khawla abu hammour

University of Jordan


Scopus Publications

Scopus Publications

  • ChatGPT in pharmacy practice: a cross-sectional exploration of Jordanian pharmacists' perception, practice, and concerns
    Khawla Abu Hammour, Hamza Alhamad, Fahmi Y. Al-Ashwal, Abdulsalam Halboup, Rana Abu Farha, and Adnan Abu Hammour

    Springer Science and Business Media LLC
    Abstract Objectives The purpose of this study is to find out how much pharmacists know and have used ChatGPT in their practice. We investigated the advantages and disadvantages of utilizing ChatGPT in a pharmacy context, the amount of training necessary to use it proficiently, and the influence on patient care using a survey. Methods This cross-sectional study was carried out between May and June 2023 to assess the potential and problems that pharmacists observed while integrating chatbots powered by AI (ChatGPT) in pharmacy practice. The correlation between perceived benefits and concerns was evaluated using Spearman's rho correlation due to the data's non-normal distribution.Any pharmacists licensed by the Jordanian Pharmacists Association were included in the study. A convenient sampling technique was used to choose the participants, and the study questionnaire was distributed utilizing an online medium (Facebook and WhatsApp). Anyone who expressed interest in taking part was given a link to the study's instructions so they may read them before giving their electronic consent and accessing the survey. Results The potential advantages of ChatGPT in the pharmacy practice were widely acknowledged by the participants. The majority of participants (69.9%) concurred that educational material about pharmacy items or therapeutic areas can be provided using ChatGPT, with 66.9% of respondents believing that ChatGPT is a machine learning algorithm. Concerns about the accuracy of AI-generated responses were also prevalent. More than half of the participants (55.7%) raised the possibility that AI systems such as ChatGPT could pick up on and replicate prejudices and discriminatory patterns from the data they were trained on. Analysis shows a statistically significant positive link, albeit a minor one, between the perceived advantages of ChatGPT and its drawbacks (r = 0.255, p < 0.001). However, concerns were strongly correlated with knowledge of ChatGPT. In contrast to those who were either unsure or had not heard of ChatGPT (64.2%), individuals who had heard of it were more likely to have strong concerns (79.8%) (p = 0.002). Finally, the results show a statistically significant association between the frequency of ChatGPT use and positive perceptions of the tool (p < 0.001). Conclusions Although ChatGPT has shown promise in health and pharmaceutical practice, its application should be rigorously regulated by evidence-based law. According to the study's findings, pharmacists support the use of ChatGPT in pharmacy practice but have concerns about its use due to ethical reasons, legal problems, privacy concerns, worries about the accuracy of the data generated, data learning, and bias risk.

  • The prevalence of Carbapenem Resistance Gram negative pathogens in a Tertiary Teaching Hospital in Jordan
    Khawla Abu Hammour, Rana Abu-Farha, Rania Itani, Samar Karout, Aya Allan, Qusai Manaseer, and Walid Abu Hammour

    Springer Science and Business Media LLC
    Abstract Background With the absence of new antimicrobial drugs being developed to replace those facing resistance, bacterial resistance continues to grow. Despite previous studies conducted in various countries, there is a lack of comprehensive local reporting on the occurrence of carbapenem resistance among gram-negative bacteria. Objective This study aims to identify the prevalence of carbapenem-resistant gram-negative bacterial isolates. Method A retrospective cross-sectional study was conducted at an academic hospital in Jordan over an eight-month period, spanning from November 2021 to June 2022. The study involved screening electronic medical records to identify patients with clinical cultures showing the growth of Gram-negative bacteria. Antimicrobial susceptibility results of the Gram-negative isolates were recorded. Results A total of 1,043 isolated Gram-negative bacteria were analyzed for carbapenem susceptibility. Among the species tested, the most common carbapenem-resistant bacteria were Acinetobacter baumannii (153/164, 93.3%), followed by Klebsiella pneumonia (184/311, 59.2%), and Pseudomonas aeruginosa (67/160, 41.9%). The least commonly isolated species resistant to carbapenem were Escherichia coli (25/361, 6.9%) and Proteus mirabilis (1/30, 3.3%). None of Serratia marcescens or Proteus vulgaris isolates were resistant to carbapenem (0%). Overall, the prevalence of carbapenem-resistance gram-negative isolates was 41.2% (430 out of 1,043). Conclusion This study provides population-specific data that are crucial for guiding empirical antimicrobial treatment decisions not only within the participating hospital but also in other nearby healthcare facilities. The results underscore the urgent need for coordinated efforts to address antibiotic resistance in Jordan. Comprehensive measures such as strict infection control methods, annual nationwide surveillance programs, and effective antimicrobial stewardship programs at the national level are imperative to reduce the overuse of broad-spectrum antibiotics.

