Jordanian Physicians Research Articles

Awareness, perspectives and practices of antibiotics deprescribing among physicians in Jordan: a cross-sectional study.

Antibiotics have significantly reduced mortality and improved outcomes across various medical fields; however, the rise of antibiotic resistance poses a major challenge, causing millions of deaths annually. Deprescribing, a process that involves discontinuing unnecessary antibiotics, is crucial for combating this threat. This study was designed to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. A cross-sectional survey was conducted between January-February 2024 to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. An electronic questionnaire served as the data collection tool. Descriptive analysis was performed using SPSS software version 26. Additionally, logistic regression analysis was carried out to identify independent factors associated with physicians' willingness to deprescribe antibiotics. The study involved 252 physicians, primarily male (n = 168, 67.7%), with a median age of 33 years. Regarding antibiotics deprescribing, 21.8% (n = 55) expressed willingness to deprescribe inappropriate antibiotics.High awareness of deprescribing was evident, with 92.9% (n = 234) familiar with the concept, 94% (n = 237) knowledgeable about appropriate situations, and 96.8% (n = 244) recognising its potential benefits. Furthermore, 81.8% (n = 205) reported having received formal training in antibiotics deprescribing, and 85.3% (n = 215) were informed about the availability of deprescribing tools.Physicians highlighted challenges including insufficient time (44.4%, n = 112) and resistance from patients (41.3%, n = 104) and colleagues (42.1%, n = 106). Despite challenges, a significant proportion regularly assessed antibiotic necessity (46.9%, n = 117) and educated patients about antibiotic-related harms (40.5%, n = 102). Logistic regression analysis revealed no significant demographic factors influencing physicians' willingness to deprescribe antibiotics (p > 0.05). Physicians in Jordan exhibit high awareness of antibiotics deprescribing and recognise its benefits. Challenges such as time constraints and communication barriers need to be addressed to facilitate effective deprescribing practices. Comprehensive guidelines and interdisciplinary collaboration are essential for promoting judicious antibiotic use and combating antimicrobial resistance.

Physicians' Knowledge of Theophylline Use: A Cross-Sectional Study from Jordan

Objective: This cross-sectional study aims to assess physicians' knowledge regarding theophylline drug and other related characteristics in Jordan. Materials and Method: The study was conducted prospectively among physicians in Jordan. Physicians were interviewed using an online questionnaire consisting of two sections. The first section included demographics and other relevant characteristics, while the second section comprised questions about theophylline drug. Results: A total of 385 participants completed the questionnaire. The majority of participants knew that theophylline is used in clinical practice as a bronchodilator (75.6%). Nearly 39% of participants knew that theophylline can be administered orally and intravenously. The largest share of participants (76.1%) did not know that theophylline dosage is calculated based on ideal body weight. Sixty percent of participants knew that theophylline use was not contraindicated during pregnancy. On the other hand, only 27.3% knew that theophylline use was not contraindicated during breastfeeding. The majority of participants (76.1%) had an overall intermediate knowledge of theophylline. Conclusions: It was noted that physicians had an overall intermediate knowledge of theophylline. Physicians demonstrated unsatisfactory knowledge about theophylline’s indications, clinical use, administration, adverse effects, and other related aspects. These findings highlight the need for educational interventions and training programs to improve physicians’ knowledge of theophylline and enhance its effective and safe use in clinical practice.

Evaluation of Antimicrobial Stewardship Programs and antibiotic prescribing patterns among physicians in ambulatory care settings in Jordan

ABSTRACT Objectives Currently, there is an urgent need to implement an Antimicrobial Stewardship Program (ASP) in outpatient settings since nearly half of the antibiotic prescribing is inappropriate or unnecessary. The implementation of ASP should emphasize educational interventions that are more interactive. This study examines the adoption of outpatient ASP by physicians in Jordan. Methods A cross-sectional study was conducted between 2 March 2022 and 20 May 2022 at major hospitals in Jordan. The survey was distributed randomly among (n = 187) Jordanian physicians. Results It was found that more than half of the physicians were females (51.9%). The participants who reported not including antibiotic stewardship-related duties in position descriptions were (40.1%). While (46.5%) of participants reported writing and displaying public commitments supporting antibiotic stewardship in ambulatory care settings. Physicians’ adoption of (action) core elements of ASPs in ambulatory care settings was positive. Almost (24.6%) reported a lack of self-evaluation of their antibiotic-prescribing practices. It was reported that (69.5%) of physicians used effective communication strategies to educate patients about when antibiotics are necessary. Conclusion It was fair adoption of the core elements in the ambulatory care settings among Jordanian physicians. Progress necessitates a comprehensive strategy tailored to the needs of the health system.

