Background: Proper drug prescribing can contribute immensely to reducing overall morbidity, mortality, and cost of pharmacotherapy, particularly in the management of heart disease. Currently, no studies have been implemented on the appropriateness of cardiologist prescribing among hospitalized pediatric patients in Palestine. This study aimed to compare the prescribing pattern of pediatric cardiologists during clinical pharmacist intervention versus routine cardiologists' practice at a tertiary care hospital in Palestine. Methods: A comparative study of 48 pediatric patients who were admitted to the cardiology ward in 2020 and readmitted in 2021 was conducted. This comprised two stages: routine practice stage (S0) of cardiologists without clinical pharmacist intervention, and intervention stage (S1) where clinical pharmacist prospectively involved in cardiology teamwork. Prescribing indicators and length of hospital stay were compared between the two study stages using Pearson's chi- square and paired t-test. Results: Compared with the routine practice stage, drugs prescribed per patient were significantly lower in the intervention stage ( mean 5.98 S1 versus 6.87 S0; P=0.043). Higher drugs prescribed by generic names were found in the intervention stage (97.2% S1 versus 72.1% S0; P= 0.002). Patients in the intervention stage encountered significantly fewer antibiotics than in the routine practice stage (60.4% and 77.1%, respectively; P=0.009). The mean length of hospital stay was significantly reduced from 8.22 days in the routine practice stage to 6.93 days in the intervention stage (P=0.032). There were no significant differences in the prescribing of essential drugs (99.3% S1 versus 95.2% S0; P=0.152) and injections (75.0% S1 versus 73.0% S0; P=0.496) between the two stages. Conclusion: Clinical pharmacist intervention has optimized the prescribing pattern of pediatric cardiologists and reduced the length of stay for hospitalized pediatric patients. Palestinian health leaders have to support the involvement of clinical pharmacists in cardiology and other disciplines to promote rational prescribing and drug utilization.
Background: Coronavirus disease 2019 (COVID-19) has spread worldwide and poses a serious public health-threat. High IL-6 levels were associated with the severity of COVID-19 and del to the use of anti-IL-6 Tocilizumab during the pandemic. Therefore, this case-control study was conducted to evaluate the role of Tocilizumab on the mortality rate among severe and critically ill COVID-19 patients. Method: A case-control study relied on the use of an electronic data collection sheet; the data were collected from February to May 2022. The study was performed on adult patients with critical COVID-19 at three major hospitals in the Gaza Strip, Palestine where patients were treated in the intensive care units (ICUs). Patients from the hospitals were included and divided into two groups by simple random sampling technique. Results: Of the 202 patients with critical COVID-19 admitted to ICUs of three hospitals, 102 (50.5%) were treated with Tocilizumab. A total of 58 (56.9%) patients in the Tocilizumab group were cured, and 44 (43.1%) died. In the control group, only 26 (26.0%) were cured and 72.0% died. There was no statistically significant effect of Tocilizumab on total hospital stay and ventilation periods. Patients treated with Tocilizumab had a longer stay in the ICU (14.02 ±8.796 days compared to 10.52 ± 9.596 days in the control group, P = 0.027), but shorter incubation periods were observed in the same group (3.25 ±1.137 days in Tocilizumab group compared to 7.38 ±3.376 days in the control group P = 0.036). Conclusion: This study found that administration of Tocilizumab can improve clinical outcomes, reduce risk of mortality, and frequency of intubation in patients severely infected with COVID-19. However, there was no significant difference between the two groups in terms of hospitalization times and mechanical ventilation needs. Based on the current report, healthcare specialists should consider Tocilizumab with the updated treatment guidelines for critically ill COVID-19 patients.
Background: Although the willingness of healthcare specialists is a determining factor in the successful implementation of clinical pharmacy services, there is little information on specialists' needs and satisfaction with incorporating such a new discipline into Palestinian clinical practice. Hence, this study aimed to determine the need and satisfaction of healthcare specialists toward the performance of clinical pharmacists in Palestine.Methods: A crosssectional study using a self-administered questionnaire was undertaken between March and May 2022 at a tertiary care pediatric hospital. A total of 175 healthcare specialists (physicians, pharmacists, and nurses) working alongside clinical pharmacists were asked to participate in this survey. T-test and one-way ANOVA were used to examine the association between need and satisfaction with the different variables. Results: Of the total; 167 specialists completed the questionnaire with a response rate of 95.4%. The majority 95.8% of specialists expressed a need to work with clinical pharmacists and 94% of them were satisfied with their positive contribution to healthcare delivery. Significant differences were found between the practitioners' need and their country of education (p= 0.009) and profession (p= 0. 026). Moreover, male participants (p = 0.001) and those holding a master's degree (p = 0.002) were significantly satisfied with the performance of clinical pharmacists in the healthcare team. Conclusion: Most healthcare specialists had a positive belief in adopting the performance of clinical pharmacists in direct patient care. Consequently, Palestinian stakeholders should be in place to extrapolate clinical pharmacy workers within various healthcare centers and promote their professional collaboration with other specialists.
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