Inactivated COVID-19 Vaccines in Jordan: A Cross-Sectional Study

Authors : Razan I. Nassar, Muna Barakat, Samar Thiab, Feras El-Hajji, Hiba Barqawi, Waseem El-Huneidi, Iman A. Basheti, and Eman Abu-Gharbieh​

Abstract : Background: The perception of COVID-19 vaccines as being unsafe is a major barrier to receiving the vaccine. Providing the public with accurate data regarding the vaccines would reduce vaccine hesitancy. Methods: A cross-sectional study was conducted to collect data on the side effects experienced by the vaccinated population to assess the safety of the inactivated COVID-19 vaccine. Results: The majority of the study participants (n = 386) were female (71.9%), and 38.6% of them were under 30 years old. Around half of the participants (52.8%) reported side effects after receiving the inactivated COVID-19 vaccine. Fatigue (85.1%), a sore arm at the site of the injection (82.1%), and discomfort (67.2%) were the most commonly reported side effects after the first dose. Reporting side effects was significantly associated with the female sex (p-value = 0.027). Significant associations between being female and experiencing chills, muscle or joint pain, anorexia, drowsiness, and hair loss were also found, as well as being above the age of 30 and experiencing a cough. Being a smoker was significantly associated with experiencing a cough, and a headache. Furthermore, chills, and a sore throat were significantly associated with individuals who had not been infected before. Conclusion: Mild side effects were reported after receiving the inactivated COVID-19 vaccine. Fatigue was the most commonly reported side effect. Females, older adults, smokers, and those who had never been infected with COVID-19 had a greater susceptibility to certain side effects.

Keywords : coronavirus; COVID-19; side effects; vaccines; inactivated COVID-19 vaccine; Jordan

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​​​​​Assessing adherence to medications: Is there a difference between a subjective method and an objective method, or between using them concurrently?

Authors : Razan I. Nassar, Bandana Saini, Nathir M. Obeidat, Noor Atatreh, Iman Bashet​

Abstract : Background: Patients’ adherence to medication can be assessed by several subjective or objective methods. The Global Initiative for Asthma (GINA) has recommended the use of both measures simultaneously. Objective: To assess patients’ adherence to medication using a subjective or an objective method separately, and via using a combination of both methods. As well as identifying the degree of agreement between the two methods. Methods: Participants who met the study inclusion criteria completed the Adherence to Asthma Medication Questionnaire (AAMQ). A retrospective audit was conducted in order to extract pharmacy refill records for the previous twelve months. The patients’ pharmacy refill records were expressed using the Medication Possession Ratio (MPR). Data were analyzed using the Statistical Package for Social Science. The degree of agreement was determined by Cohen’s kappa coefficient (κ). Results: In terms of the difference in the ability of each method to identify non-adherent patients, a higher percentage of non-adherent patients were identified using the self-reported AAMQ (61.4%) compared to the pharmacy refill records (34.3%). When both methods, in combination, were used to assess adherence, the percentage of non-adherent patients was 80.0%, which is higher than each method when used separately. Twenty percent of the patients were considered adherent on both assessment methods, while 15.7% were considered non-adherent via both methods. Consequently, the AAMQ and pharmacy refill records agreed on 35.7% of the patients. The degree of agreement analysis showed a low correlation between the two methods. Conclusion: The combination strategy resulted in a higher percentage of non-adherent patients, compared to using a subjective (the AAMQ) or an objective (the pharmacy refill records) method. The GINA guideline proposition may be supported by the present study’s findings

Keywords : asthma; adherence to medication; questionnaire; pharmacy refill records

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​​​​​Public perceptions about home delivery of medications service in Lebanon: A cross-sectional survey

Authors :Rana Abu-Farha, Karem H Alzoubi, Tareq Mukattash, Samar Karout, Rania Itani, Razan I Nassar, Muna Barakat ​

