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Fulltext Health Professionals' Knowledge, Attitudes and Practices about Pharmacovigilance in India: A Systematic Review and Meta-Analysis

Bhagavathula AS, Elnour AA, Jamshed SQ, Shehab A

PLoS One, 2016;11(3):e0152221.
PMID: 27010447 DOI: 10.1371/journal.pone.0152221

BACKGROUND: Spontaneous or voluntary reporting of suspected adverse drug reactions (ADRs) is one of the vital roles of all health professionals. In India, under-reporting of ADRs by health professionals is recognized as one of the leading causes of poor ADR signal detection. Therefore, reviewing the literature can provide a better understanding of the status of knowledge, attitude and practice (KAP) of Pharmacovigilance (PV) activities by health professionals.
METHODS: A systematic review was performed through Pubmed, Scopus, Embase and Google Scholar scientific databases. Studies pertaining to KAP of PV and ADR reporting by Indian health professionals between January 2011 and July 2015 were included in a meta-analysis.
RESULTS: A total of 28 studies were included in the systematic review and 18 of them were selected for meta-analysis. Overall, 55.6% (95% CI 44.4-66.9; p<0.001) of the population studied were not aware of the existence of the Pharmacovigilance Programme in India (PvPI), and 31.9% (95% CI 16.3-47.4; p<0.001) thought that "all drugs available in the market are safe". Furthermore, 28.7% (95% CI 16.4-40.9; p<0.001) of them were not interested in reporting ADRs and 74.5%, (95% CI 67.9-81.9; p<0.001) never reported any ADR to PV centers.
CONCLUSION: There was an enormous gap of KAP towards PV and ADR reporting, particularly PV practice in India. There is therefore an urgent need for educational awareness, simplification of the ADR reporting process, and implementation of imperative measures to practice PV among healthcare professionals. In order to understand the PV status, PvPI should procedurally assess the KAP of health professionals PV activities in India.
Fulltext A cross sectional study: the knowledge, attitude, perception, misconception and views (KAPMV) of adult family members of people living with human immune virus-HIV acquired immune deficiency syndrome-AIDS (PLWHA)

Bhagavathula AS, Bandari DK, Elnour AA, Ahmad A, Khan MU, Baraka M, et al.

Springerplus, 2015;4:769.
PMID: 26688783 DOI: 10.1186/s40064-015-1541-2

We intended to assess knowledge, attitude, perception, misconception and views (KAP-MV) of family members of PLWHA. A cross-sectional retrospective study conducted in Anti-retroviral centre of Mahatma Gandhi Memorial-MGM hospital, Warangal, Telangana, South-India from July to September 2014. A questionnaire containing 41 items was distributed among adult family members accompanying patients living with HIV/AIDS-PLWHA. Level of KAP-MV was categorized into poor (0-28), average (29-55) and good (56-82). Analysis was performed by Pearson's Chi square, analysis of variance and Spearman's correlation test on 41 variables using SPSS version 21 and p
Fulltext The attitude of medical and pharmacy students towards research activities: a multicenter approach

Bhagavathula AS, Bandari DK, Tefera YG, Jamshed SQ, Elnour AA, Shehab A

Pharmacy (Basel), 2017 Oct 11;5(4).
PMID: 29019923 DOI: 10.3390/pharmacy5040055

Aim: To assess the attitude of medical and pharmacy students in Asian and African universities towards scholarly research activities. Methods: An anonymous, cross-sectional, self-reported online survey questionnaire was administered to medical and pharmacy students studying in various Asian and African universities through social media between May and July 2016. A 68-item close-ended questionnaire consisting of Likert-scale options assessed the students' research-specific experiences, and their attitudes towards scholarly research publications. Results: A total of 512 questionnaires were completed, with a response rate of 92% from Asia and 94% from Africa. More pharmacy students (70.8%) participated than medical students (29.2%). Overall 52.2% of the pharmacy students and 40% of medical students believed that research activities provided a means of gaining respect from their faculty members. Lack of encouragement, paucity of time, gaps in research activities and practices, and lack of research funding were some of the most common barriers acknowledged by the students. A nonparametric Mann-Whitney test showed that a statistically significant difference was observed, in that more than 80% of the pharmacy students viewed scientific writing and research activities as valuable experiences (p = 0.001) and would like to involve their co-students in scholarly research activities (p = 0.002); whereas the majority of the medical students desired to be involved more in scholarly research publications (p = 0.033). Conclusion: Pharmacy students had good attitudes towards research activities and a higher number of medical students desired to be involved more in research publications. Faculties may consider taking special research initiatives to address the barriers and improve the involvement of medical and pharmacy students in scholarly research activities.
Country participated: Asia (Malaysia, India, Saudi Arabia and the United Arab Emirates) and African (Ethiopia, Kenya and Egypt)
Fulltext Enhancing health care through medical cognitive virtual agents

Mishra S, Chaudhury P, Tripathy HK, Sahoo KS, Jhanjhi NZ, Hassan Elnour AA, et al.

