Nausea and Vomiting of Pregnancy in Saudi Females: A Cross-Sectional Study.

Background: Nausea and vomiting of pregnancy (NVP) is a frequently reported medical condition during pregnancy. However, no studies have evaluated its impact on women's ability to perform acts of daily living in the Saudi population. Hence, this study aimed to explore the impact of NVP on the day-to-day functions of pregnant women in Saudi Arabia. Methods: This cross-sectional online survey study was conducted between March 18, 2019, and April 17, 2019. Pregnant females and new mothers were asked to complete an anonymous online questionnaire. Results: A total of 591 women with NVP participated in the study. Pregnant women at the time of the survey were 233 (39.4 %), and 358 (60.6 %) were new mothers who had a child under the age of 1 year. Most participants, 556 (94.1 %), reported experiencing NVP symptoms at some time during their pregnancies. NVP symptoms were most predominant during the first trimester, as experienced by 420 (75.5 %) women. NVP severely affected daily activities in 45.4 % of participants. About 58 % of the women reported that they might never consider getting pregnant again because of NVP. Conclusions: Our study found that most Saudi women suffered from NVP during their pregnancies. Additionally, NVP impacts women's daily-life functioning and their desire to become pregnant again. This warrants further studies to explore NVP socioeconomical impact on Saudi women.

Impact of vitamin B6 deficiency on the severity of diabetic peripheral neuropathy - A cross sectional study.

Background: Diabetic Peripheral Neuropathy is one of the most important and significantly prevalent microvascular complications of Diabetes Mellitus. Pyridoxine is a key nutrient for protecting nerve health. The objective of this research is to study the prevalence rate of pyridoxine deficiency in Diabetic neuropathy patients, to understand the correlation between various biochemical and markers of diabetic neuropathy and pyridoxine deficiency. Results: 249 patients were selected for the study based on the selection criteria participants. 51.8% prevalence of pyridoxine deficiency in Diabetic neuropathy patients. The nerve conduction velocity significantly reduced in pyridoxine deficiency cases (p < 0.05). A strong inverse relationship is observed with fasting blood sugar levels and glycated hemoglobin pyridoxine deficiency might contribute to impaired glucose tolerance. Conclusion: There also exists a strong inverse relationship with glycemic markers. Significant direct correlation is observed with nerve conduction velocity. Pyridoxine also has properties of antioxidant which may be utilized for the management of Diabetic Neuropathy.

Comparison of medical documentation between pharmacist-led anticoagulation clinics and physician-led anticoagulation clinics: A retrospective study.

Background and objectives: High-quality documentation is critical in medical settings for providing safe patient care. This study was done with the objective of assessing the standard of medical records in anticoagulation clinics and investigating the distinctions between notes written by pharmacists and physicians. Methods: A retrospective cross-sectional analysis of data from electronic health records (EHRs) was performed on patients who received anticoagulation and were observed at anticoagulation clinics from October to December 2020. Patients were monitored in two anticoagulation clinics, one administered by pharmacists and the other by physicians. The quality of the documentation was assessed using a score, and the note was assigned one of five categories according to its score: very good, good, average, poor, and very poor. The data was analyzed using Stata/SE 13.1. P value<0.05 was considered significant in all analytical tests. Results: A total of 331 patients were included. While 160 patients (48.3%) were followed by the physician-led clinic, 171 (51.6%) were by the pharmacist-led clinic. The average age of the patients was 54 ± 15. 60.73% of them were female, and 90.3% of them were Saudi nationals. Warfarin was the most widely used anticoagulant (70%), followed by rivaroxaban (15.7%). Compared to physicians, pharmacists demonstrated very strong documentation (54% vs. 18%). The examination of the variables considered in the study revealed that physicians had significantly less drug-drug interaction documentation (17 vs. 71 times) or drug-food interaction documentation (23 vs. 71 times) than pharmacists. In terms of follow-up frequency, pharmacists were found to adhere to the clinic protocol (150 times) more frequently than physicians (104 times). However, there was no significant difference in therapeutic plan documentation between the two groups. (p = 0.416). Conclusion: Pharmacists were more comprehensive in their documentation than physicians in anticoagulation clinics. Unified clinic documentation can ensure consistent documentation within EHRs across all disciplines.