Drug information-seeking behaviour among Jordanian physicians: a cross-sectional study.

Background: Due to the huge number of drugs available and the rapid growth and change in drug information, healthcare professionals, especially physicians, frequently require reliable, easily accessible, rapid, and accurate reference sources to obtain the necessary drug information. Several sources of information are available for physicians to use and select from; however, the information-seeking behaviour of healthcare providers is varied, and this process can be challenging. Objectives: In this study, Jordanian physicians were approached to evaluate the drug information they require, the sources of information they use, the perceived credibility of the sources, and the challenges they face when searching for the most accurate and current information about drugs. Methods: This is an observational, cross-sectional study. A self-administered questionnaire was distributed to practising physicians in Jordan using a convenience sampling method (purposive sampling followed by snowball sampling) regardless of their speciality, age, gender, seniority, or place of employment. Results: Three hundred and eighty physicians participated in the study. Most participants responded that they performed drug information searches on a weekly (155, 40.8%) or a daily basis (150, 39.5%). The drug-related information that physicians most frequently searched for concerned dosage regimens and adverse drug events. The majority of surveyed doctors (97.9%) reported using online websites to acquire drug information; UpToDate®, Medscape and Drugs.com were the most frequently used online databases, although many participants did not consider online sources to be the most reliable source. The most prevalent and recurrent challenges encountered concerned an inability to access subscription-only journals and websites (56.6%), difficulty identifying trusted and credible sources (41.8%) and the enormous number of available sources (35.3%). However, these challenges were less of a problem for physicians who currently work or have previously worked in academia (p < 0.001). Conclusion: This study demonstrated that Jordanian physicians frequently use online websites to look for drug information and all doctors face challenges throughout this process particularly those with no experience in academia. This suggests that being in academia makes the process of information-seeking easier which highlights the need for academics to transfer their knowledge and experience to their non-academic colleagues and the upcoming generations of physicians.

The practice of defensive medicine among Jordanian physicians: A cross sectional study.

Defensive medicine (DM) is a deviation from medical practice that is induced primarily by a threat of liability. While the DM behavior is well studied in the developed countries, little is known in developing countries and never been evaluated in Jordan. To evaluate the prevalence of DM practice in Jordan among physicians and to investigate reasons behind its practice and potential strategies to alleviate this practice. In this Cross-sectional study, self-administered questionnaire was distributed to a sample of physicians in both public and private sectors in Jordan. The collection period was from Jan 2021 to June 2021. The prevalence of DM practice was estimated among the study sample. Frequency scores of different DM behaviors, reasons of DM behaviors, and effectiveness of strategies in changing DM behaviors were summarized as average frequency scores with standard deviations. Multivariable linear regression models were conducted to evaluate potential predictors of total assurance and avoidance behavior scores. A total of 175 Jordanian physicians completed the survey. The prevalence of adopting (or witnessing) DM behaviors among the study sample was 68% (n = 119). Diagnostic laboratory exams followed by prescribed medications were the most practiced behaviors in excessive rate during a typical working week. Unfavorable legislation for the physician was reported as the headmost reason for practicing DM, followed by pressure from the public and mass media opinion. Continuous update of knowledge, abilities, and performance and following specific protocols and/or appropriate clinical evidence and appropriate multidisciplinary and multi-professional communication were the most effective strategies that can mitigate DM behaviors. Defensive medicine practice is common among Jordanian physicians with concerns about increasing pattern in the future.

