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Original Research 
RMJ. 2026; 51(1): 252-255


Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study

Ayesha Inam, Mir Muhammad Hassan Bullo, Abdul Samad Wadho, Firdous Begum Memon, Syed Abid Hussain Shah, Syed Mujahid Gilani.


Abstract
Objective: To evaluate healthcare provider’s (HCPs) knowledge, attitudes, and practices towards managing high-alert medications (HAMs) in the twin cities of Pakistan.
Methodology: This cross-sectional study of 385 randomly selected physicians and pharmacists in Islamabad/Rawalpindi from December 2022 to May 2023 using a validated questionnaire. Data were analyzed using descriptive statistics and chi-square tests to examine associations between demographic variables and KAP questions.
Results: HCPs demonstrated strong knowledge (90.5% recognized HAMs; physicians 99% identified anticoagulants as HAMs vs pharmacists 86%) and positive attitudes (93% supported pharmacist verification). However, significant practice gaps existed: only 26% provided patient counseling, 23% used Institute for Safe Medication Practices safety lists, and 45% encountered HAM-related injuries. Knowledge showed strong associations with age (χ²=256.8, p=0.003), profession (χ²=56.1, p=0.003), and qualification (χ²=12.3, p=0.002). While 79% practiced dose individualization, only 43% received HAM training.
Conclusion: Despite adequate knowledge and safety-conscious attitudes, critical practice deficiencies persist, particularly in patient education and safety protocol implementation. These findings underscore the urgent need for institutional HAM management protocols and competency-based training to enhance medication safety.

Key words: Healthcare providers, high-alert medications, knowledge-attitudes-practices, medication safety, Pakistan.


 
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How to Cite this Article
Pubmed Style

Inam A, Bullo MMH, Wadho AS, Memon FB, Shah SAH, Gilani SM. Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. RMJ. 2026; 51(1): 252-255.

Web Style

Inam A, Bullo MMH, Wadho AS, Memon FB, Shah SAH, Gilani SM. Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. https://www.rmj.org.pk/?mno=249315 [Access: February 21, 2026].

AMA (American Medical Association) Style

Inam A, Bullo MMH, Wadho AS, Memon FB, Shah SAH, Gilani SM. Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. RMJ. 2026; 51(1): 252-255.


Vancouver/ICMJE Style

Inam A, Bullo MMH, Wadho AS, Memon FB, Shah SAH, Gilani SM. Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. RMJ. (2026), [cited February 21, 2026]; 51(1): 252-255.


Harvard Style

Inam, A., Bullo, . M. M. H., Wadho, . A. S., Memon, . F. B., Shah, . S. A. H. & Gilani, . S. M. (2026) Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. RMJ, 51 (1), 252-255.


Turabian Style

Inam, Ayesha, Mir Muhammad Hassan Bullo, Abdul Samad Wadho, Firdous Begum Memon, Syed Abid Hussain Shah, and Syed Mujahid Gilani. 2026. Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. Rawal Medical Journal, 51 (1), 252-255.


Chicago Style

Inam, Ayesha, Mir Muhammad Hassan Bullo, Abdul Samad Wadho, Firdous Begum Memon, Syed Abid Hussain Shah, and Syed Mujahid Gilani. "Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study." Rawal Medical Journal 51 (2026), 252-255.


MLA (The Modern Language Association) Style

Inam, Ayesha, Mir Muhammad Hassan Bullo, Abdul Samad Wadho, Firdous Begum Memon, Syed Abid Hussain Shah, and Syed Mujahid Gilani. "Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study." Rawal Medical Journal 51.1 (2026), 252-255. Print.


APA (American Psychological Association) Style

Inam, A., Bullo, . M. M. H., Wadho, . A. S., Memon, . F. B., Shah, . S. A. H. & Gilani, . S. M. (2026) Health care provider knowledge and practices toward high alert medication in the twin cities of Pakistan: A cross-sectional study. Rawal Medical Journal, 51 (1), 252-255.


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