Impact of COVID-19 related movement restrictions on the follow-up care visits of adults with chronic conditions: A Saudi arabian survey study.

Aims: Lockdown measures implemented during the initial phase of the pandemic resulted in the delay and disruption of healthcare utilization for individuals with chronic conditions. We aimed to evaluate the impact of COVID-19 movement restrictions on the follow-up care visits of individuals with chronic illnesses. We also assessed the possible reasons patients missed their follow-ups and the potential barriers impeding follow-up during the pandemic. Methods: A total of 397 adults with pre-existing medical conditions participated in an online cross-sectional survey from October to December 2022. The study sample comprised 57 % females and 43 % males, with a mean age of 43 years. A 36-item online self-report survey was used for data collection.Results: Fifty-five percent of participants reported missing their follow-up during COVID-19 pandemic, and 14 % made emergency department visits due to their missed follow-up appointments. In addition, 24 % experienced complications due to their missed appointments. The mean score on the fear of COVID-19 scale was 17.8 ± 6.5 (SD). For the majority of participants (60 %), pandemic-related restrictions were the predominant barrier to their follow-up visits. Additionally, we found that as individuals' COVID-19 fear scores increased, the likelihood of missing a follow-up care visit also increased (AOR: 1.067; p-value = 0.001). However, participants who did not perceive COVID-19 pandemic-related restrictions as a barrier were less likely to miss their follow-up visits (AOR: 0.581; p-value = 0.031). Furthermore, those who understood the significance of follow-up care were less likely to miss any of their follow-up visits (AOR: 0.224; p-value < 0.001) than those who had limited understanding of its importance. Conclusion: The results showed that pandemic-related movement restrictions negatively affected attendance at follow-up visits for people with pre-existing health conditions. Initiatives should therefore be undertaken during global public health emergencies to provide medical and psychological support to vulnerable and high-risk groups.

Assessment of Caspofungin use at a Tertiary Teaching Hospital and compliance with IDSA guidelines and FDA labelings.

Objective: The aim of this study is to evaluate the utilization pattern of Caspofungin in an academic tertiary care hospital in Riyadh, Saudi Arabia. Methods: This is a retrospective study, conducted at King Saud University Medical City, Riyadh, Saudi Arabia. Adult patients who received Caspofungin from January 2015 to December 2018 were included. The appropriate use of Caspofungin was evaluated according to the international guidelines and approved recommendations. Caspofungin doses were assessed according to the FDA-approved loading and maintenance doses as well as dose-adjustment per hepatic function for cirrhotic patients and drug-drug interactions. Cultures and laboratory tests were used to evaluate the appropriate duration of Caspofungin therapy. Results: 388 patients were included. Caspofungin was inappropriately used in 253 (64%) patients. This included 78 (20%) due to inappropriate indication, 165 (42%) due to wrong dosage, and 10 (2%) patients who had a wrong duration of therapy. Conclusion: The rate of inappropriate use of Caspofungin was high. Hence, developing antifungal stewardship and drug restriction program is highly recommended.

The use of enoxaparin as venous thromboembolism prophylaxis in bariatric surgery: A retrospective cohort study.