  • The impact of educational interventional session on healthcare providers knowledge about pharmacovigilance at a tertiary Jordanian teaching hospital
    Faris El-Dahiyat, Khawla Abu Hammour, Rana Abu Farha, Qusai Manaseer, Ala’a Momani, and Aya Allan

    Springer Science and Business Media LLC
    Abstract Objective A limited number of educational interventions among health care providers and students have been made in Jordan concerning the pharmacovigilance. Therefore, the main aim of this study was to evaluate how an educational workshop affected the understanding of and attitudes toward pharmacovigilance among healthcare students and professionals in a Jordanian institution. Methods A questionnaire was used before and after an educational event to evaluate the pre- and post-knowledge and perception of pharmacovigilance and reporting of adverse drug reactions (ADRs) among a variety of students and healthcare professionals at Jordan University Hospital. Results The educational workshop was attended by 85 of the 120 invited healthcare professionals and students (a response rate of 70.8%). The majority of respondents were capable of defining ADRs (n = 78, 91.8%) and pharmacovigilance accurately (n = 74, 87.1%) in terms of their prior understanding of the topic. Around 54.1% of the participants (n = 46) knew the definition of type A ADRs while 48.2% of them (n = 41) knew the definition of type B ADRs. Additionally, around 72% of the participants' believed that only serious and unexpected ADRs should be reported (n = 61, 71.8%), also, 43.5% of them (n = 37) believed that ADRs should not be reported until the specific medication that caused it is known. The majority of them (n = 73, 85.9%) agreed that reporting of ADRs was their responsibility. The interventional educational session has significantly and positively impacted participants' perceptions (p value ≤ 0.05). The most reason for not reporting ADRs as stated by the study participants was the lack of information provided by patients (n = 52, 61.2%) and the lack of enough time to report (n = 10, 11.8%). Conclusion Participants’ perspectives have been greatly and favorably impacted by the interventional educational session. Thus, ongoing efforts and suitable training programs are required to assess the effect of bettering knowledge and perception on the practice of ADRs reporting.

  • Jordanians' knowledge, attitude and practice regarding adverse drug reactions reporting
    Faris El-Dahiyat, Khawla Abu Hammour, Rana Abu Farha, Qusai Manaseer, Ala'a Al Momanee, Aya Allan, and Rama Alkhawaldeh

    Elsevier BV

  • Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice
    Mariam Hantash Abdel Jalil, Rima Ηijazeen, Farah Khaled Abu-Mahfouz, Khawla Abu Hammour, Maria Hasan Matalqah, Jwan Saleh Khaleel Albadaineh, Shrouq Khaled AlOmoush, and Montaha Al-Iede

    Public Library of Science (PLoS)
    Background Vancomycin prescription and monitoring guidelines have been reported to be poorly followed by various centers. Aims Identifying barriers to compliance with vancomycin dosing and therapeutic drug monitoring guidelines (TDM) and possible ways to enhance compliance based on the healthcare providers’ (HCPs) perspective. Methods A qualitative study based on semi-structured interviews with HCP (physicians, pharmacists, and nurses) was conducted at two Jordanian Teaching Hospitals. Interviews were audio-recorded and analyzed through thematic analysis. The COREQ criteria for qualitative research were utilized to report the study findings. Results A total of 34 HCPs were interviewed. HCP perceived several factors as barriers to guideline recommendation compliance. Such factors included negative perception towards prescription guidelines, lack of knowledge regarding TDM guidelines, the hierarchy of medication management, work pressure, and ineffective communication among healthcare providers. Potential strategies to optimize guidelines adaptation included providing HCPs with more training and decision support tools in addition to activating the role of clinical pharmacists. Conclusions The main barriers to guideline recommendations uptake were identified. Interventions should address those barriers related to the clinical environment, including enhancing interprofessional communication related to vancomycin prescription and TDM, reducing workload and providing support systems, promoting educational and training programs, in addition to adopting guidelines suitable for the local environment.

