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International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 1084–1094 | Cite as

Assessment of patients’ knowledge and practices regarding their medication use and risks in Lebanon

  • Elsy RamiaEmail author
  • Rony M. Zeenny
  • Souheil Hallit
  • Pascale Salameh
  • on behalf of the Order of Pharmacists Scientific Committee – Medication Safety Subcommittee
Research Article

Abstract

Background Patients’ knowledge of their medications play a pivotal role in their disease management. Objective Assess the knowledge and practices of Lebanese outpatients regarding their own medication use and risks. Setting Four hundred and sixty community pharmacies across Lebanon. Method It was a cross-sectional study performed from March through May 2016 among Lebanese outpatients, using a self-administered questionnaire. Descriptive statistics were used to calculate all participants’ responses. The association between categorical variables were evaluated using Pearson χ2 test or Fisher’s exact test. Binary logistic regressions were performed to identify factors associated with medication patients’ knowledge and interest. Main outcome measure Ability of the patients to identify own medications’ elements: name, strength, dosage regimen, indication, and adverse drug reactions. Results Our study comprised 921 patients, with around 16% taking ≥5 medications/day. Around 56% of our patients showed sub-optimal medication knowledge. Patients’ higher educational level, number of chronic diseases, and patient physician interaction were associated with higher medication knowledge. Many patients admitted not discussing their medications each time they visit their physicians (38.7%); not reading the leaflet of each medication they take (61.2%); and not regularly asking their pharmacist about the potential interactions of OTC drugs with prescribed medications (53.9%). Conclusion This study showed suboptimal medication-related knowledge, and suboptimal patient’s interactions with primary care givers. Our findings serve as a platform for healthcare providers to understand patients’ needs and educate them about medication use and risks.

Keywords

Adverse drug reactions Community pharmacies Knowledge Lebanon Medication Outpatients 

Notes

Acknowledgements

We would like to thank all the inspectors of the OPL for their help in passing the surveys and data entry. We would also like to thank all the members of the OPL Medication Safety Subcommittee, namely: Aline Hajj, Hadi Sherri, Hayat Azouri, Hind Hajj, Maryam Ghorayeb, Marwan Akel, Nouhad Sarkis, and Patricia Shuhaiber.

Funding

No sources of funding were used to assist in the preparation of this study.

Conflicts of interest

The authors of this manuscript declare no conflicts of interest.

Supplementary material

11096_2017_517_MOESM1_ESM.pdf (253 kb)
Supplementary material 1 (PDF 253 kb)