Introduction: Venous thromboembolism (VTE) is one of the major causes of morbidity and mortality in bariatric patients. The use of low-molecular-weight heparin (LMWH), as enoxaparin, is considered one of the mainstays thromboprophylaxis regimens in postoperative bariatric patients. Despite the universal agreement on the importance of thromboprophylaxis in these patients, there are inadequate strong recommendations for its dosing and duration. The aim of our study is to explore the current practice on using enoxaparin in bariatric patients, as well as to assess both the efficacy and safety of varying dosing regimens. Material and methods: This is a retrospective cohort study of morbidly obese patients who underwent bariatric procedure at a tertiary care hospital between 2016 and 2019. All adult patients who met the eligibility criteria for bariatric surgery and received enoxaparin with a minimum follow-up period of one month were included in our study. Participants with a history of coagulopathy, renal or hepatic insufficiency were excluded from the study. Data collected include patient demographics, VTE risk factors, and co-morbidities. The outcome of treatment failure was defined as the composite of either VTE or major bleeding. Results: A total of 1,169 patients who underwent bariatric surgery were included in the study. The mean age was 35.54 years, with mean body mass index (BMI) of 45.78 kg/m2. The mean duration of enoxaparin use was 9 days, and the majority of patients (78%) received a prophylaxis dose of 40 mg subcutaneously (SC) once daily. The overall rate of VTE at 90 days was 1.4% while only 0.1% of patients developed major bleeding. There was no statistically significant difference in patients' age, gender, BMI, or various enoxaparin dosing regimens between patients who developed VTE or bleeding versus patients who did not develop. Patient's weight was the only statistically significant risk factor that directly correlated to higher risk of complications (P = 0.006). In the multivariable logistic regression model, higher BMI was significantly associated with treatment failure, either VTE or major bleeding [OR 1.05 (95% CI 1.0-1.09); P = 0.038]. Conclusions: The rate of VTE or major bleeding did not differ in patients who received various enoxaparin regimens. Patients undergoing bariatric surgery may benefit from enoxaparin thromboprophylaxis dose of 40 mg SC daily for a total duration of 14 days, with higher doses may be needed for extremely obese patients. We recommend standardizing the current practice of VTE prophylaxis post bariatric surgery and unifying the optimal dose and duration.

Characteristics of the ideal clinical pharmacy residency candidate: A survey of residency program directors and preceptors in Saudi Arabia.

OBJECTIVE: Residency positions are highly competitive. Pharmacy students who are familiar with the ideal qualities of residency candidates and the expectations of residency programs may be more likely to obtain one of these coveted positions. This study identifies the characteristics that residency program directors (RPDs) and preceptors use to define an ideal residency candidate. METHODS: This is a cross-sectional, descriptive study that surveyed pharmacy RPDs and preceptors across the Kingdom of Saudi Arabia. The questionnaires are comprised of two sections: demographic information and characteristics of the residency candidates. Over a five-month period (May 1, 2020 - September 30, 2020), the survey was sent electronically to the participants. RESULTS: Of the 78 surveys returned, 68 surveys were included (RPDs: 36, Preceptors: 32) and 12 surveys (15.17%) were excluded due to incompleteness. Number of RPDs responded to the survey represents (65%) of the total RPDs in Saudi Arabia. The mean response scores from the results of the Likert scale [strongly agree (1) - strongly disagree (5)] - suggest that a candidate's performance during the interview (mean score = 1.5), their professional appearance (1.5), an alignment between a candidate's interests and the program focus (1.6), and previous hospital experience (1.8) mattered most. While being from the same region (3.4), having an advanced degree (2.8) and the cumulative Grade Point Average (2.7) mattered the least. We find that previous hospital experience (29%), familiarity with the program (16%), research experience (15%), Saudi Commission for Health Specialists aggregate score (10%), and letters of recommendation (4%) are considered the top five factors. CONCLUSION: Residency candidates should focus on training in clinical settings. Offering mock interviews and Saudi Pharmacist Licensure Examination practice tests and involving pharmacy students in clinical research may increase their chance in securing a residency position.

Aspirin Use among Saudi Adults: The Prevalence and Users' Characteristics.

