Browsing by Author "Saleem, Zikria"

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    Covid-19, healthcare and self-medication issues in resource limited-settings :
    (Busitema University, 2021) Sefah, Israel Abebrese; Essah, Darius Obeng; Haque, Mainul; Opanga, Sylvia A; Kumar, Santosh; Chikowe, Ibrahim; Kibuule, Dan; Rampamba, Enos M; Kalungia, Aubrey C; Thi Phuong, Thuy Nguyen; Saleem, Zikria; Markovic‑Pekovic, Vanda; Kurdi, Amanj; Godman, Brian
    Introduction and objectives: There have been concerns with the level of misinformation regarding COVID-19 and its treatment, drug shortages, as well as increased use and prices of antimalarials, antibiotics and hygiene products during the recent pandemic. Community pharmacists can play a significant role in disease prevention and treatment in the fight against COVID-19 including providing hygiene information and medicine availability across Africa and generally. Consequently, there is a need to review the role of community pharmacists in preventing unintended consequences during any pandemic as well as the impact of COVID-19 on the demand, availability and prices of suggested medicines for its management. Method: Multiple approach involving a qualitative review of the management of COVID-19 across countries coupled with a pilot study in Ghana among six purposely selected community pharmacists during the early stages of the pandemic assessing patterns of demand, availability and prices of medicines suggested for the management of COVID-19. Alongside this, pharmacists’ future role enhancing appropriate medicine use in Ghana and wider combined with the help of senior level co-authors. Results: The majority (five out of six) of pharmacists in Ghana reported increased demand for hydroxychloroquine, antibiotics and vitamins as immune boosters resulting in shortages with price increases particularly for antimalarials. Conclusion: The global lockdown had impacted on the supply and prices of medicines in Ghana similar to other countries. Community pharmacists can play a key role with encouraging safe medicine use, reducing self-purchasing of medicines and planning workflows during future pandemics including vaccinations. They can also help address potential misinformation and its consequences as well as the unintended consequences of pandemics including better management of non-communicable diseases. Keywords: Community pharmacists, COVID-19, Ghana, misinformation, self-medication, supply chain
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    Evidence-based public policy making formedicines across countries: findings andimplications for the future
    (Future Medicine Ltd, 2021) Godman, Brian; Fadare, Joseph; Kwon, Hye-Young; Zampirolli Dias, Carolina; Kurdi, Amanj; Dias God ́oi, Isabella Piassi; Kibuule, Dan; Hoxha, Iris; Opanga, Sylvia; Saleem, Zikria; Bochenek, Tomasz; Markovi ́c-Pekovi ́c, Vanda; Mardare, Ileana; Kalungia, Aubrey C; Campbel, Stephen; Allocati, Eleonora; Pisana, Alice; Martin, Antony P; Meyer, Johanna C
    im:Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence ofnon-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases andother complex areas. This is difficult to sustain without reforms.Methods:Extensive narrative review ofpublished papers and contextualizing the findings to provide future guidance.Results:New models arebeing introduced to improve the managed entry of new medicines including managed entry agreements,fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have alsosuccessfully been introduced to improve the prescribing of established medicines. This includes encour-aging greater prescribing of generics and biosimilars versus originators and patented medicines in a classto conserve resources without compromising care. In addition, reducing inappropriate antibiotic utiliza-tion. Typically, multiple measures are the most effective.Conclusion:Multiple measures will be needed toattain and retain universal healthcare. Keywords:antimicrobials•biosimilars•COVID-19•demand-side measures•generics•guidelines•managedentry•oncology•orphan medicines•quality indicators•statins
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    Fixed dose drug combinations – are they pharmacoeconomically sound?:
    (Informa UK Limited, 2020) Godmana, Brian; McCabee, Holly; Leong, Trudy D.; Mueller, Debjani; Martini, Antony P.; Hoxhak, Iris; Mwital, Julius C.; Mutashambara Rwegereram, Godfrey; Masselen, Amos; Costao, Juliana de Oliveira; Rezende Macedo do Nascimentoa, Renata Cristina; Pires de Lemoso, Livia Lovato; Tachkovs, Konstantin; Milushewas, Petya; Patrickt, Okwen; Lum Nibat, Loveline; Laiusw, Ott; Sefah, Israel; Abdulsalimy, Suhaj; Soleymaniz, Fatemeh; Guantai, Anastasia N; Achieng, Loice; Oluka, Margaret; Jakupi, Arianit; Logviss, Konstantīns; Hassali, Mohamed Azmi; Kibuule, Dan; Kalemeera, Francis; Mubita, Mwangana; Fadaregg, Joseph; Ogunleye, Olayinka O.; Saleem, Zikria; Hussain, Shazhad; Bochenek, Tomasz; Mardare, Ileana; Alrasheedy, Alian A.; Furst, Jurij; Tomek, Dominik; Markovic-Pekovic, Vanda; Rampamba, Enos M.; Alfadl, Abubakr; Amu, Adefolarin A.; Matsebula, Zinhle; Thi Phuong, Thuy Nguyen; Thanh, Binh Nguyen; Kalungia, Aubrey Chichonyi; Zaranyika, Trust; Masuka, Nyasha; Olarua, Ioana D.; Wale, Janney; Hill, Ruaraidh; Kurdia, Amanj; Timoneya, Angela; Campbell, Stephen; Meyer, Johanna C.