Digit Health, 2024;10:20552076241256732.
PMID: 39165388 DOI: 10.1177/20552076241256732

OBJECTIVE: The modern era of cognitive intelligence in clinical space has led to the rise of 'Medical Cognitive Virtual Agents' (MCVAs) which are labeled as intelligent virtual assistants interacting with users in a context-sensitive and ambient manner. They aim to augment users' cognitive capabilities thereby helping both patients and medical experts in providing personalized healthcare like remote health tracking, emergency healthcare and robotic diagnosis of critical illness, among others. The objective of this study is to explore the technical aspects of MCVA and their relevance in modern healthcare.
METHODS: In this study, a comprehensive and interpretable analysis of MCVAs are presented and their impacts are discussed. A novel system framework prototype based on artificial intelligence for MCVA is presented. Architectural workflow of potential applications of functionalities of MCVAs are detailed. A novel MCVA relevance survey analysis was undertaken during March-April 2023 at Bhubaneswar, Odisha, India to understand the current position of MCVA in society.
RESULTS: Outcome of the survey delivered constructive results. Majority of people associated with healthcare showed their inclination towards MCVA. The curiosity for MCVA in Urban zone was more than in rural areas. Also, elderly citizens preferred using MCVA more as compared to youths. Medical decision support emerged as the most preferred application of MCVA.
CONCLUSION: The article established and validated the relevance of MCVA in modern healthcare. The study showed that MCVA is likely to grow in future and can prove to be an effective assistance to medical experts in coming days.
Fulltext Perspectives of Healthcare Professionals Regarding Factors Associated with Antimicrobial Resistance (AMR) and Their Consequences: A Cross Sectional Study in Eastern Province of Saudi Arabia

Baraka MA, Alboghdadly A, Alshawwa S, Elnour AA, Alsultan H, Alsalman T, et al.

Antibiotics (Basel), 2021 Jul 19;10(7).
PMID: 34356799 DOI: 10.3390/antibiotics10070878

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians' decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients' clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber's choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians' choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician's prescription (i.e., self-medication) represent key factors which contribute to AMR from participants' perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.
Fulltext Corrigendum to "A narrative review of approved and emerging anti-obesity medications" [Saudi Pharm. J. 31(10) (2023) 101757]

Beshir SA, Elnour AA, Soorya A, Mohamed AP, Goh SSL, Hussain N, et al.

Saudi Pharm J, 2024 May;32(5):102047.
PMID: 38596318 DOI: 10.1016/j.jsps.2024.102047

[This corrects the article DOI: 10.1016/j.jsps.2023.101757.].
Systematic Review of Glucagon-Like Peptide One Receptor Agonist Liraglutide of Subjects with Heart Failure with Reduced Left Ventricular Ejection Fraction

Hamad F, Elnour AA, Elamin A, Mohamed S, Yousif I, Don J, et al.

Curr Diabetes Rev, 2021;17(3):280-292.
PMID: 32867644 DOI: 10.2174/1573399816999200821164129

BACKGROUND: The major cardiovascular outcome trials on glucagon-like peptide one-receptor agonists have examined its effect on hospitalization of subjects with heart failure; however, very limited trials have been conducted on subjects with reduced left ventricular ejection fraction (r- LVEF) as a primary outcome.
OBJECTIVE: We have conducted a systematic review of two major (FIGHT and LIVE) placebo-controlled trials of liraglutide and its clinical effect on the ejection fraction of subjects with heart failure.
METHODS: Medline data was retrieved for trials involving liraglutide from 2012 to 2020. The inclusion criteria for trials were: subjects with or without type 2 diabetes mellitus (T2DM), subjects with heart failure with rLVEF, major trials (phase II or III) on liraglutide, trials included liraglutide with defined efficacy primary outcome of patients with heart failure with rLVEF. The search was limited to the English language, whereby two trials [FIGHT and LIVE] had been included and two trials were excluded due to different primary outcomes. Participants (541) had been randomized for either liraglutide or placebo for 24 weeks.
RESULTS: In the FIGHT trial the primary intention-to-treat, sensitivity, and diabetes subgroup analyses have shown no significant between-group difference in the global rank scores (mean rank of 146 in the liraglutide group versus 156 in the placebo group; Wilcoxon rank-sum P=.31), number of deaths, re-hospitalizations for heart failure, or the composite of death or change in NT-pro BNP level (P= .94). In the LIVE trial, the change in the left ventricular ejection fraction (LVEF) from baseline to week 24 was not significantly different between treatment groups. The overall discontinuation rate of liraglutide was high in the FIGHT trial (29%, 86) as compared to that in the LIVE trial (11.6%, 28).
CONCLUSION: FIGHT and LIVE trials have demonstrated that liraglutide use in subjects with heart failure and rLVEF was implicated with an increased adverse risk of heart failure-related outcomes.