Factors influencing telehealth awareness, utilization, and satisfaction in KSA: A national population-based study.

Background: Telehealth involves delivering healthcare remotely through digital platforms such as telephone and video calls. Use of telehealth surged during the COVID-19 pandemic because of the need for contactless healthcare. The Saudi Ministry of Health established the "937 telephone medical consultation call center" almost 10 years ago. Objectives: The aim of this study was to examine public awareness of, utilization of, and satisfaction with the 937 call center service, and to assess associated factors. Materials and methods: This national community-based, cross-sectional study was conducted through multistage sampling with proportional allocation from 20 health directorates. Participants were selected from the general population in public places and were interviewed with a validated questionnaire. Results: Of 7951 approached individuals, 7692 agreed to participate (response rate 96.7%). Seventy-eight percent of participants were aware of the 937 service, and 56.4% had previously used the service. Most (86%) users were satisfied with the service. Long waiting times were the most frequent reason (46.6%) for dissatisfaction. In multivariable analysis, service awareness and utilization were both significantly associated with having higher education (aOR 4.03, 95%CI: 3.17-5.12 and aOR 3.42, 95%CI: 2.64-4.42, respectively). Positive impressions of telephone medical consultation services, Saudi nationality, having children, having medical insurance, and having a history of chronic disease were significantly associated with awareness of, utilization of, and satisfaction with the service. Conclusion: The study revealed high awareness of, utilization of, and satisfaction with the 937 telephone medical consultation call center, thus suggesting increased public acceptance of the service. Moreover, the study identified socio-demographic factors influencing public awareness of, utilization of, and satisfaction with telehealth. Further studies are required to increase understanding of the facilitators of, and barriers to, the use of service among various population groups.

Healthcare Workers' Assessment of a Visual Triage System (VTS).

Overcrowding and extended waiting times in the emergency department (ED) can pose a significant risk of COVID-19 transmission from patients to healthy individuals. In 2017, the Saudi Ministry of Health (MOH) introduced a visual triage system (VTS) with scoring to notify healthcare workers (HCWs) in EDs about the Middle East respiratory syndrome coronavirus (MERS-CoV) infection risk. During the COVID-19 pandemic, the MOH employed a VTS to classify patients according to their potential risk of COVID-19 infection upon their admission to the ED. Suspected patients were then directed along specific pathways to reduce their contact with healthy individuals. This study assessed HCWs' satisfaction with the VTS in the ED of two major government hospitals within the Riyadh region. Additionally, it assessed HCWs' perceptions of VTS effectiveness. This study used a cross-sectional, observational design and relied on surveys for data collection. A total of 127 participants completed the survey, of which 87 (68.5%) were based in the EDs of the two hospitals. Among the ED participants, 18.1% expressed satisfaction with the VTS, 46.4% were neutral, and 33.1% reported dissatisfaction. ED participants provided feedback on the system's effectiveness, with 24.1% finding it effective, 66.7% considering it somewhat effective, and 9.2% deeming it ineffective. Of the total (127) study participants (70.1%) reported that the HCWs required better training to effectively implement the VTS infection control plans for suspected cases. Fewer than half of the participants (35.4%) deemed the time spent by VTS personnel to identify COVID-19 cases to be reasonable, whereas 22% found it too short and 27.6% considered it too long. Of the total 127 participants, 63% reported that language differences between patients and HCWs constituted barriers to the effective application of the VTS. Our study findings indicated that most ED participants had a neutral outlook on their satisfaction with the VTS and a neutral perspective on the effectiveness of VTS, viewing it as only somewhat effective. Reported weaknesses and key obstacles to the successful implementation of the VTS included language barriers. and insufficient training for HCWs, and unclear VTS pathways. The reported strengths of the VTS included its effectiveness in reducing crowds and identification of COVID-19 patients.

Evaluation of Wet Cupping Therapy: Systematic Review of Randomized Clinical Trials.

BACKGROUND: Wet cupping is a widely used traditional therapy in many countries, which justifies a continuous scientific evaluation of its efficacy and safety. OBJECTIVES: To perform a systematic review to critically evaluate and update the available evidence of wet cupping in traditional and complementary medicine. METHODS: Ten electronic databases were searched from their inceptions to February 2016. Included studies were randomized clinical trials (RCTs) that evaluated wet cupping against any type of control interventions in patients with any clinical condition, as well as healthy individuals. Cochrane risk of bias tool was used to appraise the included RCTs. RESULTS: Fourteen RCTs met the eligibility criteria. The included studies evaluated the following clinical conditions: nonspecific low back pain (NSLBP), hypertension, brachialgia, carpal tunnel syndrome (CTS), chronic neck pain, metabolic syndrome, migraine headaches, oxygen saturation in smokers with chronic obstructive pulmonary disease (COPD), and oral and genital ulcers due to Behçet disease. Two RCTs evaluated physiologic and biochemical parameters of healthy individuals. Overall, 9 RCTs favored wet cupping over various control interventions in NSLBP (n = 2), hypertension (n = 1), brachialgia (n = 1), CTS (n = 1), chronic neck pain (n = 2), oxygen saturation in smokers with COPD (n = 1), and oral and genital ulcers due to Behçet disease (n = 1). Five RCTs showed no statistically significant between-group differences: NSLBP (n = 1), metabolic syndrome (n = 1), migraine headaches (n = 1), and physiologic and biochemical parameters of healthy individuals (n = 2). Included RCTs had a variable risk of bias across all domains and suffered methodologic limitations. CONCLUSIONS: There is a promising evidence in favor of the use of wet cupping for musculoskeletal pain, specifically NSLBP, neck pain, CTS, and brachialgia. Better-quality trials are needed to generate solid evidence and firmly inform policy makers.

Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine.

OBJECTIVE: The use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities. METHODS: This is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire. RESULTS: The mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products. CONCLUSION: This preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.