Unraveling the association between vaccine attitude, vaccine conspiracies and self-reported side effects following COVID-19 vaccination among nurses and physicians in Jordan

BackgroundThe negative impact of vaccine conspiracies is linked with negative health behavior. The aim of the current study was to examine the association between attitudes toward booster COVID-19, influenza, and monkeypox (mpox) vaccinations with post-COVID-19 vaccine side effects, vaccine conspiracies, and attitude towards mandatory vaccination among nurses and physicians in Jordan. MethodsA structured closed-ended questionnaire was used to collect data on demographics, COVID-19 history, COVID-19 vaccine type and doses received, self-reported side effects post-COVID-19 vaccination, acceptance of booster COVID-19, seasonal influenza, and mpox vaccinations, attitudes towards mandatory vaccination, and beliefs in vaccine conspiracies. ResultsThe study sample comprised a total of 341 participants. Acceptance of yearly booster COVID-19 vaccination was expressed by 46.6% of the sample, while 73.3% accepted seasonal influenza vaccination, and only 37.0% accepted mpox vaccination. A higher frequency of self-reported side effects following the first COVID-19 vaccine dose was associated with embrace of vaccine conspiracies and vaccine type. For the second vaccine dose, a higher frequency of self-reported side effects was associated with the embrace of vaccine conspiracies, older age, and affiliation to private sector. In multinomial logistic regression analyses, the lower embrace of vaccine conspiracies was associated with lower odds of reporting side effects post-COVID-19 vaccination. The lower embrace of vaccine conspiracies and favorable attitude towards mandatory vaccination were associated with the willingness to get COVID-19, influenza, and mpox vaccinations. ConclusionThe study findings highlighted the negative impact of embracing vaccine conspiracies on health-seeking behavior among nurses and physicians. The findings indicated that the willingness to get vaccinated was associated with lower endorsement of vaccine conspiracies. Additionally, the lower embrace of vaccine conspiracies was associated with a lower frequency of self-reported side effects following COVID-19 vaccination. These results emphasize the importance of addressing vaccine misinformation and promoting accurate information to ensure optimal vaccine uptake and public health outcomes.

Awareness and knowledge of physicians and residents on the non-sexual routes of human papilloma virus (HPV) infection and their perspectives on anti-HPV vaccination in Jordan.

Although penetrative sex is the most common route of HPV infection, there is strong evidence of non-sexual modes of transmission. As the first of its kind, this study aimed to investigate the knowledge and awareness of Jordanian physicians on such routes. A questionnaire was conducted among a national Jordanian sample of physicians from Jordanian health sectors. The survey included questions assessing participants' knowledge on HPV, non-sexual routes of infection and HPV vaccines. Physicians' attitudes towards HPV screening and vaccination were covered. Statistical analysis was carried out using SAS 9.4, ANOVA, post-hoc Tukey-Honest test and Kruskal-Wallis test. All significant differences were set at α = 0.05. A total of 412 participants completed the survey. Physicians showed a huge deficit in knowledge on nonsexual routes of HPV transmission. They agreed that the most and least common routes of non-sexual transmission are skin to mucosa (64%) and contaminated water (15%), respectively. Females showed significantly better knowledge in all aspects of HPV transmission and vaccination (p<0.0001) and more positive attitudes towards HPV screening and vaccination compared to males (p = 0.03). Age group ≤ 25 and academic physicians demonstrated higher knowledge on HPV vaccines compared to their counterparts in non-academic places (p = 0.002). Specialty and experience seemed to have no impact on knowledge or attitudes of participants. Higher knowledge physicians had more positive attitude towards vaccination and screening compared to lower knowledge fellows (p<0.001). The noteworthy findings of this study is the extremely low level of knowledge on non-sexual routes of HPV infection among Jordanian physicians. Increasing the level of awareness of physicians and healthcare workers on these routes and their association with cervical and other cancers through university curricula and other reliable sources is strongly recommended.

Exploring the implemented guidelines for dyslipidemia treatment and care among nurses and physicians in jordanian hospitals

Abstract Funding Acknowledgements Type of funding sources: None. Background Dyslipidemia is a major risk factor for ischemic heart disease in the world. The last updated American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology/ European Atherosclerosis Society (ESC/EAS) guidelines for dyslipidemia management aimed to control blood cholesterol and reduce cardiovascular risk. In Jordan, no national guidelines have been published to date, so these guidelines are commonly used. There are a few studies exploring the implementation of these guidelines in Jordan. Purpose To explore the implementation of updated ACC/AHA and ESC/EAS guidelines for the treatment and care of dyslipidemia among nurses and physicians in Jordan. Methods: A mixed-method study was utilized with a convenience sample from three hospitals in Jordan to provide a comprehensive understanding for the investigated concepts in the current study. The quantitative part, the researcher developed a questionnaire. A questionnaire was completed by 150 nurses and 50 physicians, and moreover, 250 patients' medical records were reviewed. The qualitative part, three focus group with open-ended questions was conducted. Results The total mean scores to implement the guidelines among nurses were (1.67, 1.6 out of 4) for ACC/AHA and ESC/EAS guidelines respectively. The percentages for implementing dyslipidemia management guidelines among physicians were 22.6% consistent with ACC/AHA and 29.6% with ESC/EAS. There were high percentages of uncontrolled lipids among patients with dyslipidemia as observed in medical records. Focus group interviews revealed many barriers, like workload and limited resources and many suggestions to implement dyslipidemia management guidelines. Conclusion Results indicated limited implementation of any dyslipidemia management guidelines among Jordanian nurses and physicians in their clinical practices.

