Prescribing Renally Inappropriate Medication to Hospitalized Geriatric Patients in Makkah, Saudi Arabia.

Introduction: As a result of the physiological decline in renal function that comes with age and the common failure to recognise renal insufficiency, older adults aged 65 and above are at increased risk of receiving medications that are inappropriate for their level of renal function which in turn lead to increased risk of adverse effects. Little is known about how many older adults receive medications that are inappropriate for their level of renal function. This study aimed to determine the prevalence of renally inappropriate medications in elderly adults by reviewing patient files and evaluating the appropriateness of medication doses relative to renal function in patients aged ≥ 65 years at inpatient healthcare departments. Methods: A retrospective cross-sectional study of patients aged ≥ 65 years was conducted, covering cases from 2015 to 2021. Patient's medical records were reviewed, their renal function and medications lists were evaluated, determined whether they had been prescribed at least one renally inappropriate medication based on drug-dosing recommendations for different degrees of renal function. Results: A total of 317 elderly inpatients were included, 10% of whom had received inappropriate doses relative to their renal function. Glomerular filtration rate was associated with inappropriate dosing in this study. Of the patients CKD stage 5, 36.8% had at least one drug administered at an inappropriate dose, while this figure was 6.5% among the patients at CKD stage 1; this difference was statistically significant (p = 0.001). Conclusion: A notable portion of older adults may be at risk of adverse effects due to inappropriate medication dosing related to their renal function. Further studies with large samples, drug use analyses based on comprehensive geriatric references and a prioritisation of actual outcomes over potential outcomes are needed to further determine elderly adults' exposure to inappropriate drugs.

Screening of Geriatric Depression in Makkah, Saudi Arabia: A Pilot Study.

OBJECTIVE: There is currently limited evidence about the prevalence of depression among elderly people residing in Makkah, Saudi Arabia. This study aims to report the magnitude of depression among the older population in Makkah, Saudi Arabia, and the related risk factors. METHODS: An online cross-sectional pilot survey was carried out in Makkah City, Saudi Arabia. Data were collected using an online self-administered questionnaire. RESULTS: The study questionnaire was completed by 191 older people. The participants' ages varied from 60 to 88 years. 55.5% were women, 47.9% were married, and 21.5% were divorced/widowed. 46.6% had hypertension, 42.4% had diabetes, 17.3% had hypothyroidism, 7.9% had cardiovascular diseases (CVDs), and 6.3% reported psychiatric problems. 44.5% of the subjects had no depression, 23.5% had mild, 15.2% had moderate, and 16.8% had severe depression. The sample included 32% who had been classified as having major depression. Elderly participants with insomnia, cognitive diseases, and chronic diseases showed a high risk for experiencing severe depression (OR=2.74; 95% CI: 1.42-5.28),(OR=2.63; 95% CI: 1.29-5.40), and (OR=2.62; 95% CI: 1.11-6.14) respectively. CONCLUSION: Depression was common among the elderly population in Makkah, particularly among those with a documented history of insomnia, cognitive diseases, and chronic diseases. Depression screening and treatment for old people in medical settings is recommended.

Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability.

BACKGROUND: In primary healthcare settings, chronic low back pain (cLBP) is a widespread health issue with a great global impact. METHODS: A cross-sectional analytical study was performed on 918 adults attending primary healthcare settings in Makkah, Saudi Arabia, to estimate the cLBP prevalence, its effect on health-related quality of life (QOL), and predictors of subsequent disability. The visual analog scale of pain (VAS), World Health Organization Quality of Life Scale (WHO-QOL), and Oswestry low back pain disability index (ODI) were used to assess back pain severity, impact on QOL, and physical disability, respectively. RESULTS: The prevalence of cLBP among adults attending primary care settings in Makkah City was 25.9%, and 88.6% of them had a limited range of motion of the spine. About 58.1% had abnormal radiological findings detected by MRI. Based on the VAS scale, most patients (83.8%) had mild pain. The median (IQR) QOL score was 70 (60-80). Minimal and moderate disability scores were prevalent among 16.2% and 65.7% of patients, respectively. Disability scores were independently predicted by a lower QOL score (beta = -0.39, 95%CI = -0.49 to -0.29, p < 0.001) and higher VAS scores (beta = 0.47, 95%CI = 0.38-0.56, p < 0.001). Furthermore, disability was independently associated with having post-void residual volume (PVRV) (beta = 5.84, 95%CI = 1.97-9.72, p = 0.004) and abnormal X-ray findings (beta = 7.10, 95%CI = 1.77-12.4, p = 0.010). CONCLUSION: cLBP is common among adults attending primary care settings in Makkah City; it is associated with moderate disability and lower health-related QOL.

Polypharmacy among patients with hypertension attending primary healthcare centres.