Abstract :Objectives: To investigate the public’s perception of home delivery of medication service offered by community pharmacies in Lebanon and to assess factors affecting the use of this service. Methods: The present study represents a cross-sectional online survey study that took place in April-May 2022. The survey was uploaded on the google form platform and was distributed on popular social media platforms (Facebook and WhatsApp). Participants were asked to fill out the questionnaire to evaluate their awareness and perception of home delivery of medication service. Statistical analyses were performed using SPSS version 22. Results: During the study period, 517 participants agreed to fill out the study questionnaire. Only 18.4% of the study’s participants (n=95) had previously utilized home delivery of medications service. The majority of the participants believed that home delivery service made pharmacists less accessible to answer questions (n=332, 64.2%), and prevented pharmacists from explaining important points about prescriptions (n=322, 62.3%) compared to in-store refills. The main disadvantage of the service as perceived by the participants that home delivery of medications services is associated with the excessive cost of transporting medication (n=385, 74.5%), while the main advantage ofthis service is its ability to serve sick patients, elderly, disabled people (n=460, 88.9%). Finally, being female, being a university graduate or above, or having a monthly income of more than 500$/month are significantly associated with utilizing home delivery of medication service (p≤0.05). Conclusion: The majority of the Lebanese participants reported not utilizing the home delivery of medication service before, however, they have positively perceived medication home delivery service as an efficient pharmaceutical service. Serious efforts are needed by health policymakers to facilitate the implementation of this service in Lebanon.

Keywords :home delivery of medication, perception, public, Lebanon

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​​​​​Research Title :Knowledge, attitude, and perception of energy drinks consumption among university students in Jordan

Authors : Samar Thiab, Muna Barakat, Razan I. Nassar, Rana Abutaima, Asem Alsughaier, Roa’a Thaher, Faten Odeh, Wael Abu Dayyih​

Abstract :Energy drinks gained popularity after the launch of Red Bull in 1997. Different brands are now available and young adults mainly consume these drinks. This study assesses the knowledge, attitude, and perception of energy drink consumption among university students in Jordan. A validated online survey was used to collect the required data, extracted from Google Forms into an Excel spreadsheet and statistically analysed using Statistical Package for Social Sciences version 24.0. A nationally representative sample of university students with a mean age of 22⋅2 ± 3⋅9 years (n 749) was obtained. The participating students demonstrated a neutral level of knowledge about energy drinks, as the mean score of knowledge = 7⋅1 ± 2⋅2 (out of 12), with 66 % (n 498) of them having consumed energy drinks and experienced their effects. Generally, the study's participants demonstrated a neutral attitude towards energy drinks and 70⋅5 % (n 528) acknowledged that energy drinks increase activity, but more than 70 % of them believed that energy drinks have harmful side effects. It was found that there is a significant (P-value <0⋅5) positive correlation between knowledge score and female gender, studying a medical major, and monthly income. The main reasons for consuming energy drinks were reported to be: to stay awake for longer, help study, and become more energetic. There is a need for more structured awareness campaigns to warn students about the possible side effects of these products in order to reduce the consumption and popularity of these drinks among students.

Keywords :Attitude, Energy drinks, Knowledge, Perception, University students

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​​​​​Research Title :Skin-lightening products and Jordanian women: Beliefs and practice. A cross-sectional study

Authors : Manal Ayyash, Kamel Jaber, Razan I. Nassar, Leen Fino, Lana Mango, Alaa Abuodeh​