Work-Life Balance among Physicians in Jordan.

We aimed to assess the work-life balance, job satisfaction, and life satisfaction and their correlates among physicians in Jordan. This study utilized an online questionnaire to collect information about work-life balance and related factors from practicing physicians in Jordan from August 2021 until April 2022. The survey consisted of 37 detailed self-report questions covering seven main categories: demographics, professional and academic information, impact of work on personal life, impact of personal life on work, work/personal life enhancement, the Andrew and Withney Job Satisfaction scale, and the Satisfaction with Life Scale developed by Diener et al. Results: The study included 625 participants. Overall, 62.9% were found to have a work-life conflict. The work-life balance score was negatively correlated with age, number of children, and years practicing medicine, while it was positively correlated with number of hours per week and number of calls. Regarding job and life satisfaction, 22.1% had a score indicating job dissatisfaction, while 20.5% disagreed with the statements indicating life satisfaction. Our study demonstrates that work-life conflict is highly prevalent among Jordanian physicians and highlights the significance of work-life balance in supporting physicians' well-being and performance.

Previous Vaccination History and Psychological Factors as Significant Predictors of Willingness to Receive Mpox Vaccination and a Favorable Attitude towards Compulsory Vaccination.

During the ongoing multi-country monkeypox (Mpox) outbreak, healthcare workers (HCWs) have represented a key group in mitigating disease spread. The current study aimed to evaluate the attitude of nurses and physicians in Jordan towards Mpox vaccination, as well as their attitude towards compulsory vaccination against coronavirus disease 2019 (COVID-19), influenza, and Mpox. An online survey was distributed in January 2023 based on the previously validated 5C scale for psychological determinants of vaccination. Previous vaccination behavior was assessed by inquiring about the history of getting the primary and booster COVID-19 vaccination, influenza vaccine uptake during COVID-19, and any history of influenza vaccine uptake. The study sample consisted of 495 respondents: nurses (n = 302, 61.0%) and physicians (n = 193, 39.0%). Four hundred and thirty respondents (86.9%) had heard of Mpox before the study, and formed the final sample considered for Mpox knowledge analysis. Deficiencies in Mpox knowledge were reflected in a mean knowledge score of 13.3 ± 2.7 (out of 20.0 as the maximum score), with significantly lower knowledge among nurses and females. The intention to receive Mpox vaccination was reported by 28.9% of the participants (n = 143), while 33.3% were hesitant (n = 165), and 37.8% were resistant (n = 187). In multivariate analysis, Mpox vaccine acceptance was significantly associated with previous vaccination behavior, reflected in higher vaccine uptake and with higher 5C scores, while Mpox knowledge was not correlated with Mpox vaccination intention. The overall attitude towards compulsory vaccination was neutral, while a favorable attitude towards compulsory vaccination was associated with higher 5C scores and a history of previous vaccination uptake. The current study showed a low intention to get Mpox vaccination in a sample of nurses and physicians practicing in Jordan. The psychological factors and previous vaccination behavior appeared as the most significant determinants of Mpox vaccine acceptance and of attitudes towards compulsory vaccination. The consideration of these factors is central to policies and strategies aiming to promote vaccination among health professionals in efforts to prepare for future infectious disease epidemics.

