Feasibility, and barriers to use escitalopram in functional gastrointestinal disorders.

Background and study aims: The feasibility and barriars of escitalopram use in patients with functional gastrointestinal disorders (FGIDs) are still debated. We aimed to evaluate the feasibility, safety and efficacy and barriars of escitalopram use in managing FGIDs in the Saudi population. Patients and Methods: We included 51 patients who received escitalopram for irritable bowel syndrome (n = 26), functional heartburn (n = 10), globus sensation (n = 10) or combined disorders (n = 5). We used an irritable bowel syndrome-severity scoring system IBS-SSS), GerdQ questionnaire and Glasgow Edinburg Throat Scale (GETS) to assess disease severity change before and after treatment. Results: The median age was 33 years (25th- 75th percentiles: 29-47), and 26 (50.98%) were males. Forty-one patients experienced side effects (80.39%), but most side effects were mild. The most common side effects were drowsiness/fatigue/dizziness (54.9%), xerostomia (23.53%), nausea/vomiting (21.57%) and weight gain (17.65%). IBS-SSS was 375 (255-430) and 90 (58-205) before and after treatment, respectively (p < 0.001). GerdQ score was 12 (10-13) before treatment and 7 (6-10) after treatment (p = 0.001). GETS score before treatment was 32.5 (21-46) and after treatment became 22 (13-31) (p = 0.002). Thirty-five patients refused to take the medications, and seven patients discontinued the medication. Possible causes of the poor compliance were fear of the medications and not being convinced of taking psychiatric medications for functional disorders (n = 15). Conclusion: Escitalopram could be a safe and effective treatment for functional gastrointestinal disorders. Targeting and managing factors leading to poor compliance could further improve the treatment outcome.

Knowledge, Attitude, and Practice Towards COVID-19 Among Pharmacists: A Cross-Sectional Study.

PURPOSE: The COVID-19 outbreak has caused governments to put pandemic-related guidelines requiring compliance and understanding by healthcare professionals to mitigate its spread uncontrollably. We studied pharmacists' knowledge, attitude, and practice towards the COVD-19 outbreak compared with other healthcare workers during the pandemic in Saudi Arabia. METHODS: We surveyed pharmacists' socio-demographics (n=50) compared with other healthcare professionals (n=378) during lockdown starting in June 2020. We measured respondents' level of knowledge (n=10 questions, maximum score of 10), attitude (n=17 questions, maximum score of 80), and their practices (n=16 questions, maximum score of 80) towards COVID-19 infection. RESULTS: Median knowledge score was 8 (25th-75th percentiles: 7-9), attitude score 76 (70-80) and practice score 74 (68-78). Good knowledge predictors were >20 years working experience [OR: 2.05 (95% CI: 1.03-4.06); P=0.04] and >50% working in clinical practice [OR: 1.72 (95% CI: 1.12-2.66); P=0.01], in inverse relationship with paramedical professions [OR: 0.45 (95% CI: 0.45 (0.28-0.72)); P=0.001] and working in a university hospital [OR: 0.51 (95% CI: 0.33. 0.81); P=0.004]. Availability of pharmaceutical information and treatment options was associated with good attitude [OR: 2.19 (95% CI: 1.04-4.59); P=0.039] and acquaintance as primary information sources negatively associated with good attitude [OR: 0.34 (95% CI: 0.15-0.8); P=0.013]. Good practice predictors were female gender [OR: 3.84 (95% CI: 2.37-6.24); P<0.001], military hospital employment [OR: 2.32 (95% CI: 1.25-4.31); P=0.008], USA [OR: 3.41 (95% CI: 1.03-11.22); P=0.044] or UK [OR: 8.86 (95% CI: 1.91-41.07); P=0.005] qualifications, and information on supportive measures [OR: 2.2 (95% CI: 1.36-3.56); P=0.001]. CONCLUSION: Health workers displayed good knowledge about COVID-19, while profession and working experience predicted adequate knowledge, positive attitude, or practice towards disease management.