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.

Emergency Physicians' Knowledge, Attitudes, and Practices Related to Psychiatric Emergencies in Makkah's General Hospitals in Saudi Arabia: A Cross-Sectional Study.

Purpose: This study aims to assess the knowledge, attitudes, and practices of emergency physicians (EPs) related to psychiatric emergencies (PEs) in Makkah's general hospitals. Sample and Methods: This study was an observational cross-sectional study using an online survey distributed to 138 EPs in the emergency departments (EDs) of six public hospitals in Makkah City, Saudi Arabia, between March 15 and May 1, 2023. A convenience sample was used for data collection. The questionnaire was developed after related surveys in the literature were reviewed. Results: 59.9% of the physicians were aged 20-30 years. Most (68.8%) worked in hospitals that had psychiatric facilities. Regarding knowledge, only 30% of the emergency doctors were considered knowledgeable: the majority could identify PEs (79.7%), perform mental status examinations (71.0%), distinguish physical and mental symptoms (66.7%), and communicate with psychiatric patients (58.0%). However, only 52.9% could initiate management plans by prescribing psychiatric medication to patients. In relation to attitude, most physicians disagreed with the idea that healthcare practitioners do not need to advocate for psychiatric patients (67.4%), but many (62.3%) assumed that they do not have the responsibility to manage psychiatric patients, and they felt that conducting psychiatric evaluations in public hospitals is challenging because of the busy environment there. As regards practice, mentally ill patients (60.9%) were managed or referred by practices, and 56.5% of the EPs advised these patients upon discharge. Conclusion: The study showed that EPs have positive attitudes toward psychiatric patients, but their knowledge varied based on age, occupation levels, and years of experience. There were significant knowledge gaps, particularly regarding effective communication with psychiatric patients. Additionally, many EPs manage psychiatric patients without being aware of the psychiatric resources in their hospital. Improving medical school curricula and postgraduate training can enhance care. However, more research in this field is needed.

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.

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.