    Introduction: There are positive aspects regarding the prescribing of fixed dose combinations (FDCs) versus prescribing the medicines separately. However, these have to be balanced against concerns including increased costs and their irrationality in some cases. Consequently, there is a need to review their value among lower- and middle-income countries (LMICs) which have the greatest prevalence of both infectious and noninfectious diseases and issues of affordability. Areas covered: Review of potential advantages, disadvantages, cost-effectiveness, and availability of FDCs in high priority disease areas in LMICs and possible initiatives to enhance the prescribing of valued FDCs and limit their use where there are concerns with their value. Expert commentary: FDCs are valued across LMICs. Advantages include potentially improved response rates, reduced adverse reactions, increased adherence rates, and reduced costs. Concerns include increased chances of drug:drug interactions, reduced effectiveness, potential for imprecise diagnoses and higher unjustified prices. Overall certain FDCs including those for malaria, tuberculosis, and hypertension are valued and listed in the country’s essential medicine lists, with initiatives needed to enhance their prescribing where currently low prescribing rates. Proposed initiatives include robust clinical and economic data to address the current paucity of pharmacoeconomic data. Irrational FDCs persists in some countries which are being addressed. KEYWORDS: Fixed dose combinations; pharmacoeconomics; adherence; medicines; noncommunicable diseases; infectious diseases; lower and middle income countries
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    Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries:
    (Taylor & Francis, 2019) Godman, Brian; Haque, Mainul; McKimm, Judy; Bakar, Muhamad Abu; Sneddon, Jacqueline; Wale, Janney; Campbell, Stephen; Martin, Antony P; Hoxha, Iris; Abilova, Vafa; Paramadhas, Bene D Anand; Mpinda-Joseph, Pinkie; Matome, Matshediso; Pires de Lemos, Livia Lovato; Sefah, Israel; Kurdi, Amanj; Opanga, Sylvia; Jakupi, Arianit; Saleem, Zikria; Hassali, Mohamed Azmi; Kibuule, Dan; Fadare, Joseph; Bochenek, Tomasz; Rothe, Celia; Furst, Jurij; Markovic-Pekovic, Vanda; Bojanić, Ljubica; Schellack, Natalie; Meyer, Johanna C; Matsebula, Zinhle; Thi Phuong, Thuy Nguyen; Jan, Saira; Kalungia, Aubrey; Mtapuri-Zinyowera, Sekesai; Sartelli, Massimo; Hill, Ruaraidh
    Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use.Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known.Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals.Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.
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    Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications
    (Frontiers in Pharmacology, 2021) Sefah, Israel A.; Ogunleye, Olayinka O.; Essah, Darius O.; Opanga, Sylvia A.; Butt, Nadia; Wamaitha, Annie; Guantai, Anastasia N.; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Nambahu, Lahya; Abubakar, Abdullahi R.; Sani, Ibrahim H.; Saleem, Zikria; Kalungia, Aubrey C.; Phuong, Thuy N. T.; Haque, Mainul; Islam, Salequl; Kumar, Santosh; Sneddon, Jacqueline; Wamboga, Joshua; Wale, Janney; Miljković, Nenad; Kurdi, Amanj; Martin, Antony P; Godman, Brian
    Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high copayment levels. Consequently, there is a need to investigate this further. Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic. Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients. Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic. Keywords: Africa, Asia, community pharmacists, COVID-19, medicines, protective equipment, price rises, shortages
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    Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries
    (MDPI, 2021) Godman, Brian; Egwuenu, Abiodun; Haque, Mainul; Ombeva Malande, Oliver; Schellack, Natalie; Kumar, Santosh; Saleem, Zikria; Sneddon, Jacqueline; Hoxha, Iris; Islam, Salequl; Mwita, Julius; Rezende Macedo do Nascimento, Renata Cristina; Piassi Dias Godói, Isabella; Lum Niba, Loveline; Amu, Adefolarin A.; Acolatse, Joseph; Incoom, Robert; Abebrese Sefah, Israel; Opanga, Sylvia; Kurdi, Amanj; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Ogunleye, Olayinka O.; Olalekan, Adesola; Markovic-Pekovic, Vanda; Meyer, Johanna C.; Alfadl, Abubakr; Thi Phuong, Thuy Nguyen; Kalungia, Aubrey C.; Campbell, Stephen; Pisana, Alice; Wale, Janney; Seaton, R. Andrew
    Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up. Keywords: antimicrobials; antimicrobial stewardship programs; antimicrobial resistance; healthcareassociated infections; COVID-19; lower- and middle-income countries; misinformation; patient initiatives; surgical site infections; vaccines