Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort.

OBJECTIVE: Hydroxychloroquine (HCQ) has been used during the coronavirus disease 2019 (COVID-19) pandemic because of its reported anti-viral activity. This study examined the association of chronic HCQ use with the incidence and complications of COVID-19. METHODS: This retrospective cohort study included adults with rheumatoid arthritis and/or systemic lupus erythematosus who visited rheumatology clinics in three tertiary hospitals in Riyadh, Saudi Arabia between January 2019 and December 2020. Patients were categorized into two groups based on HCQ use. Data were obtained from the electronic health record and by interviews with patients. The primary study objective was the incidence of COVID-19 and its complications from March 2020 to February 2021. RESULTS: Almost 11% of the study cohort was positive for COVID-19, and the incidence of COVID-19 was similar between HCQ users (11.11%) and nonusers (10.86%). Disease complication rates were similar in the study arms, and they mainly included fever, dry cough, fatigue, and breathing difficulty. CONCLUSIONS: This study revealed no significant association between chronic HCQ use and the incidence of COVID-19, and disease complications were similar in the study arms.

National Antidote of Poisoning Distribution System: New Initiatives in Saudi Arabia

Objective: To declare the national antidote of poisoning distribution system as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project, the national antidote of poisoning distribution system. The project drove the antidote of poisoning distribution guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The antidote of poisoning distribution system with a defined vision, mission and goals was initiated. The services had various advantages with clinical and economic impacts on patients and healthcare services as illustrated in the review. The extension of the project was assured by risk management elements description. Furthermore, the monitoring and controlling of the services was demonstrated. The conversion to operation project though closing project stage was revealed in the analysis. Conclusion: The national antidote of poisoning distribution system is new initiative project and is considered as a part of the management of poisoning. There are multiple locations of antidote distribution services suggested and it is highly required in the Kingdom of Saudi Arabia.

Perceptions and Knowledge of Storing Medications at Home in Al-Qassim Region, Saudi Arabia

Objective: Globally people store medications at home, which is also common among the residents of Al-Qassim Region, Saudi Arabia. They should be stored safely to prevent the accidental ingestion or unintended use. However, the method of storing medications at homes in Al-Qassim region, Kingdom of Saudi Arabia is unknown. Therefore, in this study, we aimed to explore the perception and knowledge of medications stored at Al-Qassim region, Saudi Arabia. Methodology: This is a descriptive, cross-sectional survey which was conducted through the random distribution of a pre-validated structured questionnaire with the public and private sector employees and with general population from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through the Survey Monkey system and was distributed through social media. Results: A total of 708 participants responded to this survey. Most of the responders (485 (68.10%)) were females. About half of the responders were in the age group of 18–29 years (393 (58.31%)) with a significantly dominant female population compared to males (p<0.05). Most of the responders checked or almost checked the instructions of storing medications (192 (28.24%) and 273 (40.15%), respectively) without any significant difference between education level (p>0.05). Most of the responders checked the expiry date of stored medications (496 (70.06%)). Most of the responders did not receive instructions on storage of medications from pharmacist or physician (597 (84.32%)). Most of the resources regarding storage of medications were obtained from the physician (388 (54.8%)), drug leaflet (320 (45.2%)) followed by pharmacist (318 (44.92%)) and self-learned (154 (21.75%)). Therapeutic classes of stored medication were analgesics and antipyretics (322 (41.87%)) followed by cardiovascular drugs (64 (8.32%)) and oral anti-diabetic drugs (58 (7.54%)). Conclusion: The results of this study showed that people at Al-Qassim region tend to store medication at home not just over the counter medications but also medications of chronic illnesses. They should be educated on the need of medications, safety of medications and requirements of storing medications at home. Educational activities should be conducted through all possible channels to increase the awareness and to educate people on the proper method of storing medications.

Poisoning Due to Stored Medications at Home in Al-Qassim Region, Saudi Arabia

Objective: Storing medications at home is a global practice. By storing medications in an appropriate and safe environment, we can prevent accidental poisoning. Information is scarce regarding the storage of different types of medications at homes in Al-Qassim region, Kingdom of Saudi Arabia. Therefore, in this study, we aimed to explore the cases of poisoning due to stored medications at home in Al-Qassim region. Methodology: This is a descriptive, cross-sectional survey conducted through the random distribution of a pre-validated structured questionnaire among the public and private sector employees and people from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through the Survey Monkey system and was distributed through social media. Results: A total of 708 subjects responded to the survey. Most of the responders (485 (68.10%)) were females. About half of the responders were in the age group of 18–29 years (393 (58.31%)) with females being significantly dominant than males (p<0.05). Majority of the responders stored their medications separated from households’ chemicals (524 (77.06%)). Most of the responders did not store multiple medications in the same container without any significant difference related to gender or educational level (p>0.05). The total number of poisonous cases were 41 (5.79%) without any significant difference related to gender or educational level (p>0.05). Poisoning due to medications were mostly caused due to the medications stored in refrigerator (15 (40.54%)) and bedroom (10 (27.03%)). Most of the stored medications were disposed into the trash after their expiry dates (463 (65.4%)) while 189 items remained at home (26.69%). A total of 33 different types of stored medications caused poisoning in 44 cases. Paracetamol caused 6 cases of poisoning (18.18%), followed by ibuprofen 3 (9.09%) and multivitamins 3 (9.09%). Conclusion: The results of this study revealed an alarming setting of poisoning cases due to stored medications in Al-Qassim region. Awareness campaigns and more educational sessions should be conducted through social media. By doing so, people can be educated regarding the proper storage of medications to prevent poisoning. Thus, public awareness programs stressing on the safe storage and identification of the right ways to dispose of medication are highly recommended.

Medication Storage at Home among People in Al-Qassim Region, Saudi Arabia

Objective: Storing medications at home is a global practice. By storing medications in an appropriate and safe environment, we can prevent accidental poisoning. Information is scarce regarding the storage of different types of medications at homes in Al-Qassim region, Kingdom of Saudi Arabia. Therefore, in this study, we aimed to explore the types of medications stored at homes among people residing in Al-Qassim region. Methodology: This is a descriptive, cross-sectional survey conducted through the random distribution of a pre-validated structured questionnaire among the public and private sector employees and people from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through Survey Monkey system and was distributed through social media. Results: A total of 708 subjects responded to the survey. Most of the responders were females (485 (68.10%)). About half of the responders were in the age group of 18–29 years (393 (58.31%)) with a significantly dominant female population as compared to males (p<0.05). The most frequently stored medications were related to headache (462 (65.25%)) and pain (445 (62.85%)). Most of the responders stored their medications in the refrigerator (467 (65.96%)) or in their bedroom (324 (45.76%)). A total of 633 medications were found to be stored at homes during this survey. The top 20 most frequently stored medications were paracetamol (266 (42.02%)) and ibuprofen (42 (6.64%)). Conclusion: The results of this study show an alarming situation about the methods of storing medication and types of medicines stored among the residents of Al-Qassim region. More and more campaigns and awareness programs should be conducted through different types of social media to educate the people regarding the appropriate methods of storing medications at home. Such awareness programs should stress more regarding safe methods of storage and spread awareness regarding how to identify the appropriate method of disposal to prevent harmful impact on the environment.