Pattern and determinants of poisoning in a teaching hospital in Riyadh,Saudi Arabia

Background

The Drug and Poison Information Center (DPIC) at King Khalid University Hospital, Riyadh, Saudi Arabia, was founded in 1983. Since then it has responded adequately to queries from medical and non-medical callers from all over the Kingdom. Queries ranged from simple material identification to poisoning cases.

Objectives

To assess the pattern and circumstances of poisoning in the Kingdom of Saudi Arabia through reviewing data from DPIC in King Khalid University hospitals.

Methods

This is a retrospective study of referred cases and calls received by DPIC. All records and documentation forms during the study period were investigated.

Results

This study included 1161 cases. There were 7.9% infants, 52.9% under 5 years old, 7.2% between 6–12 years old and 32.0% more than 12 years old. Number of males with toxic exposure was almost equal to that of females. More than 92% of cases were toxic exposure through oral route. Causes of poisoning include drugs among 76.7% of cases followed by household chemicals (6.8%). Suicidal intention was reported among 25.6% of cases. Using multivariate regression analysis, significant predictors of suicidal attempts are more than 12 years old, patients who were exposed to more than one toxin and patient who came to the hospital within 1–3 h since poisoning.

Recommendations

Establishing and operating DPIC centers throughout the kingdom, in addition to implementing of legislations to ban over the counter selling of medications and to sell potentially dangerous chemicals in childproof containers.     

Practices,awareness and attitudes toward self-medication of analgesics among health sciences students in Riyadh,Saudi Arabia

Background

Self-medication is a common practice among health sciences students in Saudi Arabia. It is known that inappropriate selfmedication may harm individuals due to increasing the risk of drug misuse or delaying a hospital visit by masking some symptoms. Thus, the aim of our study is to investigate and assess practices, awareness and attitudes toward analgesics self-medication among health science students in Riyadh, Saudi Arabia.

Evaluation of knowledge of Alzheimer disease among health university students in Riyadh,Saudi Arabia

ObjectiveTo assess the knowledge of Alzheimer disease among healthcare students of King Saud University, Riyadh Saudi Arabia.MethodsThis cross-sectional survey was conducted via an online questionnaire using google form as the main platform to collect the data. We included Pharmacy, medical and dental students, who are studying at king Saud University, Riyadh Saudi Arabia during February to March 2019.ResultsA total of 671 healthcare students responded to the study, and a total of 529 participants completely filled the survey with a response rate 79%. Majority (70.1%) of the student studied about Alzheimer disease in their college life, only 16.6% were not and 13.2% of them not remember. Most of the respondents 373 (70%) answered correctly and said that Alzheimer disease is related to mental disorders, although majority of 73.5% knew that Alzheimer disease is a Neurodegenerative disease. There was significant difference in knowledge score of medical and dental students (p = 0.001), Pharmacy and dental students (p = 0.003) respectively.ConclusionSaudi healthcare students have variation in knowledge about Alzheimer disease. To increase levels of knowledge, it is necessary to provide adequate education Programme and training is needed in healthcare colleges. We suggest further studies with large sample sizes to identify the effectiveness of Alzheimer disease education programs healthcare schools are warranted.     

The role of pharmacoeconomics in formulary decision making in different hospitals in Riyadh,Saudi Arabia

Objective

To assess the trend of using pharmacoeconomic information by Pharmacy and Therapeutics (P&T) committees when making formulary decisions.

Design

A cross-sectional study conducted in 2007, using structured survey questionnaires which were distributed to members of the P&T committees in 11 different hospitals in Riyadh, Saudi Arabia.

Results

A total of 100 survey questionnaires were sent to head of pharmacy departments of 11 different hospitals in Riyadh, Saudi Arabia. Out of these, 48 questionnaires were completed and returned. Of the total respondents participated in the study, 64.58% were medical doctors and 16.66% were pharmacists and 75% of the respondents said they have applied pharmacoeconomic evaluations in their decision making process. More than 80% of the respondents perceived that they had a fair knowledge of pharmacoeconomics. Approximately 80% of respondents expressed some degree of agreement that pharmacoeconomics should be applied as a decision making tool. The majority of decision-makers (95%) expressed the interest in attending workshops on pharmacoeconomics.

Conclusion

The study showed that pharmacoeconomics can play an important role in the P&T committee formulary decisions. However, more education to health care professionals and to hospital administrators should be conducted to facilitate the use of such a tool. Also, hospitals should recruit health care professionals with pharmacoeconomic expertise to manage limited health resources in the best way available.     