Abstract :Background The use of skin-lightening products (SLPs) among Jordanian women has immensely increased and healthcare professionals have a vital role in raising public awareness of SLPs. The aim of this study is to identify SLPs practices among Jordanian women and their basic knowledge of the agents and the side effects associated with using these products. Methods A cross-sectional study conducted during October to December of 2022. Jordanian women above 18 years of age were invited to participate via a survey link. Descriptive statistics were used, and logistic regression was applied to screen for variables affecting the knowledge score of the participants. Results The mean age of the study participants (n = 384) was 32.04 (SD = 12.678). Results demonstrated that more than half of the participants (n = 193) reported current or past use of SLPs. Additionally, less than one-fifth (18.2%) of the participants (n = 70) reported previously experiencing some side-effects after using SLPs. About 90% of participants thought that these side-effects were caused by the active ingredients in SLPs. Most of the participants were able to identify some of the active ingredients used in SLPs such as Vitamin C (87.8%) and Hydroquinone (62.0%). It was also found that young participants, and those employed, or university students had higher knowledge scores of SLPs’ active ingredients, and of their side-effects. Conclusion This study demonstrated that Jordanian women are adequately informed about skin-lightening products. Moreover, the practices revealed an educated pattern of action when obtaining information regarding SLPs. Fundamentally, healthcare providers should be influential in educating consumers on the proper use. Strict guidelines and policies should target the practices concerned with these products

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​​​​​Research Title :Evaluation of the Association between Inhaler technique and Adherence in Asthma Control: Cross-Sectional Comparative Analysis Study between Amman and Baghdad

Authors : Zainab M. Al-kilkawi, Iman A. Basheti, Nathir M. Obeidat, Muhannad RM Saleh, Salim Hamadi, Reem Abutayeh, Razan Nassar, Ahmad R. Alsayed​

Abstract :Purpose: Asthma is a chronic condition affecting millions of people all around the world. Asthma has no cure, but disease control is essential and highly recommended. However, the available tools for asthma control assessment don’t include factors such as inhaler technique and adherence. This study aimed to assess the correlation between inhaler techniques, adherence, and level of asthma control in two different healthcare settings; Jordan and Iraq. Patients and methods: A cross-sectional observational study was con-ducted over six months, from January to August 2018, in two public hospitals in Amman (Jordan) and Baghdad (Iraq). Asthmatic patients were interviewed to assess their inhaler technique, adherence, and asthma control. The researcher personally visited both public hospitals, conducting face-to-face interviews with patients at the hospital outpatient clinics. Validated questionnaires were used for patient assessment, including demographics, asthma history and medication use, the patient’s inhaler technique, adherence, and asthma control. Results: A total of 300 patients entered the study, with a mean age of 45.54 ± 13.71. The asthma control test showed very poor asthma control for patients living in both countries (Amman n=78 (52.0%) vs. Baghdad n=106 (70.0%)). An asthma knowledge assessment showed that most asthmatic patients in both countries didn’t follow their asthma medication plan (Amman n=78 (52.0%) vs. Baghdad n=93 (62.0%). Conclusion: In both Jordan and Iraq, asthma patients were found to be poorly controlled. Knowledge of patients was inadequate, probably leading to the poorly managed chronic disease. The results of this study highlight the significance of the pharmacist’s role in recognizing asthmatic patients requiring assistance. Furthermore, they underscore the pharmacist’s pivotal contribution to delivering patient education and counseling, ultimately resulting in enhanced asthma control.

Keywords : asthma, inhaler technique, adherence, control, Middle East

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​​​​​Research Title :Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study

Authors : Rana Abu-Farha, Omar Khabour, Lobna Gharaibeh, Yusra Elrahal, Karem Alzoubi, Razan I. Nassar, Meaad Harahsheh, Ammena Binsaleh, Sireen Shilbayeh​

Abstract :This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children’s health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.

Keywords :COVID-19 ,Vaccination ,Attitude,Children ,Jordan

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​​​​​Research Title :A cross-sectional study on adult lifestyle habits during the COVID-19 pandemic

Authors :Ghadeer Suaifan, Ala’ M. Abu-Odeh, Mayadah B. Shehadeh, FahidAbu Jbara, Ward Abu Jbara, Razan I. Nassar ​

