{"id":"https://openalex.org/W7225425121","doi":"https://doi.org/10.3390/jcm15218652","title":"Clinical Recognition, Safe Triage, and Pharmacovigilance Reporting Readiness for Suspected Serious Adverse Drug Reactions in Community Pharmacies: A Covert Simulated-Patient Study in Central Jordan","display_name":"Clinical Recognition, Safe Triage, and Pharmacovigilance Reporting Readiness for Suspected Serious Adverse Drug Reactions in Community Pharmacies: A Covert Simulated-Patient Study in Central Jordan","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225425121","doi":"https://doi.org/10.3390/jcm15218652"},"language":"en","primary_location":{"id":"doi:10.3390/jcm15218652","doi":"https://doi.org/10.3390/jcm15218652","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218652","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/jcm15218652","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5014596194","display_name":"Zekrayat J. H. Medras","orcid":"https://orcid.org/0009-0005-9312-4962","observed_orcids":["https://orcid.org/0009-0005-9312-4962"]},"institutions":[{"id":"https://openalex.org/I145380033","display_name":"Amman Arab University","ror":"https://ror.org/039xekb14","country_code":"JO","type":"education","lineage":["https://openalex.org/I145380033"]}],"countries":["JO"],"is_corresponding":false,"raw_author_name":"Zekrayat J. H. Merdas","raw_affiliation_strings":["Pharmacy Department, College of Pharmacy, Amman Arab University, Amman 11953, Jordan"],"raw_orcid":"https://orcid.org/0009-0005-9312-4962","affiliations":[{"raw_affiliation_string":"Pharmacy Department, College of Pharmacy, Amman Arab University, Amman 11953, Jordan","institution_ids":["https://openalex.org/I145380033"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057957001","display_name":"Mohammad Abu Assab","orcid":"https://orcid.org/0000-0002-6002-0287","observed_orcids":["https://orcid.org/0000-0002-6002-0287"]},"institutions":[{"id":"https://openalex.org/I153687341","display_name":"Zarqa University","ror":"https://ror.org/01wf1es90","country_code":"JO","type":"education","lineage":["https://openalex.org/I153687341"]}],"countries":["JO"],"is_corresponding":false,"raw_author_name":"Mohammad Abu Assab","raw_affiliation_strings":["Clinical Pharmacy Department, Faculty of Pharmacy, Zarqa University, Zarqa 13132, Jordan"],"raw_orcid":"https://orcid.org/0000-0002-6002-0287","affiliations":[{"raw_affiliation_string":"Clinical Pharmacy Department, Faculty of Pharmacy, Zarqa University, Zarqa 13132, Jordan","institution_ids":["https://openalex.org/I153687341"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5023196150","display_name":"Anas Ibrahim Abed","orcid":"https://orcid.org/0000-0003-2828-1011","observed_orcids":["https://orcid.org/0000-0003-2828-1011"]},"institutions":[{"id":"https://openalex.org/I104941359","display_name":"Al-Ahliyya Amman University","ror":"https://ror.org/00xddhq60","country_code":"JO","type":"education","lineage":["https://openalex.org/I104941359"]}],"countries":["JO"],"is_corresponding":true,"raw_author_name":"Anas Abed","raw_affiliation_strings":["Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan"],"raw_orcid":"https://orcid.org/0000-0003-2828-1011","affiliations":[{"raw_affiliation_string":"Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan","institution_ids":["https://openalex.org/I104941359"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073155316","display_name":"Wala\u2019a Al. Safadi","orcid":"https://orcid.org/0009-0001-0366-9397","observed_orcids":["https://orcid.org/0009-0001-0366-9397","https://orcid.org/0000-0003-4931-824X"]},"institutions":[{"id":"https://openalex.org/I114972647","display_name":"University of Jordan","ror":"https://ror.org/05k89ew48","country_code":"JO","type":"education","lineage":["https://openalex.org/I114972647"]}],"countries":["JO"],"is_corresponding":false,"raw_author_name":"Wala\u2019a Al. Safadi","raw_affiliation_strings":["Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan","institution_ids":["https://openalex.org/I114972647"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161071920","display_name":"Zain Z. Zakaria","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I60342839","display_name":"Qatar University","ror":"https://ror.org/00yhnba62","country_code":"QA","type":"education","lineage":["https://openalex.org/I60342839"]}],"countries":["QA"],"is_corresponding":false,"raw_author_name":"Zain