A cross-sectional survey: The "Saudi guidelines for the prevention and management of obesity": Awareness and adaptation in Al-Qassim province.

Background: Obesity and overweight are major health problems in Saudi Arabia. In response, with reference to studies both local and from abroad, the Saudi Ministry of Health and the Saudi Arabian Society of Metabolic and Bariatric Surgery recently published the "Saudi Guidelines for the Prevention and Management of Obesity." Aims: We sought to investigate the awareness of and adherence to the "Guidelines" among health care professionals (HCPs) specializing in obesity in Al-Qassim province, Saudi Arabia. Settings and Design: Al-Qassim province, cross-sectional survey. Methods and Materials: In a cross-sectional survey, a three-part questionnaire (i.e., demographic background, information about obesity, and information about the "Guidelines") was distributed among HCPs in Al-Qassim province from January to April 2019. Data analysis was performed in Microsoft Excel. Statistical Analysis Used: Data analysis was performed in Microsoft Excel. Results: Among the 72 HCPs who completed and returned the survey, knowledge of the "Guidelines" was low (40.3%). Most were not even aware of the document's existence (59.7%), and most had not received any training regarding the Saudi obesity control program (55%). Conclusions: The survey's findings suggest that HCPs in Al-Qassim province have limited knowledge about the "Saudi Guidelines for the Prevention and Management of Obesity" and are mostly unaware of the document's existence. Even so, the overwhelming majority (82.8%) of HCPs who were aware have implemented the "Guidelines" in their clinical practice.

Hydroxychloroquine Safety Outcome within Approved Therapeutic Protocol for COVID-19 Outpatients in Saudi Arabia.

BACKGROUND: Global healthcare is challenged following the COVID-19 pandemic, since late 2019. Multiple approaches have been performed to relieve the pressure and support existing healthcare. The Saudi Arabian Ministry of Health (MOH) launched an initiative to support the National Healthcare System. Since the 5th of June 2020, 238 outpatient fever clinics were established nationwide. This study aimed to assess the safety outcome and reported adverse events from hydroxychloroquine use among suspected COVID-19 patients. METHOD: A cross-sectional study included 2,733 patients subjected to MOH treatment protocol (hydroxychloroquine) and followed-up within 3-7 days after initiation. Data was collected through an electronic link and cross-checked with the national database (Health Electronic Surveillance Network, HESN) and reports from the MOH Morbidity and Mortality (M&M) Committee. RESULTS: 240 patients (8.8%) discontinued treatment because of side effects (4.1%) and for non-clinical reasons in the remaining (4.7%). Adverse effects were reported among (6.7%) of all studied participants, including mainly cardiovascular (2.5%, 0.15% with QTc prolongation), and gastrointestinal (2.4%). No Intensive Care Unit admission or death were reported among these patients. CONCLUSION: Our results show that hydroxychloroquine for COVID-19 patients in mild to moderate cases in an outpatient setting, within the protocol recommendation and inclusion/exclusion criteria, is safe, highly tolerable, and with minimum side effects.

Optimizing carbapenem use through a national quality improvement programme.

Background: Concern about increasing carbapenem and piperacillin/tazobactam use led the Scottish Antimicrobial Prescribing Group (SAPG) to develop national guidance on optimal use of these agents, and to implement a quality improvement programme to assess the impact of guidance on practice. Objectives: To evaluate how SAPG guidance had been implemented by health boards, assess how this translated into clinical practice, and investigate clinicians' views and behaviours about prescribing carbapenems and alternative agents. Methods: Local implementation of SAPG guidance was assessed using an online survey. A bespoke point prevalence survey was used to evaluate prescribing. Clinicians' experience of using carbapenems and alternatives was examined through semi-structured interviews. National prescribing data were analysed to assess the impact of the programme. Results: There were greater local restrictions for carbapenems than for piperacillin/tazobactam. Laboratory result suppression was inconsistent between boards and carbapenem-sparing antibiotics were not widely available. Compliance with local guidelines was good for meropenem but lower for piperacillin/tazobactam. Indication for use was well documented but review/stop dates were poorly documented for both antibiotics. Decisions to prescribe a carbapenem were influenced by local guidelines and specialist advice. Many clinicians lacked confidence to de-escalate treatment. Use of both antibiotics decreased during the course of the programme. Conclusions: A multifaceted quality improvement programme was used to gather intelligence, promote behaviour change, and focus interventions on the use of carbapenems and piperacillin/tazobactam. Use of these antimicrobials decreased during the programme-a trend not seen elsewhere in Europe. The programme could be generalized to other antimicrobials.