Introduction: Despite the public routine use of aspirin as cardio-prophylaxis agent, its use is only recommended in particular situations, and not as usual primary prevention. Only few local studies investigate the use of aspirin in patients with certain diseases, but not within the public population. The purpose of this study was to evaluate the prevalence of aspirin use and identify the demographic and clinical characteristics among Saudi users. Methodology: A cross-sectional study targeting Saudi adults in Saudi Arabia was conducted over a period of four months in 2021 using online Google forms. The study collected data to assess the prevalence of use, use of aspirin according to prevention type, users' characteristics and comorbidities. Additionally, a self-assessment of knowledge, perception, reasons and attitude towards aspirin use among Saudi adults was conducted. A chi-square test was used to determine the association between the variables. A P-value ≤ 0.05 was considered statistically significant. Results: The prevalence of aspirin use was 47%. Regarding the self-assessed aspirin knowledge, the majority of the respondents (n = 481; 62.4 %) found to have good knowledge. Less than half of the participants (n = 341; 44%) use aspirin as primary prevention agent while only 23 participants (2.9%) use aspirin as secondary prevention agent. There was a significant difference between gender and user type (p = 0.001). With regards to comorbidities, hypertension, hyperlipidemia, diabetes, and obesity were common among the primary users of aspirin. Significant associations were found (p = 0.001) between participant's user type and the following characteristics such as smoking status, past medical history, presence of comorbidities. Conclusion: Aspirin use is commonly prevalent Saudi population with good level of knowledge of the therapy; however, its popular use as primary preventive agent for CVD may necessitate medical advice based on the level of cardiovascular risk.

Regulating antimicrobial sales in Saudi Arabia: Achievements and challenges.

BACKGROUND: Antimicrobials save millions of lives annually from dying because of bacterial infections, but the rapid emergence of antimicrobial resistance (AMR) becomes a global threat. The Saudi Ministry of Health (MOH) has taken containment measures to limit the misuse of antimicrobials via implementing restrictions on dispensing without prescriptions. Hence, we aim to evaluate the impact of regulating antimicrobial sales and identify challenges that pharmacists are facing to prevent self-medication with antimicrobial agents. MATERIALS AND METHODS: A cross-sectional study was conducted using two sources of data: sales reports from 3000 pharmacies in Saudi Arabia and a self-designed questionnaire. The questionnaire consists of 24 items written in English and Arabic languages, went through multiple steps to ensure validity and reliability and then distributed online. Descriptive analyses were used to present the results. RESULTS: A total of 106 pharmacists completed the questionnaire. Sixty-three per cent of the respondents observed a reduction of 40% in sales, which was consistent with pharmacies' sales reports, which revealed a 50% reduction in 2018 as compared to 2017. Seventy-six per cent of respondents agreed that antimicrobials' sales restrictions were frustrating to patients. The percentage of pharmacists who reported receiving prescriptions with complete information about patients, prescribers, medications and issue date was 70%, 54%, 86% and 77%, respectively. And 69% of respondents revealed receiving support from their employers to prevent dispensing antimicrobial agents without prescription. CONCLUSION: Restriction measures implemented by the Saudi MOH led to a 40% to 50% reduction in inappropriate sales of antimicrobials. Further studies are needed to investigate the methods for improving documentation and prescribing practices.

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia.

AIMS: Potentially inappropriate psychotropic medications (PIPMs) prescribed to older adults with psychiatric disorders can inadvertently affect their health. The use of standards and guidelines can ensure prudent prescribing and minimize the risk of morbidities. This study assessed the pattern and prevalence of prescription of PIPMs to older individuals in outpatient psychiatric settings in Saudi Arabia, using the updated 2015 Beers criteria, as well as the probability of polypharmacy. METHODS: The study was conducted in the outpatient psychiatric clinics of the only psychiatric hospital in Jazan region of Saudi Arabia. A retrospective cross-sectional review of electronic medical records was undertaken during 2018 to assess PIPM use and psychotropic polypharmacy. Descriptive statistics were generated and associations between PIPM use and baseline characteristics were assessed using multivariable logistic regression. RESULTS: Overall, 68% of 1300 older adults received PIPMs, and 77.7% were on psychotropic polypharmacy. Amitriptyline, chlorpromazine, and trifluoperazine were extensively prescribed. Paroxetine (1.2%) and benzodiazepines were prescribed to a smaller proportion of the patients. Elderly with schizophrenia (AOR = 0.046, p < 0.001) and anxiety (AOR = 0.530, p = 0.036) were significantly less likely to have PIPMs than those with dementia. Likewise, elderly with depression and anxiety were less likely to have psychotropic polypharmacy as compared to those with dementia. CONCLUSION: A substantial number of the elderly received PIPMs possibly based on implicit criteria. It is therefore important to provide mental health care providers in the region with educational programs to increase their awareness of PIPMs.