Z. Zakaria","raw_affiliation_strings":["Clinical Affairs Department, Qatar University, Doha 2713, Qatar"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinical Affairs Department, Qatar University, Doha 2713, Qatar","institution_ids":["https://openalex.org/I60342839"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037586640","display_name":"Zainab Zaki Zakaraya","orcid":"https://orcid.org/0000-0003-3691-9759","observed_orcids":["https://orcid.org/0000-0003-3691-9759"]},"institutions":[{"id":"https://openalex.org/I104941359","display_name":"Al-Ahliyya Amman University","ror":"https://ror.org/00xddhq60","country_code":"JO","type":"education","lineage":["https://openalex.org/I104941359"]}],"countries":["JO"],"is_corresponding":false,"raw_author_name":"Zainab Zakaraya","raw_affiliation_strings":["Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan"],"raw_orcid":"https://orcid.org/0000-0003-3691-9759","affiliations":[{"raw_affiliation_string":"Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan","institution_ids":["https://openalex.org/I104941359"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5037286888","display_name":"Sireen Abdul Rahim Shilbayeh","orcid":"https://orcid.org/0000-0002-5020-6838","observed_orcids":["https://orcid.org/0000-0002-5020-6838"]},"institutions":[{"id":"https://openalex.org/I106778892","display_name":"Princess Nourah bint Abdulrahman University","ror":"https://ror.org/05b0cyh02","country_code":"SA","type":"education","lineage":["https://openalex.org/I106778892"]}],"countries":["SA"],"is_corresponding":false,"raw_author_name":"Sireen Abdul Rahim Shilbayeh","raw_affiliation_strings":["Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia"],"raw_orcid":"https://orcid.org/0000-0002-5020-6838","affiliations":[{"raw_affiliation_string":"Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia","institution_ids":["https://openalex.org/I106778892"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":6,"corresponding_author_ids":["https://openalex.org/A5023196150"],"corresponding_institution_ids":["https://openalex.org/I104941359"],"apc_list":{"value":2600,"currency":"CHF","value_usd":3137},"apc_paid":{"value":2600,"currency":"CHF","value_usd":3137},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"21","first_page":"8652","last_page":"8652"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11943","display_name":"Pharmacovigilance and Adverse Drug Reactions","score":0.7577999830245972,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T11943","display_name":"Pharmacovigilance and Adverse Drug Reactions","score":0.7577999830245972,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T13970","display_name":"Pharmacy and Medical Practices","score":0.16979999840259552,"subfield":{"id":"https://openalex.org/subfields/3611","display_name":"Pharmacy"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.051100000739097595,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/serious-adverse-drug-reactions","display_name":"serious adverse drug reactions","score":0.9279999732971191},{"id":"https://openalex.org/keywords/community-pharmacy","display_name":"community pharmacy","score":0.546999990940094},{"id":"https://openalex.org/keywords/euglycemic-diabetic-ketoacidosis","display_name":"euglycemic diabetic ketoacidosis","score":0.8759999871253967},{"id":"https://openalex.org/keywords/empagliflozin","display_name":"empagliflozin","score":0.8259999752044678},{"id":"https://openalex.org/keywords/pharmacist-workload","display_name":"pharmacist workload","score":0.5239999890327454},{"id":"https://openalex.org/keywords/pharmacovigilance-training","display_name":"pharmacovigilance training","score":0.8550000190734863},{"id":"https://openalex.org/keywords/standardized-patients","display_name":"standardized patients","score":0.5070000290870667},{"id":"https://openalex.org/keywords/jordan","display_name":"Jordan","score":0.7039999961853027},{"id":"https://openalex.org/keywords/emergency-department-referral","display_name":"emergency department referral","score":0.5830000042915344},{"id":"https://openalex.org/keywords/drug-safety","display_name":"drug