Results
Study participants (n= 2,589) had a mean age of 29.3 years and more than half (51.5%) were females (Table 1). Most of the participants were from Egypt (n=819 40.8%), followed by East Mediterranean countries (Jordan, Syria, Palestine, Lebanon) and Iraq. More than 80% of the participants lived in urban areas (including capital cities). About 75% of the participants had, as a highest level of pharmacy education, either a bachelor degree in pharmacy or Pharm. D., while the rest were either pharmacy students or technicians, or they had received other post-graduate degrees. The majority were alumni of public universities (75.7%). More than half of the participants were practicing pharmacy either in community pharmacy or in hospital, years of work-experience tended to be short, i.e. less than and up to 5 years, and number of attended professional development workshops was low on average.
While only 30% of the participants had received enough education about epidemics/ pandemics and updates about coronavirus treatment, 91.2% of them do follow the latest corona virus updates on the treatment. Results were almost similar across all regions (Figure 2). As for the sources of information about coronavirus treatment among the study participants, 60.8% reported that they sourced their information from social media, followed by WHO reports and published articles (Figure 3).
Awareness scores (out of 20) were very similar across regions (Table 2), with a mean of 13.9 (out of a maximum of 20), no statistically significant difference was found between the regions (n= 2589, p= 0.193, one way ANOVA). A significant correlation between awareness scores across study countries was found (p= 0.026, Pearson correlation= -0.054) with the COVID-19 mortality statistics as they stood on the 15th of March 2020 for the countries which had at least one case at the beginning of the study25. Awareness score was higher in countries with lower mortality. No significant correlation was noted with other statistics of COVID-19 cases and deaths as they stood 15th of March, and 1st and 15th of April 2020.
Table 3 presents the total percentage and percentage of participants from the participating countries answering each of the awareness statements correctly. Interestingly, univariate analysis of the awareness score versus chosen independent variables showed significant association with many variables. This was reflected in the linear regression results, where older age participants, graduates of public universities versus private universities, higher annual attendance rates at professional workshops yearly, participants who practice in community pharmacy and hospital settings, participants who reported to have had previous knowledge from their graduating institute, participants who sourced their information about COVID-19from published studies, and those who were highly satisfied with their knowledge after 4 months of COVID-19 had higher knowledge scores (Table 4).
More than 90% of participants agreed with the statements provided regarding the role of the faculties/educational institutes expect for the statement ‘your faculty has a role in preparing you to deal with any epidemic/pandemic’ (74.8%). As for the role of the pharmaceutical associations, more than 90% of pharmacists agreed with the statements provided except for ‘pharmacists associations and societies have a role in preparing you to deal with epidemics/pandemics such as the coronavirus’. More than 80% of participants agreed with the statements provided regarding their role as pharmacists with the highest percentage being about the statement ‘you ensure your personal safety by wearing gloves and masks and avoid close contact with patients’. Significant differences were seen regarding the regional distribution of study participants’ perceptions about the current role of the faculties of pharmacies/educational institutes with regards to dealing with epidemics/pandemics and coronavirus specifically (n= 1998), while no significant differences were seen with regards to perceptions about the current role of pharmacists’ associations and societies and current role of pharmacists (Figure 4, Table 5).
Most pharmacists believed that working in the pharmacy increases their fears about getting infected with coronavirus (n= 2131, 82.3% strongly agree/agree). Significant differences found between regions (p=0.009). In addition, participants believed that they should receive training programs on how to provide mental health support for people during epidemic and pandemic outbreaks (n= 2257, 87.7% strongly agree/agree) with no significant difference found between the regions (p=0.426).