Pharmacists' satisfaction with their involvement in the management of COVID-19 patients in Saudi Arabia.

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) is a public health emergency and during this unprecedented situation, health care providers across the globe are at the frontline in the fight against this disease. Countries that have been severely hit by the pandemic are using pharmacists to help triage patients. In order to ensure the continuity of these services, it is of paramount importance that pharmacists be formally involved and engaged in the management of this pandemic. In response to the underlying knowledge deficit, this study was undertaken as the first of its kind in the entirety of Saudi Arabia. METHODS: This study is a questionnaire based cross-sectional study that was carried out for a period of five months from March 2020 to July 2020 to assess the role of working pharmacists in the management of the COVID-19 pandemic under different health care settings across Saudi Arabia. RESULTS: A total of 398 responses were recorded, in which 51.1% of the respondents were not involved in any learning or awareness activities involving health care providers (HCPs) or patients. The majority of respondents (62.9%) were not involved in creating or evaluating therapeutic plans for COVID19 patients, and 55% were not involved in therapeutic mentoring of COVID19 patients. Only a very low percentage of respondents were participating in COVID19-related research within their institution. Only 37% of respondents reported being satisfied with their role and contribution in the management of COVID-19. CONCLUSION: The present study reveals that pharmacists are underutilized in the management of COVID-19 patients in Saudi Arabia. As such, the findings emphasize the importance of enhancing the role and contribution of pharmacists in patient care management across all hospitals and especially under health care crisis conditions. The establishment of a crisis standard of care guideline for all HCPs, including pharmacists, would help in improving patient overall care under crisis conditions like the present COVID-19 pandemic.

Evaluation of a community pharmacy-based medication therapy management programme: A study protocol of a pilot randomized controlled trial with an embedded qualitative study.

OBJECTIVES: The main objectives are: to evaluate the feasibility and effectiveness of a community-pharmacy based medication therapy management programme; to explore patients' experiences and views towards medication therapy management service delivered by community pharmacists. RESEARCH DESIGN AND METHODS: A mixed-methods research design consisting of a pilot randomized controlled trial embedded with qualitative study will be used in this study. The study consists of two phases: a 6-month follow-up pilot randomized control trial (quantitative approach) to assess the feasibility and effectiveness of a community pharmacy-based medication therapy management programme. The primary outcome is HbA1C and secondary outcomes include: clinical and health services utilization and process measures, medication adherence, diabetes distress as well as satisfaction with care. Phase two consists of an embedded qualitative study using semi-structured interviews to explore patients' experiences and views with the medication therapy management programme. Study data collection will be collected between April 2021 and December 2021. ETHICS CONSIDERATION: The study has been approved by institutional review boards from Princess Nourah bent Abdulrahman University (Approval # 20-0240), King Fahad Medical City (Approval # 20-388E) and Birmingham University (Approval # ERN_20-0768).

Use of an objective structured clinical examination (OSCE) to assess intern performance in an advanced pharmacy practice experiences (APPE) Ambulatory Care rotation.