Evaluation of Antimicrobial Stewardship Programs (ASPs) and their perceived level of success at Makkah region hospitals,Kingdom of Saudi Arabia

Antimicrobial stewardship programs (ASPs) are collaborative efforts to optimize antimicrobial use in healthcare institutions through evidence-based quality improvement strategies. The general administration of pharmaceutical care in the Saudi ministry of health (MOH) is putting outstanding efforts in implementing antimicrobial stewardship in Saudi health care settings. Several surveys have been conducted globally and reported many types of antimicrobial stewardship strategies in health institutions and their effectiveness. This study aims to identify ASPs in Makkah region hospitals and their perceived level of success. We administered a regional survey to explore current progress and issues related to the implementation of ASPs in Makkah region hospitals at the pharmacy level (n = 25). Among responding hospitals, 19 (76%) hospitals, the most commonly reported ASP were as following: formulary restrictions (90%) for broad-spectrum antimicrobials and use of prospective feedback on antimicrobial prescribing (68%), use of clinical guidelines and pathways (100%), and use of automatic stop orders (68%) to limit inappropriate antimicrobial therapy. The study outcomes will also be of pivotal importance to devise policies and strategies for antimicrobial stewardship implementation in other non-MOH settings in the Makkah region. Based on our results, all reported institutions have at least one antimicrobial stewardship program in a process with a high success rate. A multidisciplinary ASP approach, active involvement of drug & therapeutic committee, formulary restrictions, and availability of education & training of pharmacists and physicians on ASP are the primary elements for perceived successful antimicrobial stewardship programs in the Makkah region hospitals.     

Status of infectious disease content in the professional pharmacy curriculum in Saudi Arabia: Results of a national survey

ObjectivesAntimicrobial resistance is one of the main global problems faced by healthcare institutions. Healthcare professionals as service providers must have a basic understanding of this emerging threat; additionally, considering the evolving role of pharmacists in both the community and hospital setting, it is crucial that pharmacists are part of the fight against this threat. Therefore, this study aimed to assess infectious disease subjects covered in the pharmacy curriculum in Saudi Arabia, to evaluate teaching and knowledge assessment strategies concerning infectious diseases, and to explore challenges faced by faculty members in teaching infectious disease courses.MethodsWe constructed a questionnaire with 26 items and sent it to infectious disease faculty members at 26 Saudi Arabian pharmacy colleges. It included questions regarding the faculty and institution, infectious disease topics, hours dedicated to each topic, and tools and strategies used in the courses for better understanding and assessment of students. In addition, we enquired about the faculty members’ current satisfaction of, and future plans for, the curriculum.ResultsThe questionnaire was completed by infectious disease faculty members, department chairs, or college deans. Among the respondent schools, 85.5% were governmental and 14.5% were private institutions. The majority of colleges (98.2%) followed a semester format schedule, with 67.3% offering solely the Doctor of Pharmacy (PharmD) program. More than 78% of respondents covered all tier 1 infectious disease topics from the American College of Clinical Pharmacy Pharmacotherapy Didactic Curriculum Toolkit. The main tool used for teaching was lectures (94.5%), while patient case application was the main teaching strategy (54.5%). Approximately 63% of respondents thought that the curricula were adequate when they were asked about their opinion of the curricula coverage, and 63.64% thought that the curriculum provided adequate baseline knowledge on infectious diseases for the following 5 years.ConclusionsThe study revealed variations in infectious disease topics covered and the time dedicated to them among pharmacy colleges in Saudi Arabia. The faculty members who responded to our questionnaire were generally satisfied with their infectious disease curriculum. To the best of our knowledge, this is the first study to assess infectious disease curricula among Saudi pharmacy colleges. Thus, the findings of this study may encourage faculty members to advocate for the standardization of infectious disease courses offered at Saudi Arabian pharmacy colleges.     

Pregnant women’s use and attitude toward herbal,vitamin, and mineral supplements in an academic tertiary care center,Riyadh, Saudi Arabia

Background

Herbal medicine has been widely utilized by pregnant women despite the limited available evidence regarding the safety and efficacy of that practice. The current available studies, from different countries, estimated that the use of herbal medicine during pregnancy range from 7% up to 96%. The aim of this study is to determine the prevalence, attitude, source of information, and reasoning behind the use of herbal medicine among pregnant women in Saudia Arabia.

