Mohamed E K Amin

University of Wisconsin–Madison, Madison, Wisconsin, United States

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Publications (7)4.7 Total impact

  • Mohamed E K Amin, Betty Chewning
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    ABSTRACT: Background Although Muslim diabetic patients may be aware of their religious exemption from fasting, many still fast and adjust their medication regimens accordingly. Pharmacists have a significant potential to identify and prevent harm from medication misuse in Ramadan. Objectives This study examines Egyptian pharmacists' knowledge regarding management of diabetes during Ramadan. It also explores pharmacists' willingness to attend a 1 day workshop on medication regimen adjustment during Ramadan. Setting Community pharmacies throughout Alexandria, Egypt. Methods A cross-sectional study using a pretested self-administered survey was conducted among a random sample of community pharmacists. The survey included three knowledge questions relevant to counseling diabetic patients during Ramadan. Questions covered the recommended timing and dosing for metformin and insulin as well as the safe blood glucose range required for diabetic patients to safely continue their fast. Using logistic regression, a model was estimated to predict pharmacists' willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Content analysis was used to analyze pharmacists' answers to the question concerning what they would like the workshop to cover. Main outcome measure Pharmacists' aggregate scores for all three diabetes management knowledge questions and pharmacists' willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Results Ninety three percent of the 298 approached pharmacists agreed to participate. Forty three pharmacists (15.9 %) did not know the correct answer to any question, 118(43.7 %) 24 answered one correctly, 86 (31.9 %) answered two correctly and only 23 (8.5 %) answered all 25 three correctly. Confidence in therapeutic knowledge regarding medication regimen 26 adjustment during Ramadan was not associated with the pharmacists' knowledge of diabetes management during Ramadan. One hundred seventy five (63.6 %) pharmacists wanted to attend a workshop on adjusting medication regimens during Ramadan. This was significantly associated with pharmacists being Muslim (OR 3.52, CI 1.70-7.27) and of younger age (OR 30 = 0.98, CI 0.96-0.99978). Pharmacists offered specific content and communication process 31 suggestions for the workshop content. Conclusion This study identifies variability among community pharmacists' knowledge of diabetes management during Ramadan. It also shows willingness among the majority of pharmacists to learn more about the topic.
    International journal of clinical pharmacy. 09/2014;
  • Mohamed E K Amin, Betty Chewning
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    ABSTRACT: During Ramadan, many Muslim patients may choose to abstain from food, drink and oral medications from dawn to sunset.
    Research in social & administrative pharmacy : RSAP. 04/2014;
  • Mohamed E.K. Amin, Betty Chewning
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    ABSTRACT: Background During Ramadan, many Muslim patients may choose to abstain from food, drink and oral medications from dawn to sunset. Objectives This study explored the utility of the Theory of Planned Behavior (TPB) model in predicting community pharmacists’ Medication Regimen Adjustment (MRA) behavior for patients during Ramadan. Methods A sample of pharmacists was drawn from a recent list of community pharmacies in the Alexandria governorate. A cross-sectional, self-administered survey was completed by community pharmacists to determine their attitudes and behaviors regarding adjustment of medication regimens around Ramadan. Multiple linear regression was used to predict MRA as a function of the TPB constructs and four other factors – “pharmacist initiation of the conversation on MRA,” “number of hours worked,” “age,” and “religion” of pharmacist. Results Two hundred seventy-seven (92.9%) of the 298 approached pharmacists participated. While 94.2% reported performing one or more kinds of MRA around Ramadan for at least one patient, the majority of these were for a small percentage of patients. The most common MRA was changing the frequency of taking the medication followed by the dose of the medication, the dosage form of the medication and the medication itself. Statistically significant predictors of MRA in the final model included patient social pressure (PSP) (β= 0.274, P<0.001), pharmacist perceived behavioral capability (PBC) (β= 0.217, P<0.001), pharmacist perceived patient benefit (PPB) (β= 0.207, P=0.001), initiating communication (β= 0.167, P=0.001) and the number of working hours (β= 0.145, P=0.005). Conclusions The TPB appears to have utility in predicting pharmacists’ MRA behavior. Pharmacists may be open to a larger MRA role than they are currently performing. There is a need to prepare pharmacists who are frequently requested to adjust patients’ medication regimens to make sure they provide a safe transition for fasting patients into and out of Ramadan.
    Research in Social and Administrative Pharmacy 01/2014; · 2.35 Impact Factor
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    ABSTRACT: Positive impact of community pharmacists' cognitive pharmaceutical services (CPS) is well documented. However, community pharmacists have been slow to expand CPS roles. This systematic review explores how community pharmacy intervention research can help inform efforts to expand cognitive pharmaceutical service delivery. To: 1) identify community pharmacy CPS intervention studies that report data on pharmacist behaviors, either as a final study outcome itself or as a fidelity measure in patient outcome studies, and 2) describe the state of this research to help frame future research agendas. Empirical articles examining improvement or expansion of community pharmacist cognitive services published through December 2010 were searched using various search engines, bibliography searches and authors' libraries. Studies were included if they: 1) reported findings on pharmacist behaviors during cognitive service delivery, 2) employed a minimum of pre-post design or two study arms for pharmacists/pharmacies, and 3) were in community-based pharmacies. A total of 50 studies evaluated impact of community pharmacy based CPS delivery; however, only 21 included a pharmacist behavior outcome measure as a final outcome or as a fidelity measure. The majority (14 out of 21) of studies used a randomized controlled trial design. Nearly half (10 of 21) addressed asthma or tobacco cessation. Limited details were provided about interventions to prepare pharmacists for CPS delivery. The most frequent measures of pharmacist behavior were patient surveys and observation of pharmacists' behavior by secret shoppers; electronic data sets were rarely used. There is a need for well-designed intervention research that evaluates how interventions impact on pharmacist cognitive service behavior. Positive findings from this review reinforce that planned interventions have the potential to improve and expand pharmacist cognitive service delivery; however, more detail is needed in study publications for this potential to be fully realized.
