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      Evaluation of the community pharmacists’ performance in the screening of non-steroidal anti-inflammatory drugs risks in Saudi Arabia

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          Abstract

          Objectives:

          To assess community pharmacists’ knowledge and practices regarding screening risk factors and providing safety information about the use of non-steroidal anti-inflammatory drugs (NSAIDs) to patients.

          Methods:

          Cross-sectional and a self-administered questionnaire-based study was conducted over a 4-month period (May-August 2019) with selected community pharmacies in Jeddah, Saudi Arabia. The questionnaire composed of demographic data and the pharmacist’s role in supplying NSAIDs.

          Results:

          The majority of participating community pharmacists dispense NSAIDs. However, many did not apply relevantly good communication skills such as seeking information about concomitant drugs (42.5%) or providing advice on managing any adverse side effects of taking NSAIDs (39.1%). Most of the community pharmacists also did not provide relevantly good communication about risk factors. The most common screening risk factors mentioned were a history of pregnancy and breastfeeding (84.2%) followed by being at an older age (74.5%) or a history of a gastrointestinal ulcer (71.5%).

          Conclusion:

          Community pharmacists in Saudi Arabia need to appropriately screen their patients for adverse drug reactions and effectively communicate the risks of using NSAIDs. The Saudi Regulatory Authority could endorse several approaches to apply a good strategy for improving the dispensing practices in community pharmacies, communication and awareness of risk factors especially in high-risk patients who are taking NSAIDs.

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          Most cited references39

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          A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly

          NSAIDs, non-steroidal anti-inflammatory drugs, are one of the most commonly prescribed pain medications. It is a highly effective drug class for pain and inflammation; however, NSAIDs are known for multiple adverse effects, including gastrointestinal bleeding, cardiovascular side effects, and NSAID induced nephrotoxicity. As our society ages, it is crucial to have comprehensive knowledge of this class of medication in the elderly population. Therefore, we reviewed the pharmacodynamics and pharmacokinetics, current guidelines for NSAIDs use, adverse effect profile, and drug interaction of NSAIDs and commonly used medications in the elderly.
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            COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?

            Given the current SARS-CoV-2 (COVID-19) pandemic, the availability of reliable information for clinicians and patients is paramount. There have been a number of reports stating that non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may exacerbate symptoms in COVID-19 patients. Therefore, this review aimed to collate information available in published articles to identify any evidence behind these claims with the aim of advising clinicians on how best to treat patients. This review found no published evidence for or against the use of NSAIDs in COVID-19 patients. Meanwhile, there appeared to be some evidence that corticosteroids may be beneficial if utilised in the early acute phase of infection, however, conflicting evidence from the World Health Organisation surrounding corticosteroid use in certain viral infections means this evidence is not conclusive. Given the current availability of literature, caution should be exercised until further evidence emerges surrounding the use of NSAIDs and corticosteroids in COVID-19 patients.
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              A review of counseling practices on prescription medicines in community pharmacies.

              Counseling has become an integral part of community pharmacy practice. Previous reviews of research into pharmacists' counseling practices on prescription medicines have primarily focused on activities at a national level. None have adopted an international perspective. To review (1) verbal counseling rates and (2) types of information provided for prescription medicines in community pharmacies and (3) to compare the research methods used in evaluating counseling practice. Published articles in English (1993-2007) were identified based on searches of on-line databases (International Pharmaceutical Abstracts, PubMed, Medline, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews) and cited references in the articles. Forty research articles met inclusion criteria for studies investigating verbal counseling rates and/or types of information provided for prescription medicines in community pharmacies. The counseling rates reported varied from 8% to 100%, depending on the research methods used. On average, lower counseling rates were found from consumer and observational studies compared with pharmacist- and simulated-patient studies. The type of prescription also influenced the rate. Higher rates were found in counseling consumers with new compared with regular prescriptions. Information on directions for use, dose, medicine name, and indications was more frequently given than information on side effects, precautions, interactions, contraindications, and storage. Most findings came from self-report and observational methods, each of which has limitations. Few studies used triangulation to overcome methodological limitations. In recent studies, simulated-patient methods have been used increasingly to evaluate counseling practice in the natural environment. The actual counseling rates are difficult to obtain due to the differences and limitations of each research method. Of all methods, simulated-patient methods appear to be a more reliable method of evaluating counseling practice in pharmacies. In providing information to consumers with prescriptions, pharmacists appear to have fulfilled the minimum legislative requirements or practice standards.
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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                Saudi Medical Journal
                Saudi Medical Journal (Saudi Arabia )
                0379-5284
                1658-3175
                August 2020
                : 41
                : 8
                : 849-857
                Affiliations
                [1] From the Department of Pharmaceutical Chemistry (Malebari, Khayyat), College of Pharmacy, King Abdulaziz University; and from the College of Pharmacy (Mahdali, Alamoudi, Alsayed, Alrasheed), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
                Author notes
                Address correspondence and reprint request to: Dr. Azizah M. Malebari, Department of Pharmaceutical Chemistry, College of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail: amelibary@ 123456kau.edu.sa ORCID ID: https://orcid.org/0000-0003-4178-0341
                Article
                SaudiMedJ-41-849
                10.15537/smj.2020.8.25221
                7502958
                32789426
                dee0c029-23dd-4ce1-99db-411cd554caf2
                Copyright: © Saudi Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 May 2020
                : 12 July 2020
                Categories
                Original Article

                non-steroidal anti-inflammatory drugs,nsaids,community pharmacists,counseling practice,adverse drug reactions

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