Publications by authors named "Yaw Owusu"

10 Publications

  • Page 1 of 1

Relationship between Stages of Change and Glycemic Control in Patients with Type 2 Diabetes Mellitus in a Primary Health-care Setting.

J Pharm Bioallied Sci 2020 Oct-Dec;12(4):400-405. Epub 2020 Oct 8.

Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

Introduction: Advanced stages of change (SOC) are usually associated with lower glycated hemoglobin (HbA1c) scores in patients with type 2 diabetes mellitus (T2DM). Additionally, these patients' adherence to antidiabetic medications is crucial to achieve controlled HbA1c scores. The purpose of this study was to determine the relationship between SOC and HbA1c as well as between medication adherence and HbA1c in patients with T2DM in a primary health-care setting in Qatar.

Materials And Methods: A cross-sectional observational study was conducted in patients with T2DM at the noncommunicable diseases clinics at Mesaimeer Healthcare Center and West Bay Health Care Center. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), whereas a two-item SOC questionnaire was used to measure the SOC. HbA1c values were obtained from the electronic database at the clinic. Spearman rank correlations were performed, with the significance level set at α < 0.05.

Results: A total of 387 patients were included in the analysis. More than 75% of them reported that they were in the maintenance stage, and 35.4% of them had a controlled diabetes status. There was no significant correlation between SOC and HbA1c or between medication adherence and HbA1c.

Conclusions: There was no relationship between SOC and HbA1c or between medication adherence and HbA1c in patients with T2DM, indicating that in this study, self-reported measures are not associated with the HbA1c scores of patients.
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http://dx.doi.org/10.4103/jpbs.JPBS_156_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909064PMC
October 2020

Evidence of community pharmacists' response preparedness during COVID-19 public health crisis: A cross-sectional study.

J Infect Dev Ctries 2021 Jan 31;15(1):40-50. Epub 2021 Jan 31.

Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

Introduction: Community pharmacists are often the first point of contact for the public, especially during pandemics. As outlined by the International Pharmaceutical Federation, community pharmacists have an important public health role during this Coronavirus Disease 2019 (COVID-19) public health emergency. We therefore investigated the current practices, response preparedness and professional development needs of community pharmacists in Qatar.

Methodology: A descriptive cross-sectional online 38-item questionnaire-based survey constructed on evidence-based public health roles of pharmacists was conducted between 28 May and 18 June 2020. Questions related to current practices required responses on a 5-point Likert-type scale ranging from "always" to "never". The questionnaire was evaluated for validity and the reliability analysis showed a Cronbach's alpha coefficient of 0.921.

Results: The response (n = 311) rate for the survey was 34.2%. More than 75% of pharmacists "always" encouraged and practiced hygiene and social distancing measures. On the other hand, the proportion of pharmacists "always" involved in patient assessment, education or providing information related to COVID-19 and application of evidence-based protocol ranged from 32 to 73%. The vast majority (87-96%) of pharmacists indicated that they needed professional development related to COVID-19. Overall, 77% of pharmacists either "strongly agreed" or "agreed" that they have all the necessary COVID-19 related emergency response preparedness and training. Country from which pharmacists obtained their first degree, and the type of pharmacy where they practice influenced their overall perception toward emergency response preparedness.

Conclusions: Community pharmacists in Qatar are willing to receive additional training related to COVID-19 public health crisis despite being prepared to engage with patients.
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http://dx.doi.org/10.3855/jidc.13847DOI Listing
January 2021

Evaluation of patient safety culture in community pharmacies in Qatar.

Int J Clin Pract 2021 May 4;75(5):e14055. Epub 2021 Mar 4.

Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

Introduction: Patient safety culture is a key contributor to medication safety globally. However, the perspective of pharmacists and other personnel in community pharmacy regarding patient safety culture may vary from one country to another.

Objective: The aim of this study was to determine the perspectives of community pharmacy personnel in Qatar about patient safety culture in community pharmacy setting.

Methods: A cross-sectional web-based survey utilising the Agency for Healthcare Research and Quality Community Pharmacy Survey on Patient Safety Culture was conducted. Participants included community pharmacy personnel practicing in Qatar. Both descriptive and inferential statistics were applied for data analyses, with statistical significance set at ≤ 0.05.

