A prospective observational study to evaluate the safety of COVID-19 mRNA vaccines administered to Qatar Rehabilitation Institute patients.

BACKGROUND: The safety of the COVID-19 mRNA vaccine in the outpatient setting has been extensively studied; however, there need to be more reports that specifically assess their safety in the inpatient population. It is hence imperative to explore the adverse drug reaction (ADR) profile in this population and monitor the progression of these ADRs in a hospital setting. This provides a unique opportunity to closely observe patients to ensure no side effects go undiagnosed. This study aims to explore and quantify the incidence and severity of ADRs in patients who have received the COVID-19 vaccine during their stay in the rehabilitation facility. METHODS: This is a prospective observational study, which included adult patients admitted to the rehabilitation facility who were deemed eligible to receive the COVID-19 vaccine during their hospital stay. Data were collected by the investigators from June 2021 to May 2022 at 24 hours, 48 hours, and 7 days post-vaccination. A piloted data collection tool was utilized. RESULTS: Thirty-five patients met the inclusion criteria. Pain at the injection site was the most commonly reported local ADR, while headache was the most frequent systemic ADR. The majority of the reported ADRs were mild to moderate in nature, with only one severe reaction detected. Although no statistical significance was noted among the variables, common patterns were identified, such as a higher occurrence of fever at 24 hours after the second dose as opposed to the first dose. Close monitoring of the included study subjects did not reveal any unanticipated ADRs or an increase in ADRs susceptibility and severity compared to the general population. CONCLUSION: This study supports the initiation of vaccination campaigns in inpatient rehabilitation settings. This approach would offer the advantage of gaining full immunity and reducing the risk of contracting COVID-19 infection and complications once discharged.

Knowledge and attitude regarding coronavirus disease 2019 (COVID-19) among hospital pharmacists in Qatar

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gained global attention because of its high transmissibility and the devastating impact on both clinical and economic outcomes. Pharmacists are among the front-line healthcare workers who contributed widely to COVID-19 pandemic control. We aim to evaluate knowledge and attitude of hospital pharmacists in Qatar about COVID-19. Methods: A descriptive cross-sectional web-based survey was distributed over a 2-months period. The study included pharmacists who are working in 10 different hospitals under Hamad Medical Corporation (HMC). The survey was developed based on information available at World Health Organization (WHO) website, Qatar Ministry of Health, and COVID-19 guideline created by HMC. The study was approved by HMC’s institutional review board (MRC-01-20-1009). Data analysis was done using SPSS version 22. Results: A total of 187 pharmacists were included (response rate 33%). The overall level of knowledge was not affected by the participants’ demographics (p-value ≥0.05). Pharmacists provided more correct answers to questions related to general knowledge about COVID-19 compared to questions specificto treatment aspects of the disease. More than 50% of pharmacists were using national resources as main source of information related to COVID-19. Good health practices and attitudes regarding disease control was reported by pharmacists, including preventive measures implementation and self-isolation when needed. Around 80% of pharmacists are in favor of taking influenza vaccine and COVID-19 vaccine. (AU)

Knowledge and attitude regarding coronavirus disease 2019 (COVID-19) among hospital pharmacists in Qatar.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gained global attention because of its high transmissibility and the devastating impact on both clinical and economic outcomes. Pharmacists are among the front-line healthcare workers who contributed widely to COVID-19 pandemic control. We aim to evaluate knowledge and attitude of hospital pharmacists in Qatar about COVID-19. Methods: A descriptive cross-sectional web-based survey was distributed over a 2-months period. The study included pharmacists who are working in 10 different hospitals under Hamad Medical Corporation (HMC). The survey was developed based on information available at World Health Organization (WHO) website, Qatar Ministry of Health, and COVID-19 guideline created by HMC. The study was approved by HMC's institutional review board (MRC-01-20-1009). Data analysis was done using SPSS version 22. Results: A total of 187 pharmacists were included (response rate 33%). The overall level of knowledge was not affected by the participants' demographics (p-value ≥0.05). Pharmacists provided more correct answers to questions related to general knowledge about COVID-19 compared to questions specificto treatment aspects of the disease. More than 50% of pharmacists were using national resources as main source of information related to COVID-19. Good health practices and attitudes regarding disease control was reported by pharmacists, including preventive measures implementation and self-isolation when needed. Around 80% of pharmacists are in favor of taking influenza vaccine and COVID-19 vaccine. Conclusion: Overall, hospital pharmacists' knowledge about COVID-19 is good in relation to the disease nature and transmission. Knowledge about treatment aspects including medications needs further enhancement. Providing continuing professional development activities regarding latest information about COVID-19 and its management, and serial newsletters updates, and encouraging journal club activities for recently published research can help improve hospital pharmacist knowledge.