  • Vancomycin audit in the paediatric population: Patterns of use and appropriateness of therapeutic drug monitoring
    Mariam Abdel Jalil, Farah Khaled, Farah Qaryouti, Khawla Abu Hammour, Mervat Alsous, and Montaha Al‐Iede

    AIMS To investigate prescribing and therapeutic drug monitoring (TDM) practices for vancomycin in pediatrics at the Jordan University Hospital and to determine the impact of inaccuracies in TDM data on dosing decisions. METHODS Patterns of vancomycin prescriptions, appropriateness of vancomycin dosing, duration, TDM, and the accuracy of the recorded dosing/sampling times were determined prospectively based on prespecified criteria. Finally, Monte-Carlo simulations were undertaken using the mrgsolve-package in R to assess the effect of inaccuracies in recording dosing/sampling times on subsequent dose adjustments. RESULTS 442 vancomycin courses were analyzed. Vancomycin prescriptions were mainly empirical (77.4%). Initial vancomycin doses were appropriate in 73.1% of vancomycin courses. Prolonged use (>5 days) was found in 45.7% of admissions with negative cultures; this was related to the diagnosis of suspected sepsis unadjusted-OR: 1.8(1.1-2.9). TDM was appropriately ordered in 90.7% of concentrations. Discrepancies between the recorded and actual times were noted in 83.9%, 82.7% of audited times of dose administration and sample collection, respectively. Based on simulations, these discrepancies were predicted to result in inappropriate dose adjustment in 37.9% of patients. CONCLUSIONS Inappropriate empirical and prolonged vancomycin use, and inaccuracies in recording dosing/sampling times, are important areas of improvement in the current clinical practice.

  • Diagnosis and treatment of stroke associated pneumonia: Qualitative exploration of clinicians’ practice
    Mohammed Zawiah, Amer Hayat Khan, Rana Abu Farha, Abubakar Usman, Abubakar Sha’aban, Khawla Abu Hammour, and Zahraa Almuhsen

    Modestum Ltd
    <b>Background:</b> Establishing and implementing a gold standard criteria for diagnosing and treating stroke-associated pneumonia (SAP) would have a significant positive impact on stroke outcomes and antibiotic stewardship. This study aimed to qualitatively explore current diagnostic and treatment practice for SAP among clinicians.<br /> <b>Methods: </b>A qualitative study was employed to conduct semi-structured interviews at the tertiary-care Jordan University Hospital. A purposive sampling technique was employed to recruit the participants, including respiratory consultants (n=3) and residents (n=9) practicing in the internal medicine wards and intensive care unit, where stroke patients are treated. The interviews were audio-recorded, transcribed verbatim, translated, and analyzed thematically using framework analysis.<br /> <b>Results:</b> Clinicians expressed their experiences, which were organized into two themes and eight emerged sub-themes: Terminology and diagnostic approach of SAP involved; no definite terminology, reliance on both clinical evidence and X-ray findings to decide, reliance on clinical evidence alone to suspect SAP and initiate empirical therapy, and SAP overdiagnosis. The treatment strategies include early treatment of SAP, treating SAP the same as CAP/HAP, predominant anaerobes coverage, and SAP overtreatment.<br /> <b>Conclusion:</b><i> </i>Our findings show a wide range of physician-based diagnostic and treatment approaches for SAP, with clinical criteria serving as the main driver for antibiotic initiation. Standard validated algorithmic-based criteria need to be established and implemented.

  • Correlation of vitamin D receptor genotypes, specific IgE levels and other variables with asthma control in children
    Walid Al-Qerem, Anan Jarab, Yazun Jarrar, Enas Al-Zayadneh, Montaha Al-Iede, Jonathan Ling, Khawla Abu Hammour, Sally S. Alabdullah, Asal Saad Alabdullah, Yamam Al Refaie,et al.