References

  1. 1.
    Cox A. Involving patients in reporting adverse drug reactions should be welcomed. Pharm J. 2009;282:16.Google Scholar
  2. 2.
    Josef Send AF, Schwab M, Gauss A, Rudofsky G, HaefelI WE, Seidling HM. Pilot study to assess the influence of an enhanced medication plan on patient knowledge at hospital discharge. Eur J Clin Pharmacol. 2014;70:1243–50.CrossRefGoogle Scholar
  3. 3.
    Hong SH, Liu J, Tak S, Vaidya V. The impact of patient knowledge of patient-centered medication label content on quality of life among older adults. Res Social Adm Pharm. 2013;9:37–48.CrossRefPubMedGoogle Scholar
  4. 4.
    Burge S, White D, Bajorek E, Bazaldua O, Trevino J, Albright T et al. Correlates of medication knowledge and adherence: findings from the residency research network of South Texas. Fam Med. 2005;37(10):712–8.PubMedGoogle Scholar
  5. 5.
    Najjar A, Amro Y, Kitaneh I, Abu-ShararS Sawalha M, Jamous A, et al. Knowledge and adherence to medications among palestinian geriatrics living with chronic diseases in the West Bank and East Jerusalem. PLoS One. 2015;10(6):e0129240.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Okuyan B, Sancar M, Izzetin FV. Assessment of medication knowledge and adherence among patients under oral chronic medication treatment in community pharmacy settings. Pharmacoepidemiol Drug Saf. 2013;22:209–14.CrossRefPubMedGoogle Scholar
  7. 7.
    McPherson ML, Smith SW, Powers A, Zuckerman IH. Association between diabetes patients’ knowledge about medications and their blood glucose control. Res Social Adm Pharm. 2008;4(1):37–45.CrossRefPubMedGoogle Scholar
  8. 8.
    Necyk C, Barnes J, Tsuyuki RT, Boon H, Vohra S. How well do pharmacists know their patients? A case report highlighting natural health product disclosure. Can Pharm J. 2013;146(4):202–9.CrossRefGoogle Scholar
  9. 9.
    Cumbler E, Wald H, Kutner J. Lack of patient knowledge regarding hospital medications. J Hosp Med. 2010;5:83–6.PubMedGoogle Scholar
  10. 10.
    Leemans L, Heylen N, Quanten A, Deferme S. Consumer study on the use of patient information leaflets. [Article in French]. J Pharm Belg. 2011;4:109–16.Google Scholar
  11. 11.
    Sleath B, Roter D, Chewning B, Svarstad B. Asking questions about medication: analysis of physician-patient interactions and physician perceptions. Med Care. 1999;37(11):1169–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Garjani A, Rahbar M, Ghafourian T, Maleki N, Garjani A, Salimnejad M et al. Relationship of pharmacist interaction with patient knowledge of dispensed drugs and patient satisfaction. East Mediterr Health J. 2009;15(4):934–43.PubMedGoogle Scholar
  13. 13.
    European Medicines Agency (EMA). Product-information templates. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000134.jsp (2016). Accessed 05 Aug 2016.
  14. 14.
    U.S. Department of Health and Human Services; Food and Drug Administration; Center for Drug Evaluation and Research (CDER); and Center for Biologics Evaluation and Research (CBER). Guidance: Useful Written Consumer Medication Information (CMI). http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm080602.pdf (2006). Accessed 06 Aug 2016.
  15. 15.
    National Patient Safety Foundation (NPSF). Ask Me 3: Good Questions for Your Good Health 2016. http://www.npsf.org/?page=askme3. Accessed 07 Aug 2016.
  16. 16.
    Rubio JS, García-Delgado P, Iglésias-Ferreira P, Mateus-Santos H, Martínez-Martínez F. Measurement of patients’ knowledge of their medication in community pharmacies in Portugal. Cien Saude Colet. 2015;20(1):219–28.CrossRefPubMedGoogle Scholar
  17. 17.
    Romero-Sanchez J, Garcia-Cardenas V, Abaurre R, Martínez-Martínez F, Garcia-Delgado P. Prevalence and predictors of inadequate patient medication knowledge. J Eval Clin Pract. 2016;22(5):808–15.CrossRefPubMedGoogle Scholar
  18. 18.
    Akici A, Kalaca S, Ugurlu U, Toklu HZ, Iskender E, Oktay S. Patient knowledge about drugs prescribed at primary healthcare facilities. Pharmacoepidemiol Drug Saf. 2004;13:871–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Ghusn H. Polypharmacy: what clinicians need to know while caring for an elderly. J Med Liban. 2012;60(4):207–13.PubMedGoogle Scholar
  20. 20.
    Yassine M, Al-Hajje A, Awada S, Rachidi S, Zein S, Bawab W et al. Evaluation of medication adherence in Lebanese hypertensive patients. J Epidemiol Glob Health. 2016;6(3):157–67.CrossRefPubMedGoogle Scholar
  21. 21.
    Al-Hajje A, Awada S, Rachidi S, Zein S, Bawab W, El-Hajj Z, et al. Factors affecting medication adherence in Lebanese patients with chronic diseases. Pharm Pract. 2015;13(3):590.CrossRefGoogle Scholar
