Hypertension drives the global burden of cardiovascular disease and its prevalence is estimated to increase by 30% by the year 2025. Nonadherence to chronic medication regimens is common; approximately 43% to 65.5% of patients who fail to adhere to prescribed regimens are hypertensive patients. Nonadherence to medications is a potential contributing factor to the occurrence of concomitant diseases. This systematic review applied a meta-analytic procedure to investigate the medication nonadherence in adult hypertensive patients. Original research studies, conducted on adult hypertensive patients, using the 8-item Morisky medication adherence scale (MMAS-8) to assess the medication adherence between January 2009 and March 2016 were included. Comprehensive search strategies of 3 databases and MeSH keywords were used to locate eligible literature. Study characteristics, participant demographics, and medication adherence outcomes were recorded. Effect sizes for outcomes were calculated as standardized mean differences using random-effect model to estimate overall mean effects. A total of 28 studies from 15 countries were identified, in total comprising of 13,688 hypertensive patients, were reviewed. Of 25 studies included in the meta-analysis involving 12,603 subjects, a significant number (45.2%) of the hypertensive patients and one-third (31.2%) of the hypertensive patients with comorbidities were nonadherent to medications. However, a higher proportion (83.7%) of medication nonadherence was noticed in uncontrolled blood pressure (BP) patients. Although a higher percentage (54%) of nonadherence to antihypertensive medications was noticed in females (P < 0.001), the risk of nonadherence was 1.3 times higher in males, with a relative risk of 0.883. Overall, nearly two-thirds (62.5%) of the medication nonadherence was noticed in Africans and Asians (43.5%). Nonadherence to antihypertensive medications was noticed in 45% of the subjects studied and a higher proportion of uncontrolled BP (83.7%) was nonadherent to medication. Intervention models aiming to improve adherence should be emphasized.

Rational: Studies conducted showed that there were gaps regarding the rational use of medicines (RUM). Aims and objectives: Evaluate RUM in main government hospitals in four emirates in UAE, using WHO prescribing indicators. Method: Multicenter prospective cross-sectional comparative study was conducted in 4 hospitals in 4 different Emirates in UAE. Using consecutive random sampling method, a total of 1100 prescriptions (2741 prescribed drugs) were collected and analyzed from surveyed hospitals from April to October 2012. Index of Rational Drug Prescribing (IRDP) was used as an indicator of RUM. Results: The main finding of this study was that, the mean values of prescribing indicators of RUM in the surveyed hospitals were estimated to be within the WHO optimal values for generics (100.0 vs. 100.0), antibiotics (9.8 ± 4.8 vs. ⩽30), injections (3.14 ± 1.7 vs. ⩽10) and formulary (EML) prescribing (100.0 vs. 100.0). However, the only discrepancy was reported regarding the number of drugs per prescription which was found to be more than the WHO optimal value (2.49 ± 0.9 vs. ⩽2); respectively. The mean IRDP was 4.55 which was less than the WHO optimal value of 5. Conclusions: Strategies and interventions are desirable to promote RUM and minimize the consequences of poly-pharmacy.

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. 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. 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. 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.

Recently, many drugs have been approved for halting overweight and obesity—few types of research shifted to using Anti-obesity medications (AOM) solely for well-being and shape-keeping. This narrative review's objective was to explore the use of AOM in relation to their medical indications, efficacy, and cardiovascular safety. We have conducted a narrative review of the literature on approved/non-approved AOM used for obesity and overweight. We have shed light on the emerging trials of therapies and evolving remedies. Recently, there has been an enormous change in the use of AOM with high consumption that deserves extensive surveillance for the long-term consequences and impact on social, mental, and physical health. Nearly six AOMs and combined therapy are approved by the Food and Drug Administration. The recent guidelines for obesity management have shifted the focus from weight loss to goals that the patient considers essential and toward targeting the root cause of obesity. The use of AOM increased enormously despite its sometimes-dubious safety and ineffectiveness. The public and medical professionals should be vigilant to the real-world benefits of anti-obesity drugs and their achieved effectiveness with an improved safety profile.

Background: The pharmaceutical care and 'extended' roles are still not practiced optimally by community pharmacists. Several studies have discussed the practice of community pharmacy in the UAE and have shown that most community pharmacists only counsel patients. However, UAE, has taken initiatives to allow and prepare community pharmacists to practice 'extended' roles. Aim of the review: The aim was to review the current roles of community pharmacists in Abu Dhabi Emirate, United Arab Emirates (UAE). Objective: The objective was to encourage community pharmacists toward extending their practice roles. Methods: In 2010, Health Authority Abu Dhabi (HAAD) surveyed community pharmacists, using an online questionnaire, on their preferences toward extending their counseling roles and their opinion of the greatest challenge facing the extension of their counseling roles. Results: Following this survey, several programs have been developed to prepare community pharmacists to undertake these extended counseling roles. In addition to that, HAAD redefined the scope of pharmacist roles to include some extended/enhanced roles. Abu Dhabi Health Services (SEHA) mission is to ensure reliable excellence in healthcare. It has put clear plans to achieve this; these include increasing focus on public health matters, developing and monitoring evidence-based clinical policies, training health professionals to comply with international standards to deliver world-class quality care, among others. Prior to making further plans to extend community pharmacists' roles, and to ensure the success of these plans, it is imperative to establish the views of community pharmacists in Abu Dhabi on practicing extended roles and to gain understanding and information on what pharmacists see as preferred change strategies or facilitators to change. Conclusions: In an attempt to adapt to the changes occurring and to the growing needs of patients and to maximize the utilization of community pharmacists' unique structured strategies are needed to be introduced to the community pharmacy profession.

Ammi visnaga is a widely distributed Ancient Egyptian medicinal plant used for treatment of several diseases including urolithiasis (kidney stones). The active chemical constituents' khellin and visnagin obtained from the A. visnaga seeds have activity of antilithiogenic and pleiotropic. However, little is known about its activity on hypertriglyceridemia. The main aim of this review is to explore the use of A. visnaga in urolithiasis and to present a case of relevancy. We highlighted a case of a patient who has recurrent urethral stones and hypertriglyceridemia. The patient was treated with A. visnaga seeds, has recovered completely from ureteral stones and his high-density lipoprotein (HDL)-cholesterol low levels retained to normal after using of A. visnaga seeds for 10 days. The present case of A. visnaga seeds being local medicinal plant has shown the effect in treating urolithiasis with extended effect on raising HDL-cholesterol. These results may provide insights for in vitro studies for isolation of these biologically active compounds for potential in raising HDL-cholesterol. Whether or not the later effect can have clinical utility remains to be explored.