safety","score":0.375}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.957099974155426},{"id":"https://openalex.org/C57658597","wikidata":"https://www.wikidata.org/wiki/Q1550789","display_name":"Pharmacovigilance","level":3,"score":0.9100000262260437},{"id":"https://openalex.org/C2777120189","wikidata":"https://www.wikidata.org/wiki/Q780067","display_name":"Triage","level":2,"score":0.5974000096321106},{"id":"https://openalex.org/C104863432","wikidata":"https://www.wikidata.org/wiki/Q614304","display_name":"Pharmacy","level":2,"score":0.5475000143051147},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.4778999984264374},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.4551999866962433},{"id":"https://openalex.org/C2426938","wikidata":"https://www.wikidata.org/wiki/Q3355478","display_name":"Medical prescription","level":2,"score":0.4528000056743622},{"id":"https://openalex.org/C2993432071","wikidata":"https://www.wikidata.org/wiki/Q45959","display_name":"Drug reaction","level":3,"score":0.4242999851703644},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.38350000977516174},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.38350000977516174},{"id":"https://openalex.org/C2779338814","wikidata":"https://www.wikidata.org/wiki/Q5179285","display_name":"Covert","level":2,"score":0.3779999911785126},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.3601999878883362},{"id":"https://openalex.org/C2778005785","wikidata":"https://www.wikidata.org/wiki/Q412888","display_name":"Drotrecogin alfa","level":5,"score":0.3375999927520752},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.3321000039577484},{"id":"https://openalex.org/C2780542314","wikidata":"https://www.wikidata.org/wiki/Q45959","display_name":"Adverse drug reaction","level":3,"score":0.3280999958515167},{"id":"https://openalex.org/C197636746","wikidata":"https://www.wikidata.org/wiki/Q7234359","display_name":"Postmarketing surveillance","level":3,"score":0.32339999079704285},{"id":"https://openalex.org/C2775887513","wikidata":"https://www.wikidata.org/wiki/Q5373824","display_name":"Empagliflozin","level":4,"score":0.3199000060558319},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3190999925136566},{"id":"https://openalex.org/C2777363581","wikidata":"https://www.wikidata.org/wiki/Q15098235","display_name":"Harm","level":2,"score":0.3127000033855438},{"id":"https://openalex.org/C519536355","wikidata":"https://www.wikidata.org/wiki/Q21021151","display_name":"Repurposing","level":2,"score":0.30660000443458557},{"id":"https://openalex.org/C2778476105","wikidata":"https://www.wikidata.org/wiki/Q628539","display_name":"Workload","level":2,"score":0.2791000008583069},{"id":"https://openalex.org/C500440147","wikidata":"https://www.wikidata.org/wiki/Q701216","display_name":"Pharmacotherapy","level":2,"score":0.2718999981880188}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/jcm15218652","doi":"https://doi.org/10.3390/jcm15218652","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218652","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/jcm15218652","doi":"https://doi.org/10.3390/jcm15218652","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218652","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320322484","display_name":"Princess Nourah Bint Abdulrahman University","ror":"https://ror.org/05b0cyh02"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":31,"referenced_works":["https://openalex.org/W2001417231","https://openalex.org/W2002687613","https://openalex.org/W2009890917","https://openalex.org/W2016660511","https://openalex.org/W2043382072","https://openalex.org/W2049159124","https://openalex.org/W2069523442","https://openalex.org/W2112669742","https://openalex.org/W2141845152","https://openalex.org/W2146272590","https://openalex.org/W2193561325","https://openalex.org/W2275737843","https://openalex.org/W2603070013","https://openalex.org/W2765434888","https://openalex.org/W2938344795","https://openalex.org/W2951936974","https://openalex.org/W2967044478","https://openalex.org/W3005096566","https://openalex.org/W3042321076","https://openalex.org/W3157567153","https://openalex.org/W4213052062","https://openalex.org/W4294214983","https://openalex.org/W4379966605","https://openalex.org/W4392186877","https://openalex.org/W4393995064","https://openalex.org/W4394010965","https://openalex.org/W4396976298","https://openalex.org/W4400922746","https://openalex.org/W4406083220","https://openalex.org/W7116870868","https://openalex.org/W7128375825"],"related_works":["https://openalex.org/W2744638342","https://openalex.org/W4406083220","https://openalex.org/W4403225926","https://openalex