    Informa UK Limited
    INTRODUCTION Asthma is a common condition affecting millions of children globally. The main goal of this study is to assess factors related to asthma management, particularly atopy level and the impact of genetic variants of the vitamin D receptor (VDR) gene. METHODS Asthmatic children were enrolled in an outpatient respiratory clinic. Information on patients' medication adherence, medical and medication factors, and sociodemographic were gathered. Spirometry FEV1% and FVC% measurements, and the asthma control test were used to evaluate the severity of asthma, and genotyping of the VDR gene and radioallergosorbent test (RAST) were conducted. Regression analyses were conducted to evaluate variables associated with asthma control and spirometry measures. RESULTS A total of 313 participants (67.4% males) were recruited in the current study. The mean age was 9.37 (±3.45) years. The mean score for adherence was 4.26 (±2.52), and only 46% of the participants had controlled asthma. Forward conditional stepwise binary regression showed that low and moderate Inhaled corticosteroids (ICS) dose (OR= 0.42 (95% CI 0.20-0.90), P = 0.026; OR = 0.371 (95% CI 0.2-0.72), P = 0.003, respectively) decreased the odds of being in the controlled asthma group, while higher inhaler score (OR = 2.75 (95% CI 2.17-3.49, P < 0.001)) increased the odds of being in the controlled asthma group. However, results found no association between VDR genotype and asthma control, spirometry values or hospitalization due to asthma. CONCLUSIONS The results indicated that many of the asthma patients had poorly controlled asthma. Factors that were associated with poor asthma control included poor inhaler technique.

  • Optimizing antimicrobial therapy in urinary tract infections: A focus on urine culture and sensitivity testing
    Rama Alkhawaldeh, Rana Abu Farha, Khawla Abu Hammour, and Eman Alefishat

    Frontiers Media SA
    Objectives: This cross-sectional study was conducted at Jordan university hospital to evaluate the impact of microbial culture data and sensitivity results on optimizing UTI treatment.Methods: All positive urine cultures requested for adult patients (≥18 years) admitted to Jordan University Hospital (JUH) within the period from January 2019–July 2021 were evaluated. The antibiotics prescribed before and after culture data and sensitivity results were compared to evaluate the impact of these diagnostic measures on optimizing UTI treatment.Results: During the study period, 2400 urine cultures revealed positive results. Among those patients, 1,600 (66.7%) were discharged before the availability of culture results and excluded. Of the remaining 800 patients, 701 patients (87.6%) received empiric treatment. After culture and sensitivity results were available, overall, 84 (10.5%) patients had optimization (improvement) in their UTI management after culture results were known, while 6 (0.8%) patients had a worsening in their treatments. Based on the culture results, we found that only 12.4% of patients were appropriately treated before and after the culture results. Moreover, our results revealed that 31.9% were inappropriately treated for their UTIs before and after culture results.Conclusion: This study revealed an alarmingly high rate of inappropriate treatment of UTIs despite the availability of urine culture and sensitivity data, and that culture results were not used to optimize treatment strategies for UTI. This practice can potentially result in poor health-related outcomes and adversely affects efforts to battle AMR. Multifaceted strategies must be implemented to help clinicians follow the best current evidence and current guidelines in their selection of antibiotics for the management of UTIs.

  • Evaluation of drug use pattern in adults' outpatient clinics in a tertiary teaching hospital using WHO core prescribing indicators
    Rana Abu Farha, Oriana Awwad, Bashar Abdurazaq, Khawla Abu Hammour, and Amal Akour

    Oxford University Press (OUP)
    Abstract Objectives This study has evaluated the drug use pattern among adults attending the outpatient clinics of the Jordan University Hospital (JUH), by assessing the adherence of prescriptions to the World Health Organization (WHO) core prescribing indicators. Methods This is a cross-sectional study that was conducted during the period from October 2011 to January 2022 at JUH. Several prescriptions from 10 different adult outpatient clinics were reviewed to evaluate hospital adherence to the five WHO core prescribing indicators. Key findings To assess the WHO core prescribing indicators, data for 2451 prescriptions were reviewed. Around one-third of the patients (33.4%) were receiving polypharmacy (five medications or more). Results revealed that two core prescribing indicators were not following the standard values specified by the WHO; the average number of drugs prescribed per encounter (3.8 medications/prescription), and the percentage of drugs from the essential drug list (EDL) (54.1%). Endocrine clinics showed the highest average of drugs (6.3) per prescription and the highest percentage of prescriptions with injectable medicines (51.7%). On the other hand, ophthalmology clinics showed the highest percentage of prescriptions with antibiotics (29.9%) and the lowest percentage of drugs prescribed from the EDL at JUH (14.1%). Evaluating factors affecting the number of prescribed medications per encounter revealed that elderly patients (&amp;gt; 60 years), being female, referring to the endocrine clinic, and having insurance have a higher average number of medications per encounter compared with others (P &amp;lt; 0.05). Conclusion The proper prescribing practices in a sizable tertiary hospital in Amman, Jordan, are clarified by this study. The percentage of medications from EDL and the typical number of drugs/encounters did not comply with WHO requirements. The study findings should guide the Jordanian health policymakers in designing and implementing strategies to limit irrational prescribing practices and raise awareness of and ensure physician adherence to the national EDL.