Abstract :COVID-19 has spread and developed into a pandemic disease, forcing countries to impose challenging protocols and lockdowns. This study assessed shopping, food consumption behavior, and feelings in Jordan and several Arab countries during the COVID-19 pandemic. A cross-sectional web-based survey among the Middle East population was conducted using an online questionnaire between July and September 2022. Participants were requested to answer a standardized and validated structured questionnaire. Demographic information, shopping behavior information, and mental health data were requested. A total of 542 respondents were included in the study. During COVID-19 quarantine, participants (68.6%) reported decreased shopping frequency and buying more food than usual (37.5%). Cereals and legumes were the primary food types stored by participants (76.9%). Multiple logistic regression revealed the age of the participant as a significant factor affecting storing of food (being ≤ 25 years old (OR = 0.456, p value = 0.038)). 75.7% of female participants eat less frequently in restaurants than usual. In contrast, among males, 48.5% reported that they eat at restaurants less frequently than usual. The country of residency and gender were the significant factors affecting negative feelings and emotions. Participants in countries other than Jordan had a higher negative feeling score (Beta = 0.086, p value = 0.042). Furthermore, females had a higher negative feeling score (Beta = -0.128, p value = 0.003) as the negative feelings score for females was 3.58 (SD = 5.443). On the other hand, it was 2.10 (SD = 5.091) for males. The COVID-19 pandemic has altered Jordanians’ attitudes, shopping, and food consumption habits. Although positive behaviors have improved, such as shopping less frequently, eating home-cooked meals, and dining with family, frequent snacking and food storage have increased. Finally, public awareness of shopping and food consumption habits should be promoted.

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​​​​​Research Title :An overview of the experience of Iraqi COVID-19 patients, and the role of the pharmacists during their infection

Authors :Razan I. Nassar, Iman A. Basheti, Alhareth Ahmad, Shaymaa Al-Majmaie, Dima Awajan, Ruaa R. Al-Alwany, Ayman Nassar, Samar Thiab ​

Abstract :Background: The global healthcare systems have faced significant challenges due to the COVID-19 pandemic. Pharmacists have been frontline healthcare workers playing a pivotal role during this pandemic. This study aimed to understand the experiences of Iraqi COVID-19 patients and highlight the role of pharmacists during their infection. Methods: A cross-sectional web-based study was conducted among the Iraqi public. Inclusion criteria comprised individuals residing in Iraq who had previously contracted COVID-19. The survey assessed demographic information, the COVID-19 experience of participants, and the role of pharmacists from the patient’s perspective. Results: Over 561 participants from various Iraqi cities responded. Most participants (43.5%) stated that their infection source was mainly contacting infected family or friends. About 40.0% of the participants required a specialist doctor visit during their infection, 5.9% required hospitalization, and 1.6% required admission to the intensive care unit (ICU). Regarding herbal products, 42.8% of the study’s participants used herbs. Fatigue and fever were the most comely reported symptoms. Vitamin C and analgesics were the most used supplements/medications. Of the participants, 35.0% stated that they visited a pharmacy in person, while 31.2% contacted pharmacists through a third person. Nearly half of the respondents strongly agreed or agreed with the statements highlighting the proactive role of pharmacists in providing medical advice, prevention tips, medication instructions, and drug-to-drug interaction guidance during the COVID-19 pandemic. Conclusion: The study highlights the significant role of pharmacists in Iraq during the COVID-19 pandemic, emphasizing their importance in patient care, medication management, and delivering health advice. Collaborative efforts between pharmacists and other healthcare professionals can further optimize patient care during health crises.

Keywords :COVID-19, Pharmacists, Iraq, Patient care, Medication management

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​​​​​Research Title :Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan

Authors : Muna Barakat , Razan Nassar, Lobna Gharaibeh L, Samar Thiab, Abdulqadir J. Nashwan​

Abstract :This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.