Pediatricians’ perspectives on childhood behavioral and mental health problems in Jordan

BackgroundMental health disorders among children are highly prevalent worldwide. In most countries, the primary care physician is point of first contact with the medical system for children with these problems. There are few data from developing countries about the ways in which these children present barriers that may hinder appropriate recognition, treatment, or referral. This study sought to explore the range and expression of childhood behavioral disorders encountered by primary care pediatricians in Jordan, as well as barriers to the identification and management of these conditions.ResultsWe used qualitative methodology to conduct 8 focus-group interviews with physicians in Jordan. A total of 36 physicians participated. Themes that emerged from the interviews were organized into four categories. The first category described specific behavioral disorders encountered by physicians, autism being the most common and problematic. Second were themes related to system issues impacting the approach to behavioral problems. These included deficiencies in physician training and a lack of mental health services. Third were family-related issues such as parenting practices and family structure that were perceived to contribute to behavioral morbidity. Finally, sociocultural attitudes that included resistance to medicalization, reluctance to discuss behavioral issues, and interpretation of certain childhood behaviors affected help-seeking behavior and acceptance of diagnosis and treatment.ConclusionsSociocultural and structural issues strongly influence the presentation and management of behavioral and mental health conditions among pediatric patients in Jordan. These findings have significant implications for the development of approaches to the detection and management of these problems in developing countries. The creation of robust pathways for early detection and intervention among children at risk for mental health can help reduce the burden of mental health morbidity in the region.

Exploring the factors impacting physicians’ attitudes toward health information exchange with patients in Jordanian hospitals

BackgroundThe uniqueness of the physician–patient relationship and the latter's lack of medical experience and knowledge necessitate providing patients with accurate and timely information necessary to engage them in treatment decision-making. Without detailed information from their physicians, patients cannot understand their medical condition, assess treatment options, and participate meaningfully in their care.ObjectivesThe present research determines the main factors influencing physicians' attitudes toward health information exchange with patients in Jordanian hospitals. The fundamental question addressed by this paper is why Jordanian physicians are reluctant to provide their patients with detailed health information about the potential risks, complications, and benefits of proposed treatments and other recognised alternative therapies.MethodThis study is qualitative in nature, adopting face-to-face interviews as the key instrument of data collection in two hospitals in Jordan. The chief consideration of the sampling process was to select direct informants whose input would generate accurate results that might be generalised or translated to other contexts or settings. Thematic analysis was then used, and all participants’ opinions, answers, and interactions were transcribed and then reduced into themes and patterns for research, as per similarities and relationships, through coding and representing the data.Key findingsThe findings show that most patients in government hospitals, especially those elderly, poorly educated, or inexperienced, choose practitioners based solely on medical service fees and costs rather than quality and convenience. On the other hand, the large number of patients attending public hospitals and the insufficiency of physicians' financial incentives in such hospitals may discourage physicians from providing patients with detailed health information. Matters, however, take a different turn in private hospitals, in which many physicians improve the patient experience to keep him and attract others by sharing information with patients about their health and treatment. However, it was noted that some physicians at such hospitals still rely heavily on their relations with health insurance companies to attract patients rather than on meaningful communication with their patients. Finally, the present findings reveal that the absence of a clear legal duty of medical disclosure negatively influences the amount of information received during the clinic visit.ConclusionsThe fact that the level of communication in Jordanian healthcare settings has not been determined in detail opens the door to unnecessary healthcare expenditure and creates uncertainty concerning the amount of information that patients need to know in order to be involved in their treatment decision-making. The lack of proper control and quality monitoring may also negatively affect the interests of patients and their rights to receive adequate information about their health status.

Awareness of Clinical Doctors and Medical Students Toward Monkeypox in Jordan: A National Cross-Sectional Study