  • Capacity Building for Health Technology Assessment in Jordan: Institutionalization and Its Use in Pricing and Reimbursement Decisions
    Emad Almomani, Eman A. Hammad, Raeda AlQutob, Khawla Abu Hammour, Emad Al-Sharu, Muien Abu-Shaer, Ibrahim Alabbadi, and Zoltán Kaló

    Elsevier BV

  • Impact of Pharmacist-Directed Medication Reconciliation in Reducing Medication Discrepancies: A Randomized Controlled Trial
    Khawla Abu Hammour, Rana Abu Farha, Rawan Ya’acoub, Zeinab Salman, and Iman Basheti

    Canadian Society of Hospital Pharmacists (CSHP)
    Background: In hospital surgical wards, patients are at higher risk for medication errors, in part because physicians may not consider themselves sufficiently trained to prescribe medications. Hence, collaborative teamwork involving the pharmacist is needed. Objectives: To assess the impact of medication reconciliation directed by pharmacists on decreasing medication discrepancies after discharge from the surgical ward. Methods: Patients admitted to the surgical unit at a tertiary teaching hospital in Amman, Jordan, between July 2017 and July 2018 were selected and randomly assigned to either the control or the intervention group. Upon admission, the number and kinds of unintentional medication discrepancies were determined for both groups. Medication reconciliation was then provided to patients in the intervention group. The number of unintentional discrepancies was re-evaluated upon discharge for both groups. To assess differences between the control and intervention groups, the χ2 or Fisher exact test was used for categorical variables and an independent-sample t test for continuous data. A paired t test was conducted to determine whether the number of medication discrepancies was reduced as a result of pharmacists’ recommendations. Results: A total of 123 patients met the inclusion criteria, 61 in the intervention group and 62 in the control group. Discrepancies of omission and wrong dose constituted 41 (77%) of the 53 discrepancies in the intervention group and 25 (76%) of the 33 discrepancies in the control group. The number of unintentional discrepancies was significantly reduced from admission to discharge in both the intervention group (p = 0.002) and the control group (p = 0.007). Of 53 recommendations made by pharmacists, 20 (38%) were accepted by the treating physician, and all of these discrepancies were resolved. Conclusions: This study sheds light on the existence of unintentional medication discrepancies upon admission for surgical patients, which may expose the patients to potential harm upon discharge from hospital. Additional studies with a larger sample size are needed to gain further insights on pharmacists’ role in implementing medication reconciliation for surgical patients. Trial Registration: NCT03928106 RÉSUMÉ Contexte : Dans les services chirurgicaux des hôpitaux, les patients sont exposés à un risque d’erreurs de médication plus élevé, en partie parce que les médecins ne se considèrent pas suffisamment formés pour prescrire des médicaments. Par conséquent, un travail d’équipe collaboratif impliquant le pharmacien est nécessaire. Objectifs : Évaluer l’impact du bilan comparatif des médicaments dirigé par les pharmaciens sur la diminution des écarts médicamenteux après la sortie du service de chirurgie. Méthodes : Les patients admis à l’unité chirurgicale d’un hôpital d’enseignement tertiaire à Amman, en Jordanie, entre juillet 2017 et juillet 2018 ont été sélectionnés et affectés au hasard au groupe témoin ou au groupe d’intervention. Lors de l’admission, le nombre et les types de divergences médicamenteuses non intentionnelles ont été définis pour les deux groupes. Le bilan comparatif des médicaments a ensuite été fourni aux patients du groupe d’intervention. Le nombre d’écarts non intentionnels a été réévalué à la sortie pour les deux groupes. Pour évaluer les différences entre le groupe témoin et le groupe d’intervention, le test χ2 ou le test exact de Fisher a été utilisé pour les variables catégorielles et un test t pour échantillon indépendant, pour les données continues. Un test t apparié a été effectué pour déterminer si le nombre d’écarts de médicaments a été réduit à la suite des recommandations des pharmaciens. Résultats : Au total, 123 patients répondaient aux critères d’inclusion : 61 dans le groupe d’intervention et 62 dans le groupe témoin. Les divergences d’omission et de mauvaise dose constituaient 41 (77 %) des 53 divergences dans le groupe d’intervention et 25 (76 %) des  33 divergences dans le groupe témoin. Le nombre d’écarts non intentionnels a été significativement réduit de l’admission à la sortie à la fois dans le groupe d’intervention (p = 0,002) et dans le groupe témoin (p = 0,007). Sur 53 recommandations émises par des pharmaciens, 20 (38 %) ont été acceptées par le médecin traitant et toutes ces divergences ont été résolues. Conclusions : Cette étude met en lumière l’existence d’écarts médicamenteux non intentionnels lors de l’admission des patients chirurgicaux, ce qui peut exposer les patients à des risques au moment de leur sortie de l’hôpital. D’autres études avec un échantillon plus important sont nécessaires pour mieux comprendre le rôle des pharmaciens dans la mise en œuvre du bilan comparatif des médicaments pour les patients chirurgicaux. Enregistrement de l’essai : NCT03928106

