Background: Medication dispensing is a fundamental function of community pharmacies, and errors that occur during the dispensing process are a major threat to patient safety. However, to date there has been no national study of medication dispensing errors in the United Arab Emirates (UAE). Objective: The study aimed to investigate the incidence, types, clinical significance, causes and predictors of medication dispensing errors. Methods: The study was conducted in randomly selected community pharmacies (n=350) across all regions of UAE over six months using a mixed-method approach, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee, which included an otolaryngologist, a general practitioner and a clinical pharmacist, evaluated the severity of errors. SPSS (Version 26) was used for data analysis. Results: The overall rate of medication dispensing errors was 6.7% (n=30912/ 464222), of which 2.6% (n=12274/464222) were prescription-related errors and 4.1% (n= 18638/464222) pharmacist counselling errors. The most common type of prescription-related errors was wrong quantity (30.0%), whereas the most common pharmacist counselling error was wrong drug (32.1%). The majority of errors were caused by medicine replaced with near expire one (24.7%) followed by look-alike/sound-alike drugs (22.3%). The majority of errors were moderate (46.8%) and minor (44.5%); 8.7% were serious errors. Predictors of medication dispensing errors were: grade A pharmacies (dispensing  60 prescriptions a day (OR 2.1; 95%CI 1.4-3.6; p=0.03) and prescriptions containing ≥4 medication orders (OR 2.5; 95%CI 1.7-4.3; p=0.01). Conclusions: Medication dispensing errors are common in the UAE and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing practice.

Objectives: To assess the effectiveness of telepharmacy services delivered by community pharmacies in hypertension management and examine its influence on pharmacists’ ability to identify drug-related problems (DRPs). Methods: This was a 2-arm, randomised, clinical trial conducted among 16 community pharmacies and 239 patients with uncontrolled HTN in the U.A.E over a period of 12 months. The first arm (n=119) received telepharmacy services and the second arm (n=120) received traditional pharmaceutical services. Both arms were followed up to 12 months. Pharmacists self-reported the study outcomes, which primarily were the changes in SBP and DBP from baseline to 12-month meeting. Blood pressure readings were taken at baseline, 3, 6, 9, and 12 months. Other outcomes were the mean knowledge, medication adherence and DRP incidence and types. The frequency and nature of pharmacist interventions in both groups were also reported. Results: The mean SBP and DBP differences were statistically significant across the study groups at 3-, 6-, and 9-month follow-up and 3-, 6-, 9-, 12- month follow-up, respectively. In detail, the mean SBP was reduced from 145.9 mm Hg in the intervention group (IG) and 146.7 mm Hg in the control group (CG) to 124.5, 123.2, 123.5, and 124.9 mm Hg at 3-, 6-, 9-, and 12-month follow-up in the IG and 135.9, 133.8, 133.7, and 132.4 mm Hg at 3-, 6-, 9-, and 12-month follow-up in the CG. The mean DBP was reduced from 84.3 mm Hg in IG and 85.1 mm Hg in CG to 77.6, 76.2, 76.1, and 77.8 mm Hg at 3-, 6-, 9-, and 12-month follow-up in the IG and 82.3, 81.5, 81.5, and 81.9 mm Hg at 3-, 6-, 9-, and 12-month follow-up in the CG. Medication adherence and knowledge of participants in the IG towards hypertension were significantly improved. The DRP incidence and DRPs per patient identified by pharmacists in the intervention and control groups were 2.1% versus 1.0% (p=0.002) and 0.6 versus 0.3 (p=0.001), respectively. The total numbers of pharmacist interventions in the IG and CG were 331 and 196, respectively. The proportions of pharmacist interventions related to patient education, cessation of drug therapy, adjustment of drug dose, and addition of drug therapy across the IG and CG were 27.5% versus 20.9%, 15.4% versus 18.9%, 14.5% versus 14.8%, and 13.9% versus 9.7%, respectively (all with p<0.05). Conclusion: Telepharmacy may have a sustained effect for up to 12 months on blood pressure of patients with hypertension. This intervention also improves pharmacists’ ability to identify and prevent drug-related problems in community setting. Pharmacy Practice is a free full-text journal with a scope on the practice of pharmacy. Pharmacy Practice covers pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology

Huntington's disease is an inherited progressive neurodegenerative disorder caused by an expansion of the polyglutamine tract leading to malformation and aggregation of the mutant huntingtin protein in the cell cytoplasm and nucleus of affected brain regions. The development of neuroprotective agents from plants has received considerable research attention. Our study aims to investigate the neuroprotective effects of luteolin and the mechanisms that underline its potential mediated protection in the mutant htt neuroblastoma cells. The mutant htt neuroblastoma cells were transfected with 160Q, and the control wild-type neuroblastoma cells were transfected with 20Q htt for 24 h and later treated with luteolin. Cell viability was determined by MTT and PI staining in both groups, while western blotting was used to evaluate caspase 3 protein expression. Aggregation formation was assessed via immunofluorescence microscopy. Also, western blotting was utilized to measure the protein expression of mutant htt aggregated and soluble protein, Nrf2 and HO-1. The impact of Nrf2 on luteolin-treated neuroblastoma cells was assessed using small interfering RNAs. Our study reports that luteolin can protect cultured cells from mutant huntingtin cytotoxicity, evidenced by increased viability and decreased apoptosis. Also, luteolin reduced the accumulation of soluble and insoluble mutant huntingtin aggregates in mutant htt neuroblastoma cells transfected with 160Q compared to the control wild-type. The mutant htt aggregate reduction mediated by luteolin appeared to be independent of the Nrf2 –HO-1 antioxidant pathway. Luteolin presents a new potential therapeutic and protective agent for the treatment and decreasing the cytotoxicity in neurodegenerative diseases such as Huntington's disease.