Background:&#x0D; Following the diagnosis of the first confirmed monkeypox case in Jordan in August 2022, the necessity for assessing the perceived knowledge among healthcare personnel has gained more significance. Given that the knowledge of healthcare professionals plays a great role in protection against newly emerging epidemics, we therefore in this study aim to assess the awareness of medical students and practicing physicians in Jordan toward the monkeypox virus.&#x0D; Method: This cross-sectional study was conducted in Jordan to assess medical students' attitudes, general practitioners, residents, and specialists regarding the monkeypox virus. Data from the WHO, CDC, and literature were used to design this questionnaire. The questionnaire comprises 53 questions divided into three sections: socio-demographic variables and work-related characteristics, general and specific knowledge about the monkeypox virus. Snowball sampling was employed since it was convenient. The data were analyzed using SPSS version 25.0. A p-value &lt; 0.05 was considered statistical significance.&#x0D; Results: Four hundred twenty-three healthcare professionals participated in this study. Only 7.3% (n = 31) of respondents have ever received information about monkeypox during studies in medicine. Respectively, the mean and median knowledge scores were 12.77 and 13, ranging from 4 to 25. More than half (51.3%, n = 3012) have heard about monkeypox before. About 45.9% (n = 194) of respondents reported that they had heard about monkeypox a few days ago for the first time, while 48.7% (n = 206) heard it a month ago. Most participants had a low level of good knowledge of monkeypox. Only 2.1% of respondents had correctly identified the natural host and the incubation period of monkeypox. More than half (52.1%) correctly answered the sign and symptoms of monkeypox. Almost 49.2% of respondents believed that monkeypox and smallpox have similar signs and symptoms. Respondents aged more than 30 years had higher level of knowledge (COR = 19.45, 95% CI = 6.7683-55.8933, p&lt; 0.001). Respondents who are specialist doctors had higher knowledge of monkeypox (COR = 7.3125, 95% CI = 1.6793-31.8429, p = 0.008) than others.&#x0D; Conclusion: Monkeypox awareness among Jordanian medical students and practitioners is low; hence immediate action should be taken to address this catastrophic problem. Consequently,&#x0D; learning about monkeypox and spreading information about its prevention is crucial. Furthermore, increasing Doctors' ability to react to human monkeypox cases and report them to a&#x0D; disease surveillance system will depend on their education about the sickness.&#x0D; &#x0D; Keywords: Jordan, Monkeypox, Clinicians, Medical Students, Knowledge.

Generic switching: Do future physicians in Jordan have enough knowledge and a positive attitude?

Background: Generic switching is a policy that has shown success in minimising pharmaceutical costs. It has also been used to mitigate recurrent and sudden drug shortages. Not all countries have policies that allow pharmacists to switch to generic drugs independently. In Jordan, only pharmacists at Ministry of Health hospitals automatically switch to generics if doctors had not already done INN prescribing. Objectives: This study targeted medical students to assess their experience with generic switching as patients, their knowledge of the subject as students, and their attitude towards it as future prescribers and policymakers. Methods: This is a descriptive, cross-sectional study conducted online. Eligibility criteria were being a fourth, fifth, or sixth-year medical school student enrolled at any of the six Jordanian universities. The questionnaire was developed by the researchers after a careful review of the relevant literature. Results: Three hundred and ninety students responded to the online questionnaire. Most participants were females (244, 62.6%), senior students in their final (6th)year (162, 41.5%) and with very good academic achievement (166, 42.6%). The highest knowledge scores concerned patient rights (0.73/1.00), followed by knowledge about monitoring after generic switching (0.66/1.00), and patients with known drug allergies (0.66/1.00). Almost half of the participants believe that pharmacists should not be given the right to do generic switching and only 16% stated that they would choose generic drugs if they needed treatment in the future. Multivariate linear regression analysis showed that significant predictors of knowledge were gender, GPA, and family income. No correlations were found between participants' knowledge scores and their attitudes towards giving pharmacists the right to independently switch drugs, or whether they would accept a substitute from pharmacists rather than having to refer to the physician. Conclusion: Medical students in Jordan lack sufficient knowledge about generic switching. Students need to be more aware of the current policies and regulations of this practice, and the role of each healthcare worker involved in it. They also need to have a more positive attitude toward generic drugs and generic switching practice to facilitate its future implementation.

Healthcare cost consciousness among physicians and their attitudes towards controlling costs in Jordan: a cross sectional study

BackgroundOne of the most significant factors influencing medication adherence and, ultimately, therapeutic outcomes for patients is the cost. The aim of this study was to examine the cost-containment strategies used by physicians in Jordan while focusing on the importance of cost consciousness in addressing healthcare costs and its consequences.MethodA quantitative study was conducted between June 19 and November 15, 2021, through a cross-sectional survey using a self-administered questionnaire.ResultsA total of 389 physicians participated in this study. Governments (65.6%), health insurance companies (60.2%), and pharmaceutical and device manufacturers (57.9%) were the most frequently mentioned entities as being primarily responsible for reducing healthcare costs. Participating physicians showed a high level of enthusiasm towards all domains of reducing healthcare costs with a mean percentage of 88.3% (standard deviation (SD): 0.04). When discussing physicians’ roles in containing healthcare costs and the effects of cost-conscious practice, most respondents agreed that there is currently too much emphasis on test and procedure costs (83.0%), that decision support tools that show costs would be helpful in their practice (84.5%), and that physicians need to take a more prominent role in limiting the use of unnecessary tests (86.0%). Around 70.0% of physicians agreed that they requested more tests when they did not know the patient well, and 80.0% of them stated that they considered the uncertainty involved in patient care to be disconcerting.ConclusionParticipating physicians showed a moderate level of cost consciousness in Jordan. However, this must be higher because it will eventually lead to cost-related nonadherence, which will have a negative impact on the patient’s health.