    Research in Social and Administrative Pharmacy 09/2013; · 2.35 Impact Factor
  • Mohamed Amin, Betty Chewning, Ashraf Wahdan
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    ABSTRACT: OBJECTIVES: This study examines the patients' perspective of the length of their patient-physician consult and its relationship to reported adherence and unmet drug information needs. METHODS: A convenience sample of 366 adult patients with chronic conditions was interviewed when leaving 20 Egyptian pharmacies after filling at least one prescription. Patients were asked whether they spent adequate time with their physician, took their refill drug as prescribed, might decrease or increase a drug dose without consulting their physician and needed to know more about their drugs. KEY FINDINGS: Only 55.2% of patients reported they spent adequate time with their physician. Patients spending adequate time with the physician were less likely to report that they needed more information about their drugs (60.9% versus 79.3%), might decrease (21.8% versus 31.7% ) or increase(11.9% versus 19.5% ) a dose without consulting their physician and were more likely to report taking the drug as prescribed (94.1% versus 83.5%). Patients with limited education and patients taking multiple drugs were less likely to report that they spent adequate time with the physician. CONCLUSION: Physicians need to take the time to identify patient questions and understanding before patients leave a visit given the high percent of respondents who did not believe they received adequate time with their physician, and that this is associated with both unmet information needs and reported nonadherence, particularly for high need patients.
    140st APHA Annual Meeting and Exposition 2012; 10/2012
  • Mohamed Amin, Betty Chewning
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    ABSTRACT: OBJECTIVES: One of the primary causes of the rise in antibiotic resistance, which can travel the globe, is the inappropriate use of antibiotics. Unlike the United States, pharmacies in Africa, Asia, Europe and South America frequently dispense antibiotics without a prescription (WP). There has been little research, however, about why pharmacists dispense antibiotics WP. This study aimed to identify factors influencing pharmacists' decisions to dispense antibiotics WP in Alexandria, Egypt. METHODS: In January 2010, the primary investigator conducted semi-structured one-to-one face-to-face interviews with open-ended questions using a convenience sample of 7 community pharmacists. Purposive and saturation sampling techniques were applied to identify participants and determine sample size, respectively. Interviews were recorded, translated, transcribed and then analysed independently by the 2 authors. Emerging themes were extracted and analysed using the grounded theory approach. RESULTS: Financial, patron and pharmacist related factors influenced the decision to dispense antibiotics WP. We identified 4 reasons that facilitated dispensing antibiotics WP: (1) profit from selling antibiotics (2) ease of obtaining antibiotic WP from other pharmacies, (3) patron's insistence on getting an antibiotic and (4) patron's inability to access a doctor. On the other hand, pharmacists reported that they would not dispense an antibiotic WP if: (1) the complexity of the patron's condition exceeds a pharmacist's expertise and needs the involvement of a doctor, (2) the requested antibiotic is hazardous or (3) the patron's condition is not worthy of an antibiotic. We identified 5 factors influencing antibiotic product selection. Pharmacists reported that they are more likely to pick a specific antibiotic that is: (1) safe, (2) suitable for the patron's condition, (3) taken in a small number of doses or produces a quick improvement, (4) matched to the patron's financial status,i.e., expensive for rich patrons and cheap for poor patrons and (5) familiar to the pharmacist. Pharmacists' belief that patrons will perceive them as incompetent or unwilling to help if they refuse to dispense an antibiotic WP was cited as a challenge in handling patrons insisting on getting an antibiotic when a pharmacist thinks that antibiotic use is not warranted. CONCLUSIONS: A heterogeneous set of factors influence pharmacists' decisions to dispense antibiotics WP as well as the antibiotic product selection. These factors compromise pharmacists' role in safeguarding the community from inappropriate antibiotic use. Policy makers need to involve pharmacists and patients when promoting the judicious use of antibiotics.
    139st APHA Annual Meeting and Exposition 2011; 10/2011
  • Mohamed E K Amin, Betty A Chewning, Ashraf M H Wahdan
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    ABSTRACT: This study sought to identify patients' perceived drug knowledge, need for more information and drug information sources, and how they varied by patient characteristics, particularly education level. A convenience sample of 366 adult patients was interviewed when leaving 20 Egyptian pharmacies after collecting a dispensed prescription. Patients were asked about their (1) perceived knowledge of their drugs' purpose, (2) use of package inserts (PIs) to learn about side effects, contraindications and drug interactions, (3) perceived need to know more about their drugs and (4) general sources of drug information beyond healthcare providers. More than 30% of the patients reported that they did not know the purpose of at least one of their drugs and only read PIs selectively. Whereas 36% read about drug interactions, more reported reading about side effects (65%) and contraindications (60%) in PIs. Sixty-nine per cent of patients reported that they needed more information about their drugs. This was true for 86.8% of patients with limited education compared to 48.5% of university graduates. University graduates reported using PI topics, newspapers, internet, TV and family and friends as sources of drug information at significantly higher rates than did patients with lower levels of education. There is a need for healthcare professionals to evaluate patient comprehension and needs for drug information, especially for patients with less schooling. Healthcare providers should also consider other information sources that a patient is using.
    International Journal of Pharmacy Practice 02/2011; 19(1):13-20.