JMIRx Med

Authors’ Response to Peer Reviews of “Administration Technique of Intranasal Corticosteroid Sprays Among Nepali Pharmacists: Cross-Sectional Study”

2026-01-29T14:15:08-05:00

This is the author(s)' response to peer review reports related to "Administration Technique of Intranasal Corticosteroid Sprays among Nepali Pharmacists: A Cross-Sectional Study"

Peer Review for “Administration Technique of Intranasal Corticosteroid Sprays Among Nepali Pharmacists: Cross-Sectional Study”

2026-01-29T14:15:08-05:00

This is a peer review report related to "Administration Technique of Intranasal Corticosteroid Sprays among Nepali Pharmacists: A Cross-Sectional Study"

Peer Review for “Administration Technique of Intranasal Corticosteroid Sprays Among Nepali Pharmacists: Cross-Sectional Study”

2026-01-29T14:15:08-05:00

This is a peer review report related to "Administration Technique of Intranasal Corticosteroid Sprays among Nepali Pharmacists: A Cross-Sectional Study"

Administration Technique of Intranasal Corticosteroid Sprays Among Nepali Pharmacists: Cross-Sectional Study

2026-01-29T14:15:08-05:00

Background: Allergic rhinitis is a common condition affecting up to 40% of people worldwide, with a notably high prevalence in South Asia. The primary treatment for moderate to severe allergic rhinitis is intranasal corticosteroid sprays, typically demonstrated to patients by registered pharmacists. However, many patients do not use these sprays correctly. Objective: This study evaluated the proficiency of pharmacists in demonstrating the correct technique for using intranasal corticosteroid sprays and the factors contributing to proper technique. Methods: In a cross-sectional survey of 365 registered pharmacists in the Kathmandu Valley, Nepal, a trained observer utilized a standardized 12-step checklist to assess each pharmacist’s technique for using intranasal corticosteroid sprays. The 12-step checklist was created after studying international guidelines, studies conducted in Nepal, international research articles, and instructional pamphlets. Simple random sampling was done to collect the data from community pharmacy in Kathmandu district. Demographics, education, experience, previous training, and instructional materials use were recorded. A total of 12 marks were awarded for all 12 steps, with one mark given to each step. Proficiency was classified as “adequate” if more than 6 out of 12 marks were obtained. Results: Out of 365 pharmacists, 239 (65.5%) were male, and 126 (34.5%) were female. 216 pharmacists out of 365 (59.2%) were aged 26 or younger whereas 235 pharmacists (69.9%) hold a diploma in pharmacy. 193 out of 365 (52.9%) pharmacists demonstrated inadequate technique, while only 172 pharmacists (47.1%) showed adequate skill overall. However, only 22 pharmacists out of 365 (6%) could demonstrate all 5 critical steps. The likelihood of providing appropriate counselling on the use of intranasal corticosteroid sprays was significantly correlated multiple independent factors. With a P < .001, a diploma in pharmacy is determined to have 97% a lower likelihood of receiving appropriate counselling than a bachelor's degree in pharmacy and above. With a P < .05, pharmacists who perform counselling sessions 1-4 times a week have 11-fold greater odds of doing so correctly than those who do not. With a P < .05, pharmacists who do not use educational leaflets are 96% less likely to provide adequate counselling. Similarly, with a P < .05, pharmacists under the age of 26 are 89% less likely than older pharmacists to provide adequate counselling. It is interesting to note that, with a P < .05, men were found to have almost 2.3 times higher odds of providing appropriate counselling then female. Conclusions: More than half of the registered pharmacists in Nepal demonstrated inadequate technique of intranasal corticosteroid sprays. The inadequate patient counselling on intranasal corticosteroid spray can significantly increase the risk of adverse drug reaction and reduce the efficacy of therapy. Thus, there is a strong need for educational intervention and policy change for improved proficiency.

Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation

2026-01-13T14:00:11-05:00

Background: Consumer-level drug recalls usually require action by individual patients. FDA has public-facing outlets to inform consumers and healthcare professionals about drug safety information including recalls, but consumers may not be aware of them. Prescribers are not notified about which of their patients are affected. The process may lead some patients to stop taking their medications. Objective: To leverage the FDA’s Healthy Citizen prototype web-based software platform, which provides users with information about recalls, to automatically notify patients of relevant recalls. Methods: We developed and evaluated an electronic notification system in the Primary Care and Cardiology practices at a large urban, academic medical center. The healthcare portal scanned the FDA Healthy Citizen Application Programming Interface nightly to detect new recalls, identified patients who had those medications in their electronic health record (EHR) medication list, and sent them a message through the EHR patient portal with a link to a customized FDA information display. Using structured interviews, we assessed qualitative feedback on the system and portal messaging from a convenience sample of 9 patients. Results: The system was technically functional, but it was not possible to trace a medication prescription from the EHR to specific lot numbers dispensed to that patient by a community pharmacy. The qualitative feedback obtained from patients showed convergence of topics. Conclusions: Lack of an accurate electronic audit trail from prescription to dispensed medication precludes clinical deployment of automated drug recall notification.

Peer Review of “Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation”

2026-01-13T14:00:11-05:00

This is a peer review report related to "Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation"

Peer Review of “Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation”

2026-01-13T14:00:11-05:00

This is a peer review report related to "Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation"

Authors’ Response to Peer Reviews of “Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation”

2026-01-13T14:00:11-05:00

This is the author(s)' response to peer review reports related to "Automating Individualized Notification of Drug Recalls to Patients: Complex Challenges and Qualitative Evaluation"

Authors’ Response to Peer Reviews of “Evaluating the Financial Factors Influencing Maternal, Newborn, and Child Health in Africa: Tobit Regression and Data Envelopment Analysis”

2025-11-28T16:45:04-05:00

This is the author(s)' response to peer review reports related to "Evaluating the financial factors influencing Maternal, Newborn, and Child Health in Africa: application DEA and Tobit Regression"

Peer Review of “Evaluating the Financial Factors Influencing Maternal, Newborn, and Child Health in Africa: Tobit Regression and Data Envelopment Analysis”

2025-11-28T16:45:04-05:00

This is a peer review report related to "Evaluating the financial factors influencing Maternal, Newborn, and Child Health in Africa: application DEA and Tobit Regression"