Results: Two hundred and forty participants completed the survey. A large proportion of the respondents (52.5%) reported an "excellent" overall rating of patient safety in their respective community pharmacies. Patient counselling and teamwork composites of patient safety culture were associated with the highest positive responses (95% and 93.7%, respectively). The "staffing, work pressure and pace" composite demonstrated the lowest positive response (50.6%) among the 11 composites. Inferential analysis revealed that working in chain pharmacies was significantly associated with positive responses related to "teamwork" (P = .019). Furthermore, working for more than 40 hours per week had a significant positive influence on the overall perceptions of patient safety (P = .025).

Conclusion: There was an overall positive perception towards patient safety culture among the surveyed community pharmacy personnel in Qatar. Superiority was observed with patient counselling and teamwork, while staffing, work pressure and pace were judged poorly, warranting further investigations and potential targeting for interventions.
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http://dx.doi.org/10.1111/ijcp.14055DOI Listing
May 2021

Barriers to Diabetes Adherence: Translation and Cultural Adaptation of the Instrument Into Arabic Context.

Value Health Reg Issues 2020 Sep 11;22:49-53. Epub 2020 Aug 11.

College of Pharmacy, Qatar University, Doha, Qatar. Electronic address:

Objectives: Barriers to Diabetes Adherence (BDA) instrument is a measure developed in English to assess barriers to adherence in adolescents with type 1 diabetes (T1DM). The main objectives of the present study were to translate and culturally adapt the BDA tool into Arabic for the assessment of barriers to adherence in adolescents with T1DM in Arabic-speaking populations.

Methods: The International Society for Pharmacoeconomics and Outcomes Research guidelines for the translation and cultural adaptation of patient-reported outcome measures were used for the process. Permission to use the instrument was obtained from the developers. This was followed by 2 forward translations of the tool into Arabic. The 2 Arabic versions were combined into a reconciled Arabic version that was then back-translated into English. This was then tested against the original tool. The resultant Arabic version underwent a cognitive debriefing process to assess its comprehension and appropriateness among potential users, and this resulted in further refinements, leading to the final Arabic version of the tool.

Results: The translation and cognitive debriefing processes revealed issues related to the cultural or conceptual equivalence of the tool that were addressed and resolved by rewording, restructuring, or addition or elimination of words or phrases that in certain circumstances necessitated communications with the developers for further clarifications of the intended meaning of relevant items. This process generated an easy, comprehensive, clear, and culturally acceptable tool as proven by the cognitive debriefing and clinical review processes.

Conclusion: A culturally acceptable Arabic translation of the BDA tool was developed to be used in adolescent Arabic population with T1DM.
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http://dx.doi.org/10.1016/j.vhri.2020.03.005DOI Listing
September 2020

Using the transtheoretical model's stages of change to predict medication adherence in patients with type 2 diabetes mellitus in a primary health care setting.

Daru 2019 Jun 7;27(1):91-99. Epub 2019 Feb 7.

Pharmacy Department, Westbay Healthcare Center, Doha, Qatar.

Background: Qatar is currently experiencing a worrying increase in the prevalence of diabetes mellitus (DM). One of the most common reasons for uncontrolled DM is non-adherence to medications. The socio-behavioral intervention has proven effective in some chronic illnesses.

Objectives: To assess the stages of change (SOC) and medication adherence scores of type 2 diabetes mellitus (T2DM) patients visiting primary healthcare institutions in Qatar, and to evaluate the cause and effect relationship between SOC and adherence to antidiabetic medications.

Methods: The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence, and a 2-item SOC questionnaire was utilized to classify the SOC. The analysis to determine if the SOC could predict medication adherence while controlling for demographic characteristics, total number of prescribed medications and disease duration was done using hierarchical multiple regression.

Results: The final analysis included 387 patients. In relation to medication adherence, majority of the patients were in the maintenance stage (76.7%), followed by the preparation stage (14.7%), the action stage (3.9%), the contemplation stage (3.4%) and the precontemplation stage (1.3%). Most of the patients were in high adherence towards antidiabetic medications (50.3%) followed by low level (26.4%) and medium level (23.3%). SOC was significant and positively predicted medication adherence, which accounted for around 58 to 60% (p < 0.001) while controlling for covariates.