  22. 22.
    Saab YB, Hachem A, Sinno S, El-Moalem H. Inappropriate medication use in elderly lebanese outpatients: prevalence and risk factors. Drugs Aging. 2006;23(9):743–52.CrossRefPubMedGoogle Scholar
  23. 23.
    Saarti S, Hajj A, Karam L, Jabbour H, Sarkis A, El Osta N et al. Association between adherence, treatment satisfaction and illness perception in hypertensive patients. J Hum Hypertens. 2016;30:341–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Zeenny R, Wakim S, Kuyumjian YM. Potentially inappropriate medications use in community-based aged patients: a cross-sectional study using 2012 Beers criteria. Clin Interv Aging. 2017;12:65–73. doi: 10.2147/CIA.S87564.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Al-Hajje A, Awada S, Rachidi S, Chahine NB, Azar R, Zein S et al. Medication prescribing errors: data from seven Lebanese hospitals. J Med Liban. 2012;60(1):37–44.PubMedGoogle Scholar
  26. 26.
    Ramia E, Zeenny R. Completion of therapeutic and safety monitoring tests in Lebanese outpatients on chronic medications: a cross-sectional study. Patient Prefer Adherence. 2014;8:1195–204.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    World Health Organization Regional Office for Europe. Exploring patient participation in reducing health-care-related safety risks. DK-2100 Copenhagen, Denmark; 2013.Google Scholar
  28. 28.
    World Fact Book of the United States Central Intelligence Agency. 2016. Lebanon Demographics Profile 2014. http://www.indexmundi.com/lebanon/demographics_profile.html. Accessed 19 Nov 2015.
  29. 29.
    Dean AG, Arner TG, Sunki GG, Friedman R, Lantinga M, Sangam S et al. Epi Info™, a database and statistics program for public health professionals. Atlanta: CDC; 2011.Google Scholar
  30. 30.
    Shrank WH, Avorn J. Educating patients about their medications: the potential and limitations of written drug information. Health Aff (Millwood). 2007;26(3):731–40.CrossRefGoogle Scholar
  31. 31.
    Oladimeji O, Farris KB, Urmie JG, Doucette WR. Risk factors for self-reported adverse drug events among medicare enrollees. Ann Pharmacother. 2008;42(1):53–61.CrossRefPubMedGoogle Scholar
  32. 32.
    Raynor K, Knapp P. Do patients see, read and retain the new mandatory medicines information leaflets? Pharm J. 2004;264(7083):268–70.Google Scholar
  33. 33.
    Vinker S, Eliyahu V, Yaphe J. The effect of drug information leaflets on patient behavior. IMAJ. 2007;9:383–6.PubMedGoogle Scholar
  34. 34.
    Nathan JP, Zerilli T, Cicero LA, Rosenberg JM. Patients’ use and perception of medication information leaflets. Ann Pharmacother. 2007;41(5):777–82.CrossRefPubMedGoogle Scholar
  35. 35.
    Herber OR, Gies V, Schwappach D, Thürmann P, Wilm S. Patient information leaflets: informing or frightening? BMC Fam Pract. 2014;2014(15):163.CrossRefGoogle Scholar
  36. 36.
    Krueger JL, Hermansen-Kobulnicky CJ. Patient perspective of medication information desired and barriers to asking pharmacists questions. J Am Pharm Assoc. 2011;51(4):510–9.CrossRefGoogle Scholar
  37. 37.
    Zeenny R., Forecasting the Future of Pharmacy In Lebanon: The Magic Of Numbers, in The Lebanese Order of Pharmacists Pharmacy Day 2016 conference presentation; 2016.Google Scholar
  38. 38.
    Obamiro KO, Chalmers L, Bereznicki LRE. Development and validation of an oral anticoagulation knowledge tool (AKT). PLoS One. 2016;11(6):e0158071. doi: 10.1371/journal.pone.0158071.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Zeolla MM, Brodeur MR, Dominelli A, Haines ST, Allie ND. Development and validation of an instrument to determine patient knowledge: the oral anticoagulation knowledge test. Ann Pharmacother. 2006;40(4):633–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Briggs AL, Jackson TR, Bruce S, Shapiro NL. The development and performance validation of a tool to assess patient anticoagulation knowledge. Res Social Adm Pharm. 2005;1(1):40–59.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Pharmacy Practice, School of PharmacyLebanese American UniversityByblosLebanon
  2. 2.Department of PharmacyAmerican University of Beirut Medical CenterBeirutLebanon
  3. 3.Psychiatric Hospital of the CrossJal EddibLebanon
  4. 4.School of PharmacySaint-Joseph UniversityBeirutLebanon
  5. 5.School of PharmacyLebanese UniversityHadath, BeirutLebanon
  6. 6.Faculty of MedicineUniversite Saint-Esprit KaslikKaslikLebanon
  7. 7.Faculty of MedicineLebanese UniversityBeirutLebanon

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