The effect of pharmaceutical companies’ marketing mix strategies on physicians prescribing practices in Jordan: a cross-sectional study

BackgroundExploring the effect of different marketing mix strategies on physicians’ prescribing practices is important due to its positive effect on the management of patients’ diseases and improving the health status of individuals by promoting the use of the most cost-effective and safe treatment for patients.AimThis study aimed to assess the perceived influence of the four pharmaceutical marketing mix strategies (product, price, place, and promotion) on physicians’ prescribing practices in Jordan.MethodA quantitative survey study was conducted from May to November 2021 on practising physicians in Jordan. This research utilised a previously validated questionnaire developed by Hailu et al. The convenience sampling technique was used to recruit the study participants. The population of the study was practising physicians from the public and private sectors in Jordan. Any physician who was licensed to practice medicine in Jordan and actively engaged in patient care was considered eligible. The minimum sample size required was 379 participants, which was calculated based on a population size of 35,000 physicians in Jordan. Student t-test/One-way independent-measures ANOVA was used to compare the mean scores (indicating being affected by marketing mix elements between different demographic groups) after performing log transformation to restore the normality of the data. For the binary regression analyses, the dependent variable was the median score for each of the marketing mix elements. For each sub-scale and the overall scale, the median score was used to define the dummy variable used in the binary regression analysis. The study protocol was approved by the Scientific Research Ethics Committee at Isra University (SREC/21/06/005).ResultsA total of 315 physicians participated in the study. Overall, participating physicians showed moderate to high influence from marketing mix elements, with a median score of 141.0 (IQR: 118.0-156.0) out of 185, representing 76.2%. The lowest median score was found for the promotional tools used by pharmaceutical companies, with a median score of 48.5 (IQR: 40.0–56.0) out of 70, representing 69.3%. The highest median score found was for the pricing strategy implemented by pharmaceutical companies, with a median score of 25.0 (IQR: 18.8–28.0) out of 30, representing 83.3%. Working in private sector settings was an important predictor that increased the probability of physicians’ prescribing practices being influenced by marketing mix elements (OR: 1.57; (95%CI: 1.00-2.47)), (p ≤ 0.05).ConclusionPhysicians in our study were highly affected by marketing mix strategies, specifically price strategy. Policymakers should guarantee a balanced relationship with pharmaceutical companies and physicians. We should make sure that promotion strategies have a positive impact on patients’ health. The government is advised to decrease the taxes on medications to decrease the overall cost for patients.

Pharmaceutical care and telemedicine during COVID-19: A cross-sectional study based on pharmacy students, pharmacists, and physicians in Jordan

Lack of access to the patient medical record (90.6%) was the major barrier for the integration of pharmaceutical care into practice. The majority of participants (93.0%) encouraged creating a website that provides pharmaceutical care. Furthermore, 45.1% would pay for such a service if present. Moreover, the majority (89.8%) agreed that creating a comprehensive database for patients’ data will help in decreasing medical errors. Among the four aspects of pharmaceutical care (technical, psychosocial, communication and administrative) that were assessed for students and pharmacist’s, general weakness in all aspects was noticed. This study highlights that absence of proper documentation of patient medical information raises the risk of medical problems and is considered the most documented barrier for the integration of pharmaceutical care. This emphasizes the future role of telemedicine and the availability of a specialized website and database repository that stores patient’s information to ensure the continuity of care even during pandemics.