临床分离91株摩氏摩根菌的药敏分析

目的探讨摩根菌对抗菌药物的体外敏感性，为临床合理用药提供参考。方法对我院2002年1月到2005年6月临床分离的91株摩氏摩根菌的来源和药敏情况进行统计分析。结果多种临床标本中均可分离到摩根菌，其中较多来自痰液（37．4％）及分泌物标本（27．5％）。住院及门诊患者均可发生摩根菌感染，以老年科（15株，16．5％）、骨科（11株，12．1％）居多。所有摩氏摩根菌株对氨苄西林、头孢唑林、头孢噻吩均耐药，对氨苄西林／舒巴坦（77．8％）、头孢呋肟（87．2％）及复方磺胺甲口恶唑（72．2％）耐药率也较高，而对哌拉西林／三唑巴坦、头孢吡肟、亚胺培南、阿米卡星的敏感性较好，敏感率分别为92．2％、85．7％、83．5％和94．5％。此外随年份增长摩根菌对各种抗生素的敏感性并无下降的趋势。结论在临床工作中应重视不常见致病菌引起的感染；哌拉西林／三唑巴坦、头孢吡肟、亚胺培南和阿米卡星等可作为临床治疗摩根菌感染的一线药物。     

Evaluation of medication counseling practice at community pharmacies in Qassim region,Saudi Arabia

Introduction

Pharmacists have a unique opportunity to promote good health through assuring the quality use of medicines. One of the most important tools to achieve this is medication counseling. Counseling plays an important role in enhancing medication adherence and optimizing medication therapy. Therefore, for improving the quality of services delivered by community pharmacists, it is essential to assess the current situation of counseling services delivered to patients.

Knowledge,attitudes and use of anabolic-androgenic steroids among male gym users: A community based survey in Riyadh,Saudi Arabia

Recreational use of anabolic-androgenic steroids (AAS) is a growing worldwide public health concern. However, studies assessing the level of awareness and knowledge of its effects on health are fairly limited, especially in developing countries, including Saudi Arabia. This community-based cross-sectional study was conducted to assess knowledge, attitudes and practices among male gym members toward AAS in Riyadh (Saudi Arabia) from March to October 2016. Twenty gyms were randomly selected from four different geographical regions (clusters) within Riyadh. In total, 482 participants responded to the self-administered anonymous questionnaire, which covered socio-demographic data, data assessing knowledge, attitude and behavior related to AAS use. The mean (±standard deviation) age of study participants was 27.2 (±6.9) years. Among these, 29.3% of participants reported having used AAS, while the majority (53.5%) reported hearing of AAS use, mostly through friends. Most study participants reported awareness of the effects of AAS on muscle mass, body weight and muscles strength (53.2%, 51.1% and 45.5%, respectively). In contrast, a higher proportion of study participants were unaware of the side-effects of AAS use. A high proportion of study participants (43.2%) reported that they had been offered AAS and 68.7% believed that AAS are easily accessible. Most of the gym users (90.1%) reported never having used any narcotics or psychoactive drugs. Regression analysis revealed that use of anabolic-androgenic steroids is significantly associated with “weight lifting practice” OR [95%CI]?=?1.9[1.02???3.61], P?=?0.044; “using supplementary vitamins, OR [95%CI]?=?7.8[4.05???15.03], P?<?0.0001, knowing anyone using anabolic-androgenic steroids’ OR [95%CI]?=?7.5[3.78???14.10], P?<?0.0001, and someone advised Gym users to take anabolic-androgenic steroids” OR [95%CI]?=?2.26[1.23???4.14], P?<?0.008. Our findings suggest that the level of awareness regarding the possible side-effects of AAS is fairly limited. Thus, efforts directed toward educating the public and limiting access to AAS as well as health policy reforms are crucial to reduce future negative implications of AAS use.     

Pharmacokinetics of meropenem in critically ill patients in Saudi Arabia

BackgroundMeropenem is commonly used in the ICU to treat gram-negative infections. Due to various pathophysiological changes, critically ill patients are at higher risk of having subtherapeutic concentrations and hence have a higher risk of treatment failure—especially in regions where gram-negative drug resistance is increasing, such as Saudi Arabia. No studies have evaluated the pharmacokinetics of meropenem in critically ill patients in Saudi Arabia. Our primary objective is to assess the percentage of patients achieving the therapeutic target for meropenem.MethodsThis prospective observational study was conducted in the ICUs of King Khalid University Hospital. Patient were included if >18 years-of-age and received meropenem for a clinically suspected or proven bacterial infection. The primary outcome was to assess the percentage of patients who achieved the pharmacokinetic/pharmacodynamic (PKPD) therapeutic target of a free trough concentration four times the MIC. The secondary outcome was to estimate the pharmacokinetics of meropenem. Pharmacokinetic analysis was performed using Monolix Suite 2020R1 (Lixoft, France).ResultsTrough concentrations were highly variable and ranged from <0.5 µg/mL to 39 µg/mL, with a mean ± SD trough concentration of 8.5 ± 8 µg/mL. Only 46% of patients achieved the therapeutic target. The only significant predictor of failing to achieve the PKPD target was augmented renal clearance.ConclusionIn conclusion, more than half of our patients did not achieve the PKPD target. Thus, there is a need for better dosing strategies of meropenem in critically ill patients in Saudi Arabia such as extended and continuous infusion.     