.org/W2096644138","https://openalex.org/W2598808467","https://openalex.org/W2521101798","https://openalex.org/W2330980861","https://openalex.org/W7224097139","https://openalex.org/W2925484313","https://openalex.org/W4367723910"],"abstract_inverted_index":{"Background/Objectives:":[0],"Serious":[1],"adverse":[2],"drug":[3],"reactions":[4],"(ADRs)":[5],"may":[6],"first":[7,29],"present":[8],"with":[9,151,237,252],"nonspecific":[10],"symptoms":[11],"outside":[12],"hospital":[13],"settings,":[14],"where":[15],"delayed":[16],"recognition":[17,39],"or":[18,98,178,319],"escalation":[19,293],"can":[20],"postpone":[21],"definitive":[22],"care.":[23],"Community":[24],"pharmacists":[25],"are":[26],"often":[27],"a":[28,106,242],"point":[30],"of":[31,42,87,116,135,145,322],"contact,":[32],"but":[33],"behavior-based":[34],"evidence":[35],"on":[36],"their":[37],"clinical":[38,49,137],"and":[40,54,79,118,128,160,215,246,271,300],"triage":[41,141,202],"serious":[43],"ADRs":[44],"is":[45],"limited.":[46,285],"We":[47],"evaluated":[48],"assessment,":[50,299],"recognition,":[51,268,291],"safe":[52,201,272],"triage,":[53,273],"subsequent":[55],"pharmacovigilance":[56,125,248,281],"reporting":[57,126,302],"readiness":[58,129],"across":[59],"three":[60,88],"high-risk":[61],"presentations.":[62],"Methods:":[63],"A":[64,167],"cross-sectional":[65],"covert":[66],"simulated-patient":[67],"study":[68],"was":[69,105,170,180,203,235,283],"conducted":[70],"in":[71,76,143,172,182,191,206,218,228,260,267],"384":[72],"urban":[73,257],"community":[74,258],"pharmacies":[75,259,318],"Amman,":[77],"Zarqa,":[78],"Al-Balqa,":[80],"Jordan.":[81],"Pharmacies":[82],"were":[83,130,250,265],"randomly":[84],"assigned":[85],"one":[86],"standardized":[89],"scenarios:":[90],"semaglutide-associated":[91],"acute":[92],"pancreatitis,":[93],"empagliflozin-associated":[94],"euglycemic":[95,277],"diabetic":[96],"ketoacidosis,":[97],"apixaban-associated":[99],"gastrointestinal":[100],"bleeding.":[101],"The":[102],"primary":[103],"outcome":[104],"guideline-informed":[107],"safe-triage":[108,239],"response":[109],"requiring":[110],"urgent":[111],"ED/EMS":[112],"referral,":[113],"explicit":[114,269],"communication":[115],"urgency,":[117],"no":[119],"management":[120,185],"likely":[121,186],"to":[122,187,316],"delay":[123,188],"care;":[124],"behavior":[127],"assessed":[131],"separately":[132],"after":[133,303],"completion":[134],"the":[136,175,207,219,229,276],"consultation.":[138],"Results:":[139],"Safe":[140],"occurred":[142,190],"41.7%":[144],"encounters":[146],"(design-based":[147],"95%":[148,212,224],"CI,":[149],"37.0\u201346.3),":[150],"higher":[152,253],"performance":[153],"for":[154,275,297],"apixaban":[155,220],"(60.9%)":[156],"than":[157,227],"semaglutide":[158,230],"(42.2%)":[159],"empagliflozin":[161,208],"(21.9%;":[162],"overall":[163],"p":[164],"<":[165],"0.001).":[166],"medication-related":[168],"cause":[169],"recognized":[171],"72.9%,":[173],"whereas":[174,241],"specific":[176],"syndrome":[177],"harm":[179],"named":[181],"39.6%;":[183],"unsafe":[184],"assessment":[189],"26.3%.":[192],"Only":[193],"8.3%":[194],"spontaneously":[195],"raised":[196],"reporting.":[197],"In":[198,256],"adjusted":[199],"analysis,":[200],"less":[204],"prevalent":[205,217],"scenario":[209,221],"(aPR":[210,222],"0.51,":[211],"CI":[213,225],"0.35\u20130.74)":[214],"more":[216],"1.54,":[223],"1.21\u20131.96)":[226],"reference":[231],"scenario.":[232],"High":[233],"workload":[234],"associated":[236,251],"lower":[238],"prevalence,":[240],"visible":[243],"consultation":[244],"area":[245],"recent":[247],"training":[249],"prevalence.":[254],"Conclusions:":[255],"central":[261],"Jordan,":[262],"important":[263],"gaps":[264],"observed":[266],"escalation,":[270],"particularly":[274],"ketoacidosis":[278],"presentation.":[279],"Spontaneous":[280],"engagement":[282],"also":[284],"Interventions":[286],"should":[287,312],"prioritize":[288],"drug-specific":[289],"red-flag":[290],"unambiguous":[292],"language,":[294],"workflow":[295],"support":[296],"focused":[298],"low-burden":[301],"immediate":[304],"patient":[305],"safety":[306],"has":[307],"been":[308],"addressed.":[309],"These":[310],"findings":[311],"not":[313],"be":[314],"generalized":[315],"rural":[317],"other":[320],"regions":[321],"Jordan":[323],"without":[324],"further":[325],"evaluation.":[326]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-11-07T00:00:00"}