Keywords : Deprescribing; Jordan; Pharmacy practice; Polypharmacy

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​​​​​Research Title :Investigation of the knowledge, attitudes, and perceptions regarding the utilization of rosemary among the population in Jordan

Authors :Samar Thiab, Razan I. Nassar, Saif Alislam Alamleh, Abdullah Aboqubo, Abdullah Aljebori ​

Abstract : Rosemary (Rosmarinus officinalis) has a rich historical use for various reasons due to its beneficial characteristics including stimulating hair growth, providing antioxidant and antibacterial effects, and functioning as a skin conditioner and fragrance enhancer. The plant is cultivated in Jordan and using it is gaining popularity among the population. Aim of the study To assess the knowledge, attitude and perception of rosemary use among Jordanians. Materials and methods A cross-sectional study was conducted targeting at least 385 participants via social media platforms. Face and content validity of the questionnaire was performed by independent researchers. The questionnaire was divided into three main sections including the demographics section, the knowledge section and the attitude toward rosemary use. Statistical analysis was conducted using SPSS including descriptive statistics, chi-square tests, and multiple linear regression. Results The study’s participants (n = 407) had a mean age of 30.98 years old (SD = 12.76). The mean knowledge score for the participants ranged from -5 to 7, with a mean of 2.96 (SD = 2.61), with younger participants exhibiting higher knowledge scores regarding rosemary. Approximately half of the participants (48.2%) reported using rosemary for medical purposes. About three-quarters reported using rosemary oil, but a higher percentage reported using the leaves. Around three quarters administered it orally or applied it topically. Most participants obtained rosemary by growing it at home or from herbalists. Family and friends were the main influencers for rosemary users. Most of the study participants strongly agreed/agreed that plants possess a healing power (94.4%). The most reported reason for using rosemary was improving the hair condition (82.1%) followed by gastrointestinal problems (67.9%). Conclusions The study highlights the widespread use of rosemary for different reasons through different methods of application. Addressing misconceptions and enhancing knowledge dissemination may allow informed decision-making and promote the safe and effective use of herbal therapies.

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​​​​​Research Title :Exploring Jordanian medical students’ perceptions and concerns about ChatGPT in medical education: a cross-sectional study

Authors :Adnan Abu Hammour, Khawla Abu Hammour, Hamza Alhamad, Razan Nassar, Faris El-Dahiyat, Majd Sawaqed, Aya Allan, Qusai Manaseer, Mohammad Abu Hammour, Abdulsalam Halboup, Rana Abu Farha ​

Abstract :Background The integration of Artificial Intelligence (AI) tools like ChatGPT into medical education is expanding, offering benefits such as efficient information synthesis. However, concerns about the accuracy, reliability, and proper use of these tools persist. Understanding medical students’ perceptions of ChatGPT is crucial for optimising its use in educational settings. Objectives To evaluate how medical students perceive ChatGPT for educational purposes and to assess its perceived advantages and disadvantages. Methods A cross-sectional study was carried out using a questionnaire with five main domains to explore Jordanian medical students’ perceptions, practices, and concerns regarding the ChatGPT. This study was conducted from May to July, 2023, and the data were collected using the convenience sampling technique through Google Forms shared within medical students’ Facebook groups. Descriptive statistics summarised participant demographics, while logistic regression identified factors influencing ChatGPT usage. Variables with a P-value ≤ 0.05 in multiple regression were considered statistically significant. Results Nearly two-thirds (N = 136, 61.5%) claimed to have knowledge of AI but not in clinical settings. Most participants (88.5%, N = 216) were aware of ChatGPT, with 86.9% (N = 212) agreeing that ‘Medical students can benefit from using ChatGPT.’ Additionally, 83.2% (N = 203) felt that ‘ChatGPT helps students quickly and easily summarize complex information.’ Conversely, 78.3% (N = 191) expressed concerns about ChatGPT’s potential inaccuracies, with accuracy and reliability cited as primary concerns. Multiple logistic regression showed that younger students (OR = 0.902, P = 0.025) and those with lower proficiency (OR = 0.487, P = 0.007) used ChatGPT more frequently than others. Conclusion Although the use of the ChatGPT could be more beneficial for aiding students in developing medical knowledge, evidence-based academic regulations should guide its use. Future research should be conducted to examine the enablers and barriers to ChatGPT use in medical education.