Conclusions: SOC was significant and positively predicted medication adherence. The study recommends that the SOC questionnaire could potentially be used to identify patients at risk for low adherence.
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http://dx.doi.org/10.1007/s40199-019-00246-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593032PMC
June 2019

Assessment of a Statistical Algorithm for the Prediction of Benign Paroxysmal Positional Vertigo.

JAMA Otolaryngol Head Neck Surg 2018 10;144(10):883-886

Department of Otolaryngology, University of Illinois, Chicago.

Importance: Benign paroxysmal positional vertigo (BPPV) is an otologic pathologic condition defined as a sensation of spinning triggered by changes in head position relative to gravity and caused by an entrapment of fragmented endolymph debris most commonly in the posterior semicircular canal. Confirmation of diagnosis requires experience with procedures that are poorly known by those other than practitioners with advanced otologic training. The complexity in the diagnosis of BPPV inspired the design of a questionnaire-based algorithm that would be useful for determining a vestibular diagnosis and treatment options.

Objective: To assess a statistical algorithm for the diagnosis of BPPV in a busy tertiary care setting, with the long-term goal of implementing a clinical pathway to efficiently diagnose and treat patients with dizziness.

Design, Setting, And Participants: In this retrospective case series, 200 patients who visited the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins University School of Medicine for their initial vertigo symptoms from September 1, 2016, to December 31, 2016, were assessed.

Interventions: Use of a validated patient questionnaire as a tool to differentiate patients with dizziness in an electronic medical record review.

Main Outcomes And Measures: Linear predictor (LP) value based on the questionnaire for the diagnosis of BPPV.

Results: Of the 200 patient visits reviewed (132 [66%] female), 106 (53.0%; 68 [64%] female) had the information necessary to calculate the LP value and had a confirmed final diagnosis. On the basis of an LP value of 0.2 or greater, the sensitivity for a diagnosis of BPPV was 0.75 and the specificity was 1.0. The positive predictive value was 1.0, whereas the negative predictive value was 0.96. Patients with BPPV had a statistically significantly different LP value (odds ratio, 5.92; 95% CI, 2.73-12.83) than did patients without BPPV.

Conclusions And Relevance: The findings of this study suggest that the algorithm is efficient for the diagnosis of BPPV in a clinical care setting.
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http://dx.doi.org/10.1001/jamaoto.2018.1657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233832PMC
October 2018

Emigration of skilled healthcare workers from developing countries: can team-based healthcare practice fill the gaps in maternal, newborn and child healthcare delivery?

Int J MCH AIDS 2017 ;6(2):121-129

The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., PO Box 234, Riverdale, Maryland 20738, USA.

Background And Introduction: Emigration of healthcare workers from developing countries is on the rise and there is an urgent need for policies that increase access to and continuity of healthcare. In this commentary, we highlight some of the negative impacts of emigration on maternal and child health and discuss whether team-based healthcare delivery could possibly mitigate the shortfall of maternal and child health professionals in developing countries.

Methodology: We cross-examine the availability of supporting structures to implement team-based maternal and child healthcare delivery in developing countries. We briefly discuss three key supporting structures: culture of sharing, telecommunication, and inter-professional education. Supporting structures are examined at system, organizational and individual levels. We argue that the culture of sharing, limited barriers to inter-professional education and increasing access to telecommunication will be advantageous to implementing team-based healthcare delivery in developing countries.

Conclusion And Global Health Implications: Although most developing countries may have notable supporting structures to implement team-based healthcare delivery, the effectiveness of such models in terms of cost, time and infrastructure in resource limited settings is still to be evaluated. Hence, we call on usual stakeholders, government, regulatory colleges and professional associations in countries with longstanding emigration of maternal and child healthcare workers to invest in establishing comprehensive models needed to guide the development, implementation and evaluation of team-based maternal and child healthcare delivery.
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http://dx.doi.org/10.21106/ijma.204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777387PMC
January 2017

Direct Oral Anticoagulant Use in Atypical Thrombosis-Related Conditions.