  • Is COVID-19 multisystem inflammatory syndrome a new variant of Kawasaki Disease?
    Khawla Abu Hammour, Rana Abu Farha, Qusai Manaseer, Tasnim Dawoud, and Walid Abu Hammour

    The Archives of Rheumatology
    Objectives: In this systematic review, we aimed to evaluate the clinical features, therapeutic options, and outcomes of children with multisystem inflammatory syndrome in children (MIS-C) and to investigate whether MIS-C is a new variant of Kawasaki disease. Materials and methods: Adhering to PRISMA principles, we searched for eligible studies between December 2019 and June 2020 through the following databases: PubMed, ISI Web of Science, SCOPUS, and Science Direct. Studies including original data of patients aged &lt;21 years with MIS-C and descriptions of clinical signs, laboratory or radiological investigations were selected. Results: A total of 84 studies were identified, for which 48 were eligible for full screening and only 13 studies (n=657) met our inclusion criteria. More than 70% of patients with MIS-C tested positive for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). The most common symptoms were gastrointestinal (80 to 100%) and most patients presented with fever for &gt;4 days. Mucocutaneous manifestations are similar to Kawasaki disease presented in up to 64% in some studies. Almost all patients had significant elevations in inflammatory markers, and up to 50 to 100% had elevated troponin suggesting myocardial damage. Intravenous immunoglobulin (IVIG) was administered to 60% of patients in 12 studies and 80 to 100% in five studies. Steroids were administered to 10 to 95% of patients. The overall mortality rate was 0.9%. Conclusion: The temporal association between novel coronavirus disease 2019 (COVID-19) onset and Kawasaki-like disease and MIS-C suggests a causal link. Both syndromes have similar cascades of symptoms and hyperinflammation, which likely explain their response to the same immunomodulatory agents. However, it is unclear yet why some children appear more susceptible to develop MIS-C.

  • Detection of medication administration errors at a tertiary hospital using a direct observation approach
    Alaa M. Yousef, Rana K. Abu-Farha, and Khawla M. Abu-Hammour

    Elsevier BV

  • The Appropriateness of Empiric Treatment of Urinary Tract Infections in a Tertiary Teaching Hospital in Joran: A Cross-Sectional Study
    Rama Alkhawaldeh, Rana Abu Farha, Khawla Abu Hammour, and Eman Alefishat

    This is a cross-sectional study that was conducted at Jordan University Hospital (JUH) to evaluate the appropriateness of Urinary Tract Infection (UTI) empiric treatment based on microbial culture data and susceptibility testing. All urine cultures requested for adult patients (≥18 years) admitted to JUH within the period from January 2019–July 2021 were reviewed and only those cultures with positive episodes of infection were considered. In this study, 6950 urine culture episodes were screened; among them, 34.5% (n = 2400) revealed positive results. Among those patients with positive culture episodes, 1600 patients (66.7%) were discharged before the availability of culture results and were excluded. Of the remaining eligible 800 patients, 701 (87.6%) received empiric treatment. In 26.8% of the eligible cases (n = 214), the prescribed empiric agents failed to have appropriate coverage of the identified pathogens, and in 14.6% of the cases (n = 117) the identified microorganisms were reported as resistant to the prescribed empiric agents. Furthermore, only 13.4% of the patients (n = 107) were appropriately treated for their UTI with empiric antibacterial agents. We were not able to judge the appropriateness of UTI treatment for one third (n = 263, 32.9%) of the patients, because they did not have susceptibility reports performed. This study revealed an alarmingly high rate of inappropriate treatment of UTIs, which encourages the emergence of bacterial resistance and affects health-related outcomes negatively. Therefore, antimicrobial stewardship programs must be applied to optimize antibiotic consumption in hospital settings.