Keywords : Artificial intelligence, ChatGPT, perception, concerns, medical students, Jordan

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​​​​​Research Title :Healthcare providers' perspectives on corticosteroid-containing drugs: a cross-sectional study in the United Arab Emirates

Authors : Muna Barakat, Diana Malaeb, Ahmad El Ouweini, Salah Aburuz, Sham ZainAlabdin, Omar El Khatib, Bassem Sadek, Razan I. Nassar, Amal Akour​

Abstract : Background Addressing knowledge and concerns related to corticosteroid is essential to enhance patient care, promote optimal utilization, and minimize their potential side effects. Methods A cross-sectional study was conducted to assess knowledge and attitudes regarding corticosteroid use among healthcare providers (HCPs) in the United Arab Emirates using a validated questionnaire. Knowledge, attitudes, and fear items were described as frequency and percentages. Then, a total score was calculated; multilinear regression was used to see the effect of demographics on these scores. Results Among 129 HCPs, 100 had previously prescribed corticosteroids (77.5%), with intranasal spray being the most dispensed dosage form (89.0%). Respiratory diseases were the most reported indication for corticosteroid dispensing (93.0%). HCPs preferred corticosteroids for their ability to quickly relief of patients' symptoms (67.0%). About 60.0% identified increased appetite as a patient-reported side effect. The assessment of the HCPs' knowledge showed a median score of 10 out of 11 (IQR = 9–11). The median fear score was six out of 10 (IQR = 4–10), but they were significantly and conversely related to each other. Conclusion This study revealed that while HCPs in the UAE possess substantial knowledge regarding corticosteroid use, their concerns, particularly around side effects, indicate a need for further education. Addressing these concerns through targeted educational programs could enhance the safe and effective utilization of corticosteroids, ultimately improving patient care outcomes.

Keywords :Corticosteroids, Corticophobia, Perception, Knowledge, Fear, UAE

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​​​​​Research Title :Knowledge Gap or Prepared Force? Exploring United Arab Emirates Pharmacy Students and Pharmacists' Monkeypox Readiness

Authors : Razan I. Nassar, Alhareth Ahmad, Iman A. Basheti, Amin M. Omar, Hiba Jawdat Barqawi, Karem H. Alzoubi, Moyad Shahwan, AlMuzaffar M. Al Moukdad, Mays Alrim Al Moukdad, Eman Abu-Gharbieh ​

Abstract :Background: The WHO classified the mpox outbreak as a worldwide health emergency. Increasing the contribution of healthcare providers, such as pharmacists, can enhance preventive efforts. Assessing the knowledge and confidence levels of pharmacists in diagnosing and managing mpox cases can shape the response strategies necessary for the management of such outbreaks. Methods: This research employed a cross-sectional survey designed to assess the knowledge and preparedness of pharmacy students and pharmacists in the United Arab Emirates (UAE) regarding the mpox virus outbreak. Independent researchers evaluated the survey items to confirm the face and content validity of the developed survey. The final study’s survey was structured into three distinct sections, each addressing a specific area of interest. Data were analyzed using the IBM SPSS Statistics. Results: The 388 participants had a median age of 22.00 years (IQR = 5.00). The survey revealed that participants primarily relied on the WHO reports for mpox information (79.8%). The total knowledge scores (TK score) varied, ranging from −6 to 23 (median = 6.00), and symptom knowledge scores (SK score) ranged from −3 to 9 (median = 2.00). Older participants (p-value = 0.008) and females (p-value = 0.014) exhibited significantly higher TK scores. Only about 31.0% of participants expressed confidence in diagnosing mpox cases, and 34.6% expressed confidence in managing mpox cases. Nearly a quarter of the participants (24.5%) thought that getting vaccinated against COVID-19 led to contracting mpox more likely, whereas 45.7% believed that a previous infection with COVID-19 increases the risk of having mpox and its associated symptoms. Many respondents (38.7%) expressed their concern that mpox could emerge as the next major epidemic following COVID-19. Conclusion: Although pharmacists and pharmacy students in the UAE are aware of mpox, their knowledge and confidence levels in diagnosing and managing vary significantly. These findings suggest the need for targeted educational programs to enhance the understanding and preparedness of pharmacists to manage and prevent mpox cases.