PURPOSE: Intern assessment during advanced pharmacy practice experiences (APPEs) are generally based upon each individual preceptor's perceptions without an objective measurement of intern understanding and performance. Therefore, we sought to determine whether a pre- and post-OSCE could be used to confirm that interns achieved the goals and objectives of the Ambulatory Care rotation. The aims of this study were to determine whether a pre-rotation OSCE can help pharmacy interns self-assess their clinical strengths and weaknesses and assess whether their knowledge and skills improved after completing a post-rotation OSCE. METHODS: Pharmacy interns undergoing APPE Ambulatory Care rotations from September 2018 to March 2020 participated in a pre- and post-rotation OSCE to assess their knowledge of various chronic disease states. Interns completed pre- and post-OSCE surveys to assess their perceptions about their knowledge and the OSCE experience. RESULTS: Pharmacy intern knowledge about diabetes, hypertension, dyslipidemia, and atrial fibrillation significantly improved post-OSCE compared to their pre-OSCE scores (p < 0.001). The mean post-OSCE scores for diabetes (p < 0.001), dyslipidemia (P = 0.046), anticoagulation (P = 0.006), and the overall mean post-OSCE scores (P = 0.005) were significantly higher compared to interns' pre-OSCE scores. Students believed that the post-OSCE significantly highlighted their strengths and weaknesses in skills and knowledge compared to the pre-OSCE (P = 0.008). CONCLUSION: Pre- and post-APPE OSCE assessments are important tools that can provide interns and preceptors with objective evaluations of student performance. OSCEs can either be used as an alternative to perception-based assessments or integrated into existing preceptor evaluations. Furthermore, OSCEs can help preceptors identify areas that require more emphasis in their rotations.

Aspirin prescribing pattern and guidelines-adherence evaluation for primary prevention of cardiovascular diseases at a teaching hospital.

The present study investigates the aspirin prescribing pattern and guidelines-adherence evaluation for primary prevention of cardiovascular diseases at a teaching hospital. A total of 816 patients were included in the study, the patients who received aspirin aged 60-69 (29.65%), followed by patients aged 50-59 years old (29.53%) and 70-79 years old (22.91%). Demographic information shown that the majority of the patients were males (58.55%). The BMI revealed that 85.78% of patients were obese. The majority of the patients have diabetes 78.67%, hypertension 74.38%, and dyslipidemia 65.68%. The mean systolic blood pressure was 136 ± 7.4 and diastolic blood pressure was 74.9 ± 5.2. After applying aspirin candidacy calculation, only 6% patients were highly recommended to be on aspirin, 49% patients had reasonable recommendation of aspirin, 27% patients use aspirin based on "may be considered" recommendation, and 23% patients were on aspirin with no indication or recommendation. The study highlights the importance of following the international recommendations in aspirin prescribing, and flags the inappropriate use and prescribing by our healthcare providers. The current study encourages further investigation to be carried out which should include patient and clinician education, to well understand and alleviate the inequalities in aspirin use and adherence. Further studies are also warranted to understand of the prescribing pattern and to provide solutions to avoid aspirin associated complications.

The influence of demographics on influenza vaccine awareness and hesitancy among adults visiting educational hospital in Saudi Arabia.

OBJECTIVE: To understand the influence of demographics and education levels on awareness levels, and on the prevalence of hesitancy to receive the influenza vaccine among adult patients at King Saud University Medical City (KSUMC). METHOD: A crosssectional study in the outpatient pharmacy area at KSUMC was conducted. Data was collected from January 1 to January 31, 2020. A total of 318 random adult patients were encountered and a predesigned survey was administered. After capturing demographic information, respondents were categorized into 3 groups: group A consisted of respondents who had never heard of the influenza vaccine; group B was comprised of respondents who answered that they had never received the influenza vaccine; and group C included respondents who answered that they had received at least one influenza vaccine. RESULTS: Out of the 317 survey respondents, 36 (11%) had never heard of the influenza vaccine (Group A). Of the remaining 281 (89%), 122 (39%) had not received the vaccine (Group B), whereas 159 (50%) had received it (Group C). Chi-square test results indicated a significant association between age group and awareness of the vaccine (p = .023). Moreover, there was a significant association between education level and awareness of the vaccine (p = .002). The prevalence of vaccination hesitancy was 42%. Chi-square test results indicated a significant association between gender and vaccination hesitancy (p < .001), and between education level and vaccination hesitancy (p = .011). CONCLUSION: Influenza vaccination hesitancy is prevalent among the study's population. Further efforts by health care providers and public health services may be necessary to educate the community regarding the influenza vaccine's safety and efficacy.