Association of medication storage with diabetes control: A cross-sectional study from Saudi Arabia

BackgroundIn addition to diet restriction and physical activity, diabetes mellitus is managed by the chronic use of medications that require appropriate storage conditions to maintain their stability and effectiveness. However, there is a lack of information regarding patients’ knowledge of medication storage and practices in Saudi Arabia. Therefore, the objective of this study was to determine the diabetics’ knowledge about medication storage requirements and to evaluate the impact of antidiabetic medications storage on the blood glucose levels.MethodsThis study was a cross-sectional in the form of an interviewer-guided interview using a close-ended questions. The study was conducted among patients diagnosed with diabetes at diabetic clinics of public hospitals and other diabetic specialized clinics in Hail region of Saudi Arabia, over a period of four months between January to April 2019.ResultsA total of 501 completed questionnaires were returned. Of the respondents, 51.5% were males and 48.5% were females. Of the total participants 52.7% never achieved normal blood glucose range, which was associated with health literacy and medication storage knowledge. Almost half of the participants stored the medication correctly and others have poor knowledge and practice of medication storage, of whom 7.8% always store their medicines in their cars.ConclusionAlmost half of the participants lack the knowledge of appropriate storage conditions of diabetes medications, which was shown to have a significant association with blood glucose levels.     

Community Pharmacy Staff Knowledge,Opinion and Practice toward Drug Shortages in Saudi Arabia

Drug shortages continue to pose a significant threat to public health and safety. Drug shortages not only worsen patient outcomes, but also significantly burden healthcare systems with additional costs. This study aimed to assess community pharmacy staff knowledge, opinion, and practice toward drug shortages in Saudi Arabia from November 2019 to March 2020. This was a cross-sectional study carried out among 1,008 community pharmacists from Saudi Arabia using a validated, self-administered and Internet-based survey. Analysis was done using chi square and fisher exact tests. Most participants were males (97.2%), less than 30 years old (48.1%), and non-Saudi citizens (94.4%), and 72.0% had good knowledge of drug shortages (score = 4–5). Around 36.0% reported that it takes 1–3 days to receive a response to the shortage report. There was a statistically significant association between the professional level of the community pharmacists and their opinion about reporting drug shortages (P < .05). Most community pharmacies (56.2%) did not receive any notification about drug shortages. In conclusion, most community pharmacists are knowledgeable and have good practice regarding drug shortages, but their opinions about drug shortages differ according to each pharmacy reporting policy.     

Pharmacist,the pharmaceutical industry and pharmacy education in Saudi Arabia: A questionnaire-based study

Background: In Saudi Arabia there is an estimated need of more than 100,000 pharmacy graduates to cover all present sectors. The shortage of pharmacists has affected many of these sectors especially the pharmaceutical industry. The contribution of Saudi pharmacists to local pharmaceuticals industry would be extremely beneficial and important for shaping the future of the drug industry within the Kingdom. It is not clear whether future Saudi pharmacists are willing to contribute to local pharmaco-industrial fields. Methods: A cross-sectional, questionnaire-based survey was conducted on all final-year pharmacy students in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA). Results: Out of a total of 130 students registered in the final-year of the pharmacy program in KSU, 122 (93.8%) were able to complete the questionnaire. The results showed that the majority (83%) of Saudi pharmacy students indicated that they had not received practical training in the pharmaceutical companies, while only 17.2% of the students felt that they had the knowledge and the skills to work in the pharmaceutical industry after graduation. The majority of the students (66.7%) chose clinical pharmacy as their future career field while only 10.9% indicated willingness to work in a pharmaceutical industry career. Only 8.2% selected working in the pharmaceutical industry. The significant predictor of possibly choosing a career in the local drug industry is a student with a bachelor’s degree (compared to Pharm D degree) in pharmacy (OR = 2.7 [95% CI 1.1–6.3]). Conclusion: Pharmacy students who are enrolled in the capital city of Riyadh are not properly trained to play an influential role in local drug companies. As a result, their level of willingness to have a career in such important business is not promising (more among Pharm D program). Future research in other pharmacy colleges within Saudi Arabia is needed to confirm such results.