Keywords :Mpox; pharmacists; UAE; knowledge; diagnose; management

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​​​​​Research Title :Measuring the empathy levels among pharmacy students: a journey toward enhancing effective communication and understanding in the pharmacist-patient relationship

Authors : Alhareth Ahmad, Razan I. Nassar, Samar Thiab, Mohammad Alostath, Rania Aldarawish, Sofiyan Mohd Ramahi, Anas Abed, Ahmad A. Assiri​

Abstract :Background: Empathy is an essential skill for healthcare professionals, including pharmacists, because it improves person-centered care and treatment outcomes. Measuring the level of empathy among pharmacy students gives an understanding and insight into their readiness for incorporating a person-centered practice in their future work. This study aimed to assess empathy levels among Jordanian pharmacy students and explore the factors influencing these levels. Methods: A cross-sectional study using a web-based survey was conducted among currently enrolled pharmacy students from various academic years at both public and private Jordanian universities. The survey consisted of three sections; demographics, the Interpersonal Reactivity Index (IRI) to identify pharmacy students’ empathy level, and items specifically related to the pharmacist-patient relationship. Statistical analysis was conducted using SPSS software. Multiple linear regression was used to reveal the factors affecting students’ empathy. Results: A total of 396 pharmacy students participated in the current study, with a mean age of 21.65 years (SD = 2.865), and about three-quarters were female (73.5%). The mean IRI score for the students was 70.89 (SD = 12.82), with subscale means as follows: perspective-taking (18.52), fantasy (17.05), empathic concern (20.16), and personal distress (15.16). Students’ age, gender, awareness of the term empathy, and studying empathy at universities were among the factors that significantly affected the students’ empathy scores. Conclusion: The present study reveals moderate empathy levels among Jordanian pharmacy students and sheds light on an understudied aspect within the pharmacy practice in Jordan. Significant demographic and educational factors affected the pharmacy students’ empathy levels. Incorporating empathy education in pharmacy curricula can better prepare pharmacy students for person-centered care.

Keywords :empathy, IRI, pharmacy students, communication, training, emotional intelligence, Jordan

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​​​​​Research Title :Exploring the utilization of supplements, natural products, and medications among Jordanian COVID-19 patients

Authors : Alhareth Ahmad, Amani Alhadid, Maysaa Binni, Eman Elayeh, and Razan Nassar ​

Abstract :Background: The COVID-19 pandemic has significantly impacted global health, leading individuals to explore several treatments, including pharmaceutical medications, dietary supplements, and natural products, in order to manage their symptoms. Understanding these treatment patterns is vital for public health planning and policy development. Methods: A cross-sectional survey was conducted from February to May 2021, to investigate the use of supplements, natural products, and medications among Jordanian COVID-19 patients, assessing the prevalence, types, and perceived effectiveness of these interventions. Data were collected using a structured questionnaire. Participants were recruited through social media. Descriptive statistics and chi-square tests were employed for data analysis through SPSS. Results: The study included 1,178 Jordanian individuals who had contracted COVID-19. Of the participants, 54.8% were female, and 44.9% were aged 18-25. The most commonly reported symptoms were loss of smell (63.8%), headache (63.3%), and sore muscles (59.0%). Regarding treatment, 82.4% used at least one vitamin, with vitamin C (75.8%) and zinc (59.9%) being the most used. Natural substances such as honey (36.3%) and ginger (34.6%) were also widely used among the participants. Antipyretics, especially Paracetamol (60.5%), were the most frequently used drugs. Many participants perceived these treatments as effective, with vitamin C and honey being rated as effective by 62.9% and 67.8% of users, respectively. Conclusion: The study highlights a high prevalence of supplement and natural product use among Jordanian COVID-19 patients. These findings provide valuable insights into patient behaviors and can inform future healthcare strategies and policy formulations in similar contexts. Understanding these patterns is essential for developing effective public health guidelines and interventions during pandemics.