  • Jordanian experience: The internet pharmacy drug delivery platform during the COVID-19
    Khawla Abu Hammour, Mariam Abdeljalil, Qusai Manaseer, and Bayan Al-Manaseer

    Elsevier BV

  • Perceived public stress among jordanians during the covid-19 outbreak
    Mariam H. Abdel Jalil, Mervat M. Alsous, Eman A. Hammad, Rimal Mousa, Mais M. Saleh, and Khawla Abu Hammour

    Cambridge University Press (CUP)
    ABSTRACTObjectives:Outbreaks and containment measures implemented to control them can increase stress in affected populations. The impact of the coronavirus disease 2019 (COVID-19) outbreak on perceived stress levels in the Jordanian population is unknown. The aim of the study was to determine the perceived stress level and factors associated with it in the Jordanian population during the COVID-19 outbreak.Methods:Required data, such as those from the Perceived Stress Scale (PSS-10) and possible predictors of perceived stress, were collected through a Web-based survey. Statistical analysis was conducted through SPSS.Results:The mean (SD) of perceived stress score was 19.8 (6.7). Regression analysis revealed that stress was increased in females, young adults, usually being stressed more than others by a health problem, increased perceived severity of the disease, increased overall worry score, and student’s worry regarding their studies/graduation. Perceived stress was decreased if participants’ self-rated health status score increased.Conclusions:In the context of increasing public health preparedness, the results of this study can be used in designing interventions to alleviate stress in susceptible segments of the Jordanian community.

  • Impact of Distance Learning on Pharmacy and Pharm.D Undergraduates’ during the COVID-19 Pandemic in Jordan
    Anan S. Jarab, Walid Al-Qerem, Tareq L. Mukattash, Douaa Al-Hajjeh, Ahmed Al-Azayzih, and Khawla Abu Hammour

    The University of Jordan
    Objective: The study aims to evaluate the impact of distance education on Pharmacy, Pharm.D and postgraduate students’ satisfaction and its associated factors during COVID -19 pandemic.&#x0D; Methods: A cross-sectional web-based survey was distributed online for Pharmacy, Pharm.D and postgraduate Diploma and Master Students across Jordanian universities. Expiratory factor analysis (EFA) and Cronbach’s alpha were conducted to examine the validity and the internal consistency of the survey, respectively. .Analysis of Covariance (ANCOVA), Chi square test and t-test were conducted to evaluate the variables associated with students’ satisfaction with distance learning.&#x0D; Results: A total of 860 students completed the survey. The EFA generated a three-factor model including positive impact, negative impact and general impact. The mean scores of the factors were 2.84 (SD=1.03), 2.78 (SD=0.92) and 2.34 (SD=1.22) respectively. Several factors were associated with students’ level of satisfaction with distant learning including gender, nationality, university type and field of study.&#x0D; Conclusion: Distance education had negative impact on Pharmacy and Pharm.D. students’ satisfaction, which opens the doors for the necessity to improve the distance education for university students. Variables including gender, nationality, university type and field of study were associated with students’ level of satisfaction. 

  • Genetic and Clinical Characteristics of Patients in the Middle East With Multisystem Inflammatory Syndrome in Children
    Walid Abuhammour, Lemis Yavuz, Ruchi Jain, Khawla Abu Hammour, Ghalia F. Al-Hammouri, Maha El Naofal, Nour Halabi, Sawsan Yaslam, Sathishkumar Ramaswamy, Alan Taylor,et al.

    American Medical Association (AMA)
    Key Points Question What are the clinical, genetic, and laboratory characteristics of Middle Eastern patients with multisystem inflammatory syndrome in children (MIS-C)? Findings In this cohort study of 45 patients with MIS-C of primarily Arab and Asian origins, an enrichment of rare, likely deleterious immune-related genetic variants was found, with a possible association between genetic findings and MIS-C onset and resistance to treatment. Meaning These findings suggest that comprehensive genetic profiling of patients with MIS-C of diverse ethnicities is essential to characterize the genetic contribution to this disease.