Impact of clinical pharmacist-led diabetes management clinic on health outcomes at an academic hospital in Riyadh, Saudi Arabia: A prospective cohort study.

BACKGROUND: Diabetes prevalence is estimated to reach 20.6% by 2030. Studies have illustrated main reasons for uncontrolled patients and concluded: low level of awareness, limited access to healthcare providers, and lack of cooperation between different disciplines. The role of pharmacists has been proven to improve patient-related outcomes, including an improvement in HgA1C readings between 0.54% and 1.6%. OBJECTIVES: This study was conducted to evaluate diabetes-related health outcomes in a pharmacist-led diabetes clinic in terms of HgbA1C level, guideline-recommended routine screenings, medication adherence, and biomarkers of other comorbidities. METHOD: A prospective cohort study conducted from August 2017 until July 2018 at an academic hospital. The pharmacist-led diabetes clinic was providing the service for a half-day per week. The study included all adult diabetic patients referred to the pharmacist-led clinic and had -at least- three 3-month apart follow-up visits with no exclusions. The baseline assessments for patients receiving routine diabetic care was performed using HgbA1C level, blood pressure, lipid and thyroid panel, eye and foot examinations, preventive measures, and adherence. The baseline results were compared to the follow-up results thereafter. A descriptive analysis was used to report the differences between intervals. Main outcome measure: (a) Reduction in HgbA1c levels, (b) intervention made by clinical pharmacists in an outpatient setting. RESULT: The study included thirty-five patients. The mean ± SD age was 56 ± 10 years old. At baseline, mean HgbA1C was 9.5% ± 1.3%. HgbA1C was ≥10% for 13 patients. Albuminuria was never previously assessed for 14 patients. Twenty percent were receiving incorrect dose compared to the guideline-recommended statin therapy. By the end of study, mean HgbA1C had significantly improved to be 8.3% ± 1.4% (p = 0.0004). Nine patients achieved their HgbA1C goal of <7%. All patients were assessed for albuminuria, and managed accordingly. Thirty-two patients were eligible to receive statin therapy, and prescribed appropriate doses. Additionally, peripheral neuropathy was assessed for all cohort, and seven patients received recommended vaccinations. CONCLUSION: Involving clinical pharmacists in diabetes management clinic can provide valuable services, help patients to adhere to the therapeutic plans, and assist physicians to achieve better treatment outcomes.

Pharmacy students attitude and perception toward working in community pharmacy in Saudi Arabia.

OBJECTIVE: The objective of this study is to determine the level of attitude and perception of Saudi pharmacy students toward working in community pharmacies after graduation and to assess cultural, educational, and job related barriers and limitations that interfere with students and community pharmacy as a favorable workplace. METHODS: A cross sectional questionnaire, was mailed to a random sample of 600 pharmacy students. It included questions on students' future careers, ideal environment and barriers that might face them in community pharmacy. RESULTS: Four hundreds and twelve (412) completed the survey (response rate was 69%). Mean age was 23 years and 51.2% of respondents were female. Our results revealed low responses toward how interested they are to work in community pharmacy. The study response showed that improvement in salary and money incomes (46%) and culture and society issue (45%) are the two main barrier to make the career in community pharmacy more attractive. CONCLUSIONS: Saudi pharmacy students had a negative attitudes and insufficient knowledge about community pharmacy. Pharmacy school would have an important role to fill the knowledge gap and prepare the student to work in the community pharmacy. In order to successfully "Saudization" the community pharmacy setting, efforts should be made to overcome their perceived barriers.

Pharmacy students' satisfaction with Introductory Pharmacy Practice Experiences (IPPE) at community pharmacy: The case of Saudi Arabia.