Ann Pharmacother 2018 02 16;52(2):185-197. Epub 2017 Sep 16.

2 Qatar University, Doha, Qatar.

Objective: To review the published literature for evidence of the efficacy and safety of direct oral anticoagulants (DOACs) when used in the management of atypical thrombosis-related conditions.

Data Sources: A comprehensive MEDLINE database search (1948 to July 2017) and EMBASE search (1980 to July 2017) were conducted using the search terms direct oral anticoagulant in combination with acute coronary syndrome (ACS), antiphospholipid antibody syndrome (APLAS), and cancer-associated thrombosis (CAT).

Study Selection And Data Extraction: The literature search was limited to studies that were conducted in humans and published in English. Clinical trials, observational studies, and case series were selected.

Data Synthesis: A total of 20 published studies were selected from the literature. Only 1 randomized controlled study showed a significant reduction in cardiovascular outcomes on DOAC use in ACS patients but at the expense of increased bleeding. For the use of DOACs in APLAS, the evidence from case series seems to suggest low incidence of thromboembolic events or recurrent thrombosis in low-risk patients. Finally, in cancer patients, DOACs were comparable to warfarin in preventing CAT in 8 studies of different designs. Major bleeding with DOACs was not significantly lower than in patients who received an enoxaparin/warfarin regimen.

Conclusions: Until more evidence from the ongoing clinical trials is available, DOACs may not be favorable add-on therapy in ACS patients receiving standard antiplatelet therapy but may be alternative to warfarin in preventing or treating thrombosis in low-risk APLAS patients as well as in cases of CAT in which patients have to be managed with warfarin.
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http://dx.doi.org/10.1177/1060028017731850DOI Listing
February 2018

Progress in the discovery of treatments for C. difficile infection: A clinical and medicinal chemistry review.

Curr Top Med Chem 2014 ;14(1):152-75

Department of Pharmaceutical Sciences, The Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, 34 Rainbow Drive, Hilo, HI 96720, USA.

Clostridium difficile is an anaerobic, Gram-positive pathogen that causes C. difficile infection, which results in significant morbidity and mortality. The incidence of C. difficile infection in developed countries has become increasingly high due to the emergence of newer epidemic strains, a growing elderly population, extensive use of broad spectrum antibiotics, and limited therapies for this diarrheal disease. Because treatment options currently available for C. difficile infection have some drawbacks, including cost, promotion of resistance, and selectivity problems, new agents are urgently needed to address these challenges. This review article focuses on two parts: the first part summarizes current clinical treatment strategies and agents under clinical development for C. difficile infection; the second part reviews newly reported anti-difficile agents that have been evaluated or reevaluated in the last five years and are in the early stages of drug discovery and development. Antibiotics are divided into natural product inspired and synthetic small molecule compounds that may have the potential to be more efficacious than currently approved treatments. This includes potency, selectivity, reduced cytotoxicity, and novel modes of action to prevent resistance.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921470PMC
http://dx.doi.org/10.2174/1568026613666131113154753DOI Listing
August 2014

A training program for pharmacy students on providing diabetes care.

Am J Pharm Educ 2013 Sep;77(7):153

Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, Hawaii.

Objective: To compare second- and third-year pharmacy students' competence, attitudes, and self-confidence in providing diabetes care before and after completing a hand-on diabetes training program and to determine if the program had an impact on students' attitude and self-confidence based on their year in the curriculum.

Design: The program included classroom lectures and hands-on learning sessions in 5 facets of diabetes care. Pre- and post-test instruments measured students' competence, attitudes, and confidence in diabetes care.

Assessment: Students' competence and the mean overall confidence score significantly improved after completing the program, while mean overall attitude score did not. Third-year students had significantly higher confidence scores than did second-year students on both pre- and post-program tests. No significant difference was found for attitude scores between second- and third-year students.

Conclusion: The hands-on learning program was an effective approach to training pharmacy students in diabetes care, improving both their competence and confidence.
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http://dx.doi.org/10.5688/ajpe777153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776907PMC
September 2013
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