Keywords : Vitamins; Dietary Supplements; Natural Products; Medications; Jordan; COVID-19

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​​​​​Research Title :The psychological and behavioral impact of coronavirus outbreak on people living in the countries of the Levant: a cross-sectional study

Authors :Husam Abazid, Abdalwhab Zwiri, Osama R. Atoom, Esraa Ebraheem Al Jomaa, Razan I. Nassar, Dina Alkaddah, and Wardeh Mahmoud Abu Kluob ​

Abstract :The COVID-19 pandemic has had profound psychological and behavioral effects on populations worldwide. The Levant Countries have faced unique challenges that have exacerbated the mental health burden on individuals. Limited research specifically addressed the psychological and behavioral impact on people living in the Levant. This study aims to fill this gap by examining the cross-sectional data on mental health outcomes and behavioral changes in this region. A cross-sectional online survey was conducted between 1 November and 20 December 2022, targeting individuals from Jordan, Syria, Palestine, and Lebanon. The questionnaire, validated by experts, covered demographic information, mental health status, and behavioral changes. Data was analyzed using SPSS, employing descriptive statistics and logistic regression to identify factors associated with anxiety and depression. A total of 610 individuals participated in the study, with about two-thirds female. Of the participants (n = 610), 37.7% reported anxiety, and 34.0% reported depression post-pandemic. Interestingly, the results highlighted an increase in anxiety and depression during the pandemic compared to before the pandemic. Females were significantly more likely to suffer from both anxiety and depression (p < 0.001). Moreover, behavioral changes included increased social media use (90%) and improvements in personal hygiene (45.1%). Our study concluded that The COVID-19 pandemic led to significant mental health challenges and behavioral changes among individuals in the Levant. This study suggests implementing a reliable crisis management strategy by governments that outlines recovery measures to help people navigate through this period with minimal impact on the quality of their lives.

Keywords :COViD-19 pandemic;mental health; anxiety;depression; behavioralchanges; levant region

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​​​​​Research Title :Drug regulatory affairs under focus: Knowledge and perceptions among pharmacists and pharmacy students

Authors : Manal A. Ayyash, Razan I. Nassar, Raghad Al-Muhtaseb, and Kamel A. Jaber​

Abstract :Objectives Pharmaceutical product development, registration, and post-marketing surveillance are the main concerns of the Regulatory Affairs (RA) profession in regulated pharmaceutical industries. The RA assumes a pivotal role in ensuring product quality, patient safety, and drug efficacy and constitutes a vital part of the pharmaceutical industry. The current study aims to evaluate the knowledge and understanding of the concept of RA and Drug Registration (DR) among pharmacists and pharmacy students in Jordan. Methods A cross-sectional study was conducted targeting pharmacists in different sectors and pharmacy students to assess knowledge and perceptions of RA and DR in Jordan. The participants were invited to participate by sending the survey link through social media platforms (WhatsApp). Results A total of 411 participants completed the study survey. Among the study participants, 193 were pharmacists (47.0%), while the rest were pharmacy students. The majority indicated that they had never taken a course related to RA during their undergraduate studies (77.4%). About half of the participants lacked awareness of RA personnel responsibilities with most of the participants agreeing that workshops, lectures, and training are required. Interpretation of results and conclusion This study aims to elevate Jordanian pharmacists’ awareness by focusing the efforts on young pharmacists and pharmacy students. This can be achieved by implementing RA courses within the pharmacy curricula and upholding the role of the regulatory bodies in Jordan.

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