Access to antibiotics without prescription in community pharmacies in Yemen during the political conflict

Halboup, Abdulsalam; Abdi, Abdikarim Mohamed; Ahmed, Maqsood; Al-Qadasi, Farouk Abdulrahman; Othman, Gamil

doi:10.1016/j.puhe.2020.03.003

Cited by 18 publications

(35 citation statements)

References 26 publications

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“…The target populations in all the studies were CP 28 (62.2%), 19-Boura F, Al-Tabakha M, Hassan N, Darwich M. Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review. Pharmacy Practice 2022 Jul-Sep;20(3):2701. https://doi.org/10.18549/PharmPract.2022.3.2701 3 22,24,26,29,30,[32][33][34][35]38,39,41,42,46,47,[49][50][51][52][53][54][55][58][59][60] pharmacy staff (pharmacists and non-pharmacists) 10 (22.2%), 18,23,31,36,37,43,44,48,57,60 and CP and GP 1 (2.2%). 27 Table 1 provides a summary of the descriptive characteristics of the included studies in the review.…”

Section: The Characteristics Of the Included Studiesmentioning

confidence: 99%

“…[19][20][21][22][23][24][25][26]28,29,[31][32][33]35,36,38,[41][42][43][44]46,[48][49][50][51][52]57,58,[60][61][62] Some studies got the information through direct questioning of the pharmacy representatives (manager or pharmacist in charge) 3 (6.7%), 23,25,28 or the participants whom the SP was interacting with 5(11.1%). 20,57,58,60,61 Others reported the information based on estimation 9 (20%), 19,26,31,36,38,42,49,61,61 or through surveying the participants 4 (8.9%). 22,30,…”

Section: The Outcomes Measures and Major Findings Of The Included Stu...mentioning

confidence: 99%

“…22,36,52 The most outcome measured in the included studies was the adequacy of skill (pre-dispensing and/or post-dispensing) 38 (84.4%), 19,21,22,[24][25][26][27][28][29][30][31][32][33][34][35][36]38,[40][41][42][43][44][45][47][48][49][50][51][52][53][54][55][56][58][59][60][61][62] the the drug use pattern 19 (42.2%). 18,24,26,27,29,[31][32][33]36,[41]…”

Section: The Outcomes Measures and Major Findings Of The Included Stu...mentioning

confidence: 99%

“…A broad variety of terms were used in the studies to the individuals used to perform the simulated visits. The individuals were described as SP 37 (82.2%), 19,20,[22][23][24][25][26][27][28][30][31][32][33][34][35][36]38,[41][42][43][44][45][47][48][49][50][51][52][54][55][56][58][59][60][61][62][63] simulated client 10 (22.2%), 18,21,24,27,29,35,39,40,47,5 7 and mystery shopper 10 (22.2%), 23,26,29,32,[40][41][42]54,55,59 mystery patient 3 (6.7%), 21,26,…”

Section: The Characteristics Of the Simulated Patient And Simulated V...mentioning

confidence: 99%

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Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review

Boura¹,

Al-Tabakha²,

Hassan³

et al. 2022

PHARMPRACT

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Background: The use of simulated patient (SP) methodology in pharmacy practice settings has increased recently. However, its applications can vary significantly within a region, hence affecting the quality of the SP methodology. Objective: The purpose of this systematic review is to critically assess the use of the SP methodology for assessing the practice of community pharmacists (CP) in the Middle East and North Africa (MENA) region. Methods: A comprehensive literature search was conducted using EMBASE, MEDLINE, ProQuest, and SCOPUS to identify articles published from 2011 to 2022. The selection of relevant studies for inclusion in the systematic review was based on the pre-determined inclusion criteria. The Mixed Method Appraisal Tool (MMAT) was used to assess the methodological quality of the included studies. Results: Electronic search yielded 478 publications. A total of 45 studies were reviewed. The studies were conducted in 12 countries of the MENA region. The sample size between the reviewed articles ranged from 20 to 1000 (median= 129). A greater number of the included studies measured the adequacy of skill (pre-dispensing and/or post-dispensing) 38 (84.4%). The vast majority of the studies reported unsatisfactory results regarding the competencies of CP. The number of the SP ranged from 1 to 37 (median= 2). Most of the studies recruited only one SP per pharmacy 35 (77.8%). The most common data collection method was written data collection form 42 (93.3%). Few studies only had a detection system for SP visits 11 (24.4%), and only six studies incorporated performance feedback (13.3%). More than two-thirds of the studies provided a training session for SP 37 (82.2%). There was variation in the symptoms and drugs used in the SP scenarios in the studies. Conclusion: Although the results demonstrate the growth in the use of the SP method in MENA region countries, studies showed high variability in the level of reporting the study methodology. Consequently, we argue the need for standardized reporting of these studies.

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Section: The Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: The Outcomes Measures and Major Findings Of The Included Stu...mentioning

confidence: 99%

Section: The Outcomes Measures and Major Findings Of The Included Stu...mentioning

confidence: 99%

Section: The Characteristics Of the Simulated Patient And Simulated V...mentioning

confidence: 99%

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Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review

Boura¹,

Al-Tabakha²,

Hassan³

et al. 2022

PHARMPRACT

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“…There was pharmacy sale and counter-prescribing of antimicrobials, in common with many others countries especially in the global south, and as previously documented for Yemen. 55,56 In these contexts, pharmacies are usually the first port-of-call for clients with minor ailments, and, thus, serve an important public health function. Our results conform with a 2014 study by Belkina et al in which 78.2% (n=400) teachers indicated having obtained a non-prescribed antibiotic.…”

Section: Prescription and Dispensing Practicesmentioning

confidence: 99%

Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Orubu

Najwa²,

Ching

et al. 2021

Preprint

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Antimicrobial resistance (AMR), largely driven by irrational use of antimicrobials, is a global, multi-faceted problem calling for a complete understanding of all contributory factors for effective containment. In conflict settings, war-wounds and malnutrition can combine with existing social determinants to increase demand for antibiotics, compounding irrational use. In this study, we focus on Yemen, a low-income country with active conflict for the last five years, and analyze the current status of awareness and stewardship efforts regarding AMR. We performed a survey of prescribers/physicians and pharmacists to describe perceptions of AMR prevalence, antibiotic use practices and stewardship in Yemen, supported by a non-systematic scoping literature review and a key informant interview. Participants (96%, n=57) reported a perceived high AMR prevalence rate. Prescribers (74%, 20/27) reported pressure to prescribe broad-spectrum antibiotics. In the majority of cases (81%, 22/27), Antimicrobial Sensitivity Tests (AST) were not performed to inform antibiotic choice. The main barrier to AST was cost. Most pharmacists (67%, 18/27) sold antibiotics without prescriptions. Amoxicillin (including amoxicillin-clavulanate) was the most-commonly prescribed (63%, 17/27) or dispensed (82%, 22/27) antibiotic. AST was rated the least important solution to AMR in Yemen. While there was awareness of a high AMR rate, stewardship is poor in Yemen. We note that barriers to the use of AST could be addressed through the deployment of low-cost AST kits. Compulsory continuing education emphasizing the use of AST to guide prescribing and patients’ awareness programs could help avoid irrational use.

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Urinary Tract Infections Management in the Developing Countries

Halboup

Al-Khazzan

Battah

et al. 2023

Handbook of Medical and Health Sciences in Developing Countries

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Access to antibiotics without prescription in community pharmacies in Yemen during the political conflict

Cited by 18 publications

References 26 publications

Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review

Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review

Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Urinary Tract Infections Management in the Developing Countries

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