Saudi Arabia has several hypertensive patients who require close attention and specialised care for their medications. Polypharmacy is one of the reasons for the failure of patient compliance with antihypertensive medications. Therefore, this study aims to gain a better perspective on polypharmacy in hypertensive patients attending primary healthcare (PHC) centres in Makkah, Saudi Arabia. Methods: This was an observational, cross-sectional, descriptive study of hypertensive patients followed up at 10 PHC centres in Makkah, Saudi Arabia, from 1 July 2019 to 30 June 2022. Frequencies and percentages were used to present categorical data, and Pearson's χ 2 test was used to measure differences. A P value less than 0.05 was considered statistically significant. Results: A total of 506 patients were included in this study. The mean age of the patients was 60 years, and more than half (69%) were females. Regarding antihypertensive medication use, 64% were on antihypertensive combination therapy, 76% on dual therapy, 21% on triple therapy, and 3% on quadruple therapy. Moreover, 21% of the hypertensive patients were exposed to polypharmacy. There was a significant relationship (P<0.001) between the overall number of chronic medications used per day and the duration of hypertension. Conclusion: More clinical research is needed to identify the impact of polypharmacy on the quality of healthcare in PHC centres in general and hypertensive patients specifically in different regions of Saudi Arabia.

Prevalence of Depression and Anxiety Disorders Among Surgical Doctors in Public Hospitals in Makkah City, Saudi Arabia: An Analytical Cross-Sectional Study.

Background Depression and anxiety are among the most prevalent illnesses worldwide. Although depression affects many individuals throughout their lives, physicians are at a heightened risk of developing the disorder due to their high-stress levels and enormous responsibilities. The study aimed to examine the prevalence of depression and anxiety disorders among surgical doctors in Makkah city hospitals as well as the risk factors. Methods Analytical cross-sectional research was performed at all public hospitals in Makkah city, Saudi Arabia. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used as the screening tool. Results Of the 153 surgeons, 47.1% were Saudis, 81.7% were men, and 46.7% were residents. A personal history of anxiety or depression was apparent among 11.8% of the surgeons, while 4.6% had a family history of a mental disorder. Based on the HADS questionnaire responses, the prevalence rate of anxiety was 30.7%, and 27.5% of the surgeons had depression. Based on the univariate regression analysis, anxiety was significantly linked with being a participant in the Saudi Board program (p=0.010), working for more than nine hours (p=0.020), and having work-related stress (p=0.011 for moderate stress and p=0.001 for severe stress) as well as related to those who were rarely or never satisfied with their income (p=0.016 and p=0.047, respectively) and who was rarely satisfied with their career (p=0.019). Depression among surgeons was significantly linked with the age of 50 to 59 (p=0.023) as well as related to those who were usually satisfied with their career (p=0.022) and those with moderate work-related stress (p=0.016). Conclusion Psychological disorders such as depression and anxiety are prevalent among surgeons. They should be appropriately evaluated at regular intervals throughout life, especially during residency programs, to ensure physical and mental well-being, appropriate training exposure, and patient safety.

Over-the-Counter Medication Use among Parents in Saudi Arabia.

Introduction: Self-medication is a growing public health concern worldwide. Studies have shown a gap between best practice and the current practice of using over-the-counter (OTC) medications. Despite being a well-recognised problem in Saudi Arabia, few studies have investigated OTC medication use in Saudi Arabia. Therefore, this study aimed to investigate the attitudes and knowledge of parents regarding OTC medication use in the Jeddah region, Saudi Arabia. Method: A cross-sectional study was carried out via an electronic questionnaire sent randomly to parents over four months, from 1 January to 30 April 2022. The participants' characteristics and categorical variables were represented descriptively by frequency and percentage. A Chi-square test was used to test the relationship between the variables. Results: In total, 211 questionnaires were included in this study. Females represented 54.5% of the participants included in the study. Parents belonging to the 18-to-30-year-old group comprised the highest percentage (37.9%), and most of the parents (72.9%) had received an undergraduate education. Family physicians were the most common source (37.3%) of information about OTC medications, whereas more than half of parents purchased OTC medications from the community pharmacy (58.8%). While almost half of the parents (52.1%) visited a family physician when side effects of OTC medications appeared in their children, only (33.6%) stopped giving their children the OTC medicine. The relationship between the sociodemographic characteristics (including educational level, marital status, and employment status) and OTC drug consumption was significant (p < 0.001). Conclusion: Educational campaigns are needed to guide patients about the proper use of OTC medications. Studies on OTC medication use are lacking in Saudi Arabia in terms of its frequency, reasons for use, type of self-medication, and contributing factors.

Effect of the Long COVID-19 Quarantine and Associated Lack of Physical Activity on Overall Health.

Background The COVID-19 pandemic's mandatory quarantine encouraged a sedentary lifestyle, which had detrimental effects on health. The purpose of this study is to evaluate the health effects of the prolonged COVID-19 quarantine. Methods A descriptive cross-sectional study was conducted using an online questionnaire to assess the effects of physical activity and dietary patterns on weight gain and perceived stress. Results Of the 384 participants, the majority (58.6%) experienced stress, while 22.4% saw a dramatic decline in physical activity and only 19.8% performed regular physical activity. Although 64.1% of the participants reported eating healthily, 40.6% gained weight during the quarantine. Insufficient exercise (OR 1.966, 95% CI: 1.001-3.858) and consuming soft drinks frequently (OR 2.363, 95% CI: 1.137-4.910) were the two most important predictors of weight gain. The likelihood of developing psychological stress was increased by consuming more food (OR 2.592, 95% CI; 1.268-5.298), eating few vegetables (OR 3.154, 95% CI: 1.203-8.269), and insufficient exercising (OR 2.211, 95% CI: 1.063-4.600). Conclusion Long quarantines and physical inactivity raise the risk of weight gain and stress, both of which have detrimental effects on general health.