Antimicrobial resistance (AMR) is a serious healthcare problem that affects public health globally. Appropriate understanding and knowledge of prudent antimicrobial use and resistance, along with providing evidence-based information sources, are needed for informed antibiotic prescribing practices. This study aimed to assess the knowledge, opportunity, motivation, behavior of pharmacists and their information sources regarding antibiotic use and resistance in Jordan. An online cross-sectional questionnaire was developed and administered to pharmacists during the period of July–September 2021. The survey is an adapted version of the validated European Centre for Disease Prevention and Control (ECDC) survey for antibiotic use and resistance. Pharmacists from all sectors (n = 384), of whom 276 (71.9%) were community pharmacists, completed an online questionnaire. While respondents scored highly (>87%) on knowledge on effective use, unnecessary use, and associated side effects of antibiotics, lower scores were recorded for knowledge on the spread of antibiotic resistance (52.9%). Pharmacists support easy access to guidelines on managing infections in 56% of cases, and easy access to materials advising prudent antibiotic use and resistance in 39.8% of cases. One-third of respondents (37.0%) reported no knowledge of any initiatives on antibiotic awareness and resistance. Pharmacists were aware (13.3%), unaware (36.2%), or unsure (50.5%) of the existence of a national antibiotic resistance action plan. Pharmacists indicated an interest in receiving more information on resistance to antibiotics (55.2%), medical conditions for which antibiotics are used (53.1%), how to use antibiotics (45.1%), prescribing of antibiotics (34.4%), and links between the health of humans, animals, and the environment (28.6%). Findings can inform antimicrobial stewardship with required interventions to improve antibiotic use.

Background: A subpopulation of statin users such as subjects with chronic kidney disease (CKD), Human Immune virus (HIV, acute coronary syndrome (ACS), revascularization, metabolic syndrome, and/or diabetes may particularly benefit from pitavastatin pharmacotherapy. Aim of the systematic review: The current systematic review aimed systematically evaluate the effect of pitavastatin on primary cardiac events in subjects receiving pitavastatin in comparison to the other four statin members. Methods: We have conducted a systematic review on phases III and IV of randomized controlled trials (RCT-s, 11 trials) for subjects with primary cardiac events who have received pitavastatin. Subjects were diagnosed with any type of dyslipidemia (population 4804), who have received pitavastatin (interventions) versus comparator (comparison) with the primary efficacy endpoint of minimization of LDL-C and non-HDL-C, having an increase in HDL-C and/or reduction in major adverse cardiac events (MACE, cardiovascular death, myocardial infarction (fatal/nonfatal), and stroke (fatal/nonfatal) and/or their composite (outcomes). The secondary safety endpoint was the development of any adverse effects. Results: In the included trials (11), participants (4804) randomized for pitavastatin or comparator (atorvastatin, pravastatin, rosuvastatin, simvastatin) and followed up for 12 to 52 weeks. In terms of the primary outcome (reduction in LDL-C), pitavastatin 4 mg was superior to pravastatin 40 mg in three trials, while the 2 mg was comparable to atorvastatin 10 mg in four trials and simvastatin 20 and 40 mg in two 2 trials. However, rosuvastatin 2.5 mg was superior to pitavastatin 2 mg in two trials. Pitavastatin increased HDL-C and reduced non-HDL-C at the majority of the eleven trials. Regarding the safety profile, pitavastatin has proved to be tolerated and safe. Conclusion: The FDA proven indications of pitavastatin are primary dyslipidemia and mixed dyslipidemia as adjunctive therapy to dietary changes to lower total cholesterol, LDL-C, apolipoprotein B (Apo B), triglycerides (TG), and to increase HDL-C. Pitavastatin might be suitable for subjects with diabetes, ACS (reduced revascularization), metabolic syndrome, CKD, HIV, and subjects with low levels of HDL-C. We highly recommend rational individualization for the selection of statin.

Aims: The study aimed to evaluate the potential benefits of luteolin treatment in Huntington's disease (HD), an inherited progressive neurodegenerative disorder.Methods: HD N171‐82Q transgenic and WT mice received luteolin or vehicle for treatment at 6 weeks of age. The mice's body weight changes and survival rates were monitored throughout the study, and a series of motor functional tests were conducted. Serum level of the marker NfL was also determined. Immunohistochemical staining and western blotting were utilized to assess the expression of huntingtin aggregates.Results: Luteolin treatment enhanced survival and prevented weight loss in HD mice compared to the vehicle‐treated HD group. Furthermore, the luteolin‐treated HD mice exhibited enhanced motor coordination and balance and significantly reduced motor dysfunction. Also, luteolin decreased serum NfL levels in HD mice. Notably, the accumulation of huntingtin aggregates was significantly reduced in the brain's cortex, hippocampus, and striatum of luteolin‐treated HD mice compared to the vehicle‐treated HD group.Conclusion: Luteolin holds promise as a therapeutic agent for improving survival outcomes, managing motor dysfunction, and reducing huntingtin aggregates in HD. The findings are of significance as currently, there are no approved therapeutic interventions that reverse HD pathology or slow down its progression.