A possible increase in liver enzymes due to amlodipine: A case report.

Amlodipine is a commonly prescribed antihypertensive drug, well tolerated and has rarely been attributed as a cause for elevated liver enzymes. Here, we present a 47-year-old male patient known to be hypertensive and admitted to our rehabilitation facility after an acute stroke. During his stay, amlodipine was started in addition to other antihypertensive medications to control his blood pressure. His liver transaminases after 4 days (notably alanine aminotransferase) were found to be markedly elevated. After reviewing the medications and investigating probable causes, amlodipine was suspended. After 5 days of suspending amlodipine, the transaminases started to trend downward. The Naranjo Adverse Drug Reaction Probability Scale and the Roussel Uclaf Causality Assessment Method were performed to assess causality in this suspected idiosyncratic drug-induced liver injury case. Both the scores denoted a probable amlodipine-induced liver injury. Previous case reports related to amlodipine-induced liver injury are mentioned and presented in the table below. In conclusion, amlodipine, though not well known to be hepatotoxic, can induce liver enzyme elevations in an idiosyncratic manner.

Prescribing Pattern of Proton Pump Inhibitors in Qatar Rehabilitation Institute: A Retrospective Study.

OBJECTIVE: Proton pump inhibitors (PPIs) are still widely used despite increasing reports of their adverse events. This drug use evaluation study was conducted to assess the prescribing pattern of PPIs for patients admitted to the Qatar Rehabilitation Institute (QRI). METHODS: An observational, retrospective, patients' chart-based study included all patients who received a PPI in QRI between April 1, 2017, and October 1, 2017. A standardized tool was prepared and reviewed by the involved clinical pharmacists to collect appropriate data for the evaluation. Statistical analysis was performed using the 25th Version of the Statistical Package of the Social Sciences (SPSS®). FINDINGS: A total of 119 patients received PPIs during the audit period, of which esomeprazole was the most frequently prescribed (34%). Majority of the patients (94%) were started on PPI without further investigations for confirming the indication, and the indication was not documented in 78% of the participants. Nonsteroidal anti-inflammatory drugs were the most commonly co-prescribed medications with PPIs (59%). Pantoprazole was co-prescribed with clopidogrel in 42% of the patients. CONCLUSION: This drug utilization study shows the need for a proper prescribing practice considering a clear indication and recommendations about the duration of therapy and the need for reassessment in QRI.

A case of probable oxybutynin-induced increase in liver enzymes.

We describe the case of a 49-year-old male who presented to the emergency department with right-sided weakness and inability to speak. He was diagnosed with stroke and was admitted to Qatar Rehabilitation Institute after he was treated for the acute phase at Hamad General Hospital. As part of his management, he was started on oxybutynin 5 mg orally twice daily for the treatment of overactive bladder. Within a week, his liver enzymes started to increase. After a thorough medication review, oxybutynin was suspended as it was the only suspected medication to be responsible of this elevation in liver enzymes. When Naranjo Adverse Drug Reaction Probability Scale was used to assess the probability of an adverse drug reaction (ADR), a score of 6 was obtained indicating a "Probable" ADR. In conclusion, this is the first published report of oxybutynin-induced elevation in liver enzymes. Further reports are required to highlight this probable ADR and alert all health professionals about it.