  • Evaluation of Drug Use Pattern in Pediatric Outpatient Clinics in a Tertiary Teaching Hospital Using WHO Drug-Prescribing Indicators
    Aya Aldabagh, Rana Abu Farha, Samar Karout, Rania Itani, Khawla Abu Hammour, and Eman Alefishat

    Informa UK Limited
    Purpose The main aim of the study is to assess physicians’ prescribing patterns using the World Health Organization (WHO) prescribing indicators among pediatric outpatient clinics, and to identify areas in need of intervention regarding the rational use of medicines among pediatric outpatients in Jordan. Methods This is a descriptive observational cross-sectional study that was conducted at the outpatient pediatric clinics at Jordan University Hospital (JUH). During the study period, prescriptions were collected over a period of two months. Prescribing patterns were assessed using the five WHO drug prescribing indicators. Results A total of 1011 prescriptions/encounters were assessed. More than half of the encounters were for male patients (n= 595, 58.9%), and the median age of patients was eight years (IQR = 7.9). The average number of drugs prescribed per encounter was 1.8 ± 1.3; however, a specific individual clinic, the respiratory clinic, witnessed an average of 2.1 drugs prescribed per encounter. All of the prescribed drugs were prescribed by generic name (100%). Only 47.7% of the drugs were from the essential drug list of the JUH. Overall, antibiotics were prescribed in 19.5% of the encounters, but at higher rates in some clinics such as respiratory clinics (50.8%). Injectables were prescribed in 9.5% of the 1011 encounters; however, they were prescribed at higher rates in endocrinology and neurology clinics, in 44.8% and 31.3% of encounters, respectively. Conclusion This study revealed some adequate prescribing habits with an optimal prescribing pattern of generics and number of drugs per encounter among pediatric patients. However, the prescribing patterns of the essential drug list, antibiotics, and injectables, in specific clinics, failed to meet WHO standards. The findings of this study shed light on the need to establish national strategies to improve prescribing practices among the pediatric population.

  • Potential prescribing omissions of medications in older adults based on START version 2 criteria in a tertiary Jordanian teaching hospital
    Khawla Abu Hammour,, Mariam Abdeljalil, Rana Abu Farha, Sara Alhabeis, Qusai Manaseer, and Samah AbuMoghli

    Open Science Publishers LLP
    Khawla Abu Hammour1*, Mariam Abdeljalil1, Rana Abu Farha2, Sara Alhabeis3, Qusai Manaseer4, Samah AbuMoghli1 1Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman, Jordan. 2Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan. 3Clinical Pharmacist, Al-Balqa’ Applied University, Salt, Jordan. 4Faculty of Medicine, University of Jordan, Amman, Jordan.

  • Hospital staff perspectives: Medication reconciliation responsibility and barriers at a tertiary teaching hospital in Jordan
    Seliman M Ibrahim, Khawla Abu Hamour, Farah Abu Mahfouz, Mariam H Abdel Jalil, and Eman A Hammad

    Oxford University Press (OUP)
    Abstract Objectives To explore hospital staff perspective on the responsibility and barriers to medicine reconciliation (MedRec) at a leading internationally renowned teaching hospital in Jordan. Methods A cross-sectional study using a self-completed questionnaire was conducted at Jordan University Hospital (JUH). The target sample was members of the health team caring for patients across various locations and settings. A convenient sample of physicians, pharmacists and nurses was targeted. Those were approached at various days, shifts, locations to scop various views and practices across JUH. Key findings Two hundred questionnaires were included in the analysis, of which 41 (20.5%) completed by physicians, 23 (11.5%) by pharmacists and 136 (68.0%) by nurses. For most steps, physicians were seen as the prim responsible health providers. Nurse perceived their role to come second. Whilst pharmacists perceived limited or no role of nurses in a number of steps. The main barriers reported are heavy workload 158 (79%), followed by lack of time 152 (76%) and communication between health care providers 140 (70%). Pharmacists highlighted lack of knowledge, clarity and training as leading barriers too. Conclusions Physicians are perceived as the leading provider responsible for all MedRec steps. MedRec as a process involve overlapping functions with various skill-based steps. A number of steps allocated potentially to nurses or pharmacists, particularly comparing different sources of information, constructing medication lists or written summaries upon discharge. Barriers to MedRec might be overcome by interdisciplinary discussions and mapping MedRec process clearly.

  • Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation?
    Maram Abu Moghli, Rana Abu Farha, and Khawla Abu Hammour

    SAGE Publications
    Objective This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital. Method This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients’ Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients’ BPMH and their current medications was conducted where discrepancies were recognized. Results Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants ( n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions ( n = 71, 65.1%,) and the second most common type being additions ( n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified. Conclusion This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.