OBJECTIVE: To assess pharmacy students' satisfaction with introductory pharmacy practice experiences (IPPE) at community pharmacy and the impact of the training on their future career. METHODS: A self-administered questionnaire was made available to 74 male pharmacy students who completed 4 weeks community pharmacy IPPE. The questionnaire consists of 24 questions that were organized into 5 domains with a scale of six options were used to answer each question. RESULTS: A total of 43 students completed the survey (58%). Most of them evaluated their training experience as either as good (41.86%) or excellent (41.86%). One third of students (34.88%) were very satisfied about the clarity of the community pharmacy IPPE goals and objectives given prior to the training period. About half of students (51.6%) received a good direction and feedback from their preceptors. Regarding the contact with the patient or guardian, (39.53%) of the students chose neutral while (25.58%) of the students were very satisfied. The learning environment was satisfactory for (32.56%) of students. Regarding skills domain, students strongly agreed that their skills were improved; Communication skills as reported by (48.84%) of students, documentation skills as reported by (34.88%) of students, and clinical skills as reported by (34.88%) of students. CONCLUSION: Surveyed male students were in general satisfied with their training experience at community pharmacy. Providing an orientation to the community pharmacy preceptors and granted electronic access of necessary information to the students might increase their satisfaction.

Prevalence and severity of dyspepsia in Saudi Arabia: A survey-based study.

BACKGROUND AND AIM: Dyspepsia is one of the gastrointestinal diseases that is very common worldwide. Despite its prevalence globally, which ranges between 1.8% and 57%, no study has assessed the prevalence in Saudi Arabia. This study was aimed to investigate the prevalence and severity of dyspepsia in the general population of Saudi Arabia. METHODS: A modified Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was utilized to conduct our study. The questionnaire score ranges between 0 and 32, where zero indicated no dyspepsia, a score of 1-8 indicated mild dyspepsia, a score of 9-15 indicated moderate dyspepsia and a score of higher than 15 represented severe dyspepsia. Socio-demographic data of the participants including age, gender, marital status, BMI, job description, insurance, and education level were collected. Using Statistical Package for Social Sciences version 21.0 (SPSS), a univariate analysis was performed to assess the association of participants characteristics with the prevalence of dyspepsia, whereas logistic regression analysis was used to correlate their characteristics with the severity of dyspepsia. RESULTS: During a period of one month, March 1st to 31st 2019, a total of 778 participants have completed the survey. Most of them were females accounting for 68% of the population, married (63.9%), middle aged (range 34-51 years old) and literate with high school education (72.3%). Ninety two percent (92%) of the study population were found to experience dyspepsia. However, there is no significant association between socio-demographic characteristics and dyspepsia or its severity as well. CONCLUSION: The prevalence of dyspepsia in Saudi Arabia is the highest in the gulf region which would potentially lead to more GI complications, and associate to poor health and economic outcomes. Education programs are essential to raise the people awareness of dyspepsia and the appropriate ways to prevent it.

Adherence to prophylactic dual antiplatelet therapy in patients with acute coronary syndrome - A study conducted at a Saudi university hospital.

OBJECTIVES: The aim of this study was to evaluate patients' self-reported adherence to dual antiplatelet therapy (DAPT) and determine the factors associated with premature discontinuation of DAPT. METHODS: The cross-sectional interview-based study was conducted among adult outpatients who visited the outpatient department of King Khalid University Hospital, Cardiac Center in Riyadh, Saudi Arabia, over a period of 3 months from May to July of 2016. Medication adherence was assessed using the Self-efficacy for Appropriate Medication Use Scale (SEAMS), which is composed of 13 items with a 3-point Likert scale. RESULTS: A total of 192 patients participated in the study. The majority of the participants were male (82.1%), and the mean age was 55.66 ± 10.80 years. More than 84% (84.4%) of the patients reported that they were "confident" in taking several medications each day. The minimum and maximum SEAMS scores were 22 and 39, respectively, with the mean score being 30.8 ± 3.5. Almost all patients had moderate scores and adherence; only one patient got a score of 39. Among sociodemographic characteristics, only health insurance and income were significantly associated with the medication adherence score (p < 0.05). CONCLUSIONS: Study results concluded that patients had a moderate level of adherence towards DAPT in Saudi Arabia, however Patient education on DAPT is essential to improve adherence to medication treatment. More effective intentions and education methods should be developed to improve long-term DAPT adherence.