PurposeTo develop an in-depth understanding of the barriers to medication adherence among patients with uncontrolled diabetes attending primary health care (PHC) centers in Qatar by exploring and integrating patients’ and health care providers’ perspectives.Participants and methodsA descriptive qualitative methodology was used in this study. A trained researcher conducted semi-structured face-to-face interviews at two PHC centers. Patients with uncontrolled diabetes (with varied sociodemographic characteristics) and their respective health care providers (physicians, pharmacists, nurses, dieticians, and others) were purposively selected from the two PHC centers. All interviews were audio recorded, transcribed verbatim, and analyzed using thematic content analysis.ResultsThirty interviews (14 patients and 16 health care providers) were conducted. A number of barriers to medication adherence were identified and classified broadly under three main themes: 1) patient-related factors, which included patients’ individual characteristics and patients’ perception, attitude, and behavior; 2) patient–provider factors, which included communication and having multiple health care providers caring for the patient; and 3) societal and environmental factors, which included social pressure and traveling to visit friends and relatives.ConclusionPatients with uncontrolled diabetes face multiple barriers to medication adherence. Similar themes emerged from both patients and their care providers. This research highlights the need for concerted multidimensional efforts and series of interventions to overcome these barriers. One vital intervention is expanding the scope of pharmacists’ role within the PHC centers through providing medication reconciliation, patient-tailored medication counseling, and medicines use review, which may improve treatment outcomes among patients with diabetes.

Objectives This study evaluated Qatar's community pharmacists’ therapeutic recommendations, medication labelling, dispensing and counselling practices in response to common cold and allergic rhinitis symptoms. Methods A simulated client method was used to assess the practice behaviour of community pharmacists. Twenty‐five pharmacies in Qatar were randomly selected and further randomised into two groups: common cold (n = 15) and allergic rhinitis (n = 10). The pharmacies were visited or called according to the study group twice by two independent simulated clients; each simulated client visited or called the 25 pharmacies once. Therapeutic recommendations, labelling, dispensing and counselling practices from the studied pharmacies were compared to Joint FIP/WHO (International Pharmaceutical Federation/World Health Organization) standard guidelines. Data analyses were performed using both descriptive and inferential statistics (α = 0.05). Key findings Cough syrups (37%), analgesics (31%) and antihistamines (19%) were the most frequently dispensed medicines in the common cold scenario. Pharmacists were less likely to dispense cough syrups (12%) and analgesics (12%), but were more likely to dispense antihistamines (35%) in the allergic rhinitis scenario. Antibiotics were found in three encounters for each scenario. Many community pharmacists did not adhere to medicine labelling standard. No significant differences were found regarding labelling practices and important questions to be asked (P > 0.05), except questions related to fever and cough symptoms (P < 0.05). The median cost for treating allergic rhinitis was higher, but this did not reach statistical significance (QAR 60 versus QAR 51 (equivalent to USD 16.44 versus USD 13.97), P = 0.586). Furthermore, no significant differences were found between pharmacists’ gender (P = 0.642), pharmacy type (P = 0.487) and duration of encounter (P = 0.266). Conclusions Community pharmacists in Qatar appeared to exhibit practices that are below the established standards in response to common cold and allergic rhinitis symptoms.

Background: Several instruments are currently used to assess Coronavirus Disease 2019 (COVID-19) -induced psychological distress, including the 22-item Impact of Event Scale-Revised (IES-R). The IES-R is a self-administered scale used to assess post-traumatic stress disorder (PTSD). The current study aimed to examine the construct validity of the IES-R, based on the Rasch model, with COVID-19-related data, as well as to test the multilevel construct validity of the IES-R within and among countries during the pandemic crisis. Methods: A multi-country web-based cross-sectional survey was conducted utilizing the 22-item IES-R. A total of 1020 participants enrolled in our survey, of whom 999 were included in the analyses. Data were analyzed using Rasch modeling and multilevel confirmatory factor analysis (MCFA). Results: The Rasch modeling results of the IES-R demonstrated that the IES-R is a satisfactory instrument with the five-point Likert scale, asserting that its 22 items are significant contributors to assessing PTSD as a unidimensional construct covered by the items of the IES-R. The MCFA confirmed that the 22-item IES-R, with its three factors, including intrusion, avoidance, and hyperarousal, demonstrates adequate construct validity at the within- and among-country levels. However, the results of the Akaike information criterion (AIC) model determined that the 16-item IES-R is better than the 22-item IES-R. Conclusion: The results suggested that the 22-item IES-R is a reliable screening instrument for measuring PTSD related to the COVID-19 pandemic, and can be utilized to provide timely psychological health support, when needed, based on the screening results.

Objectives: The aim of this study is to assess the knowledge (K), attitude (A), and readiness to practice (rP) levels regarding disaster medicine and preparedness among health profession students at Qatar University. Methods: A survey-based study was carried out to assess medical, pharmacy, and health sciences students’ KArP levels using pretested and validated questionnaire. Student’s t-test, analysis of variance, correlation, and linear regression were used with an alpha level of 0.05. Results: The difference in the mean KArP level between genders was not significant (P > 0.05). Students from the College of Health Sciences had significantly higher KArP levels than those from the College of Pharmacy (101.5 vs 90.0; P = 0.033). Overall, Qatari students had better knowledge, attitude, and readiness to practice scores and total KArP scores than non-Qatari students. Moreover, students who were born in Qatar also had better knowledge, attitude, and readiness to practice scores and total KArP scores than students who were born outside Qatar. Significant direct moderate correlations were found among the 3 KArP parameters (P < 0.001). Knowledge and attitudes were indicated to be significant predictors of readiness to practice (P < 0.001). Conclusions: Students from the health colleges at Qatar University have moderate disaster medicine preparedness

Background: Pharmacoeconomic evaluation is important for breast-cancer medications due to their high costs. To our knowledge, no systematic literature reviews of pharmacoeconomic studies for breastcancer medication use are present in developing-countries. Objectives: To systematically review the existing cost-effectiveness evaluations of breast-cancer medication in developing-countries. Methodology: A systematic literature search was performed in PubMed, EMBASE, SCOPUS, and EconLit. Two researchers determined the final articles, extracted data, and evaluated their quality using the Quality of Health-Economic Studies (QHES) tool. The interclass-correlation-coefficient (ICC) was calculated to assess interrater-reliability. Data were summarized descriptively. Results: Fourteen pharmacoeconomic studies published from 2009 to 2019 were included. Thirteen used patient-life-years as their effectiveness unit, of which 10 used quality-adjusted life-years. Most of the evaluations focused on trastuzumab as a single agent or on regimens containing trastuzumab (n = 10). The conclusion of cost-effectiveness analysis varied among the studies. All the studies were of high quality (QHES score >75). Interrater reliability between the two reviewers was high (ICC = 0.76). Conclusion:In many studies included in the review, the use of breast-cancer drugs in developing countries was not cost-effective. Yet, more pharmacoeconomic evaluations for the use of recently approved agents in different disease stages are needed in developing countries.