Assessment of Jordanian physicians’ knowledge about venous thromboembolism risk and management among COVID-19 patients

Abstract Objectives The aim of this study was to assess Jordanian physicians’ awareness about venous thromboembolism (VTE) risk among COVID-19 patients and its treatment protocol. Methods This was a cross-sectional-based survey that was conducted in Jordan in 2020. During the study period, a convenience sample of physicians working in various Jordanian hospitals were invited to participate in this study. Physicians’ knowledge was evaluated and physicians gained one point for each correct answer. Then, a knowledge score out of 23 was calculated for each. Key findings In this study, 102 physicians were recruited. Results from this study showed that most of the physicians realize that all COVID-19 patients need VTE risk assessment (n = 69, 67.6%). Regarding VTE prophylaxis, the majority of physicians (n = 91, 89.2%) agreed that low molecular weight heparin (LMWH) is the best prophylactic option for mild-moderate COVID-19 patients with high VTE risk. Regarding severe/critically ill COVID-19 patients, 75.5% of physicians (n = 77) recognized that LMWH is the correct prophylactic option in this case, while 80.4% of them (n = 82) knew that mechanical prevention is the preferred prophylactic option for severe/critically ill COVID-19 patients with high bleeding risk. Moreover, 77.5% of physicians (n = 79) knew that LMWH is the treatment of choice for COVID-19 patients diagnosed with VTE. Finally, linear regression analysis showed that consultants had an overall higher knowledge score about VTE prevention and treatment in COVID-19 patients compared with residents (P = 0.009). Conclusion All physicians knew about VTE risk factors for COVID-19 patients. However, consultants showed better awareness of VTE prophylaxis and treatment compared with residents. We recommend educational workshops be conducted to enhance physicians’ knowledge and awareness about VTE thromboprophylaxis and management in COVID-19 patients.

Knowledge, Attitude, and Practice of Hearing Loss Among Physicians in Jordan

The aim of this study is to assess the knowledge, attitude, and practice of physicians regarding hearing loss and its management among children in Jordan as an example of developing countries. The cross-sectional survey composed of 18 questions was used to fulfill the aim of the study. The study population consisted of 335 physicians working in Jordan, with different specialties. The data were collected through site visits to a variety of health care facilities, as well as an online version of the survey to facilitate data collection and ensure participants' comfort. The majority of physicians (30.7%) were general practitioners or family doctors, followed by pediatricians (12.8%). Most of the physicians (88.7%) had experience ranging from 1 to 10 years; the majority of physicians (60.3%) were younger than 30 years of age. Most of the physicians identified the importance of newborn hearing screening. Physicians showed limited knowledge about the management and intervention of infants with permanent hearing loss. Only 11.5% of respondents would refer a child with confirmed hearing loss to an audiologist, and 1.9% of them would refer to a speech therapist. Even though the majority of the physicians (69.0%) reported not receiving any training to deal with deaf and hard of hearing children, they felt confident in talking with parents about hearing loss and its management. This study revealed that physicians have limited knowledge regarding hearing loss in children as well as its management and intervention. Furthermore, this study illustrates the need for more ongoing medical education programs regarding hearing loss in children.

Physicians' Health-Related Quality of Life and Its Associated Factors During COVID-19 Pandemic in Jordan: A Cross-Sectional Study.

Healthcare workers worldwide have been exposed to extraordinary stress during COVID-19 pandemic. This study aimed to investigate health-related quality of life (HRQoL) level and its health and occupational associated factors among Jordanian physicians during COVID-19 pandemic. A cross-sectional design using an online survey was adopted targeting physicians at different Jordanian hospitals. The study survey included demographics, HRQoL measured by 12-item Short Form health survey (SF-12) mental and physical components, physicians' evaluation of work conditions during COVID-19, Neck Disability Index (NDI), Depression Anxiety Stress Scale (DASS 21), and International Physical Activity Questionnaire (IPAQ). Descriptive analyses were conducted to summarize primary data. Factors associated with HRQoL were determined using a multiple variable regression analysis. In total, 326 physicians successfully completed the survey, 44.2% were males with mean age of 32.08 (±6.93). SF-12 mental component mean was 52.13 (±20.84) and physical component mean was 69.24 (±18.1). Physicians HRQoL level was significantly associated with levels of stress (β = -0.23, 95% CI -1.05 to -0.27), depression (β = -0.22, 95% CI -1.09 to -0.28), neck disability (β = -0.30, 95% CI -1.08 to -0.57), health self-evaluation (β = 0.14, 95% CI 1.66-7.87), sleep self-evaluation (β = 0.09, 95% CI 0.16-3.58), and physical activity level (β = 0.09, 95% CI 0.00-0.001). Jordanian physicians' level of HRQoL was relatively low during COVID-19. Healthcare facilities administrators should take into consideration factors associated with physicians' HRQoL level when planning for future healthcare emergencies.