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 Table of Contents  
Year : 2022  |  Volume : 1  |  Issue : 3  |  Page : 87-96

The 2nd International Annual Conference of the SSCP Accepted Abstract: Clinical Pharmacy; Students Theme

Date of Web Publication30-Sep-2022

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/WKMP-0249.357711

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How to cite this article:
. The 2nd International Annual Conference of the SSCP Accepted Abstract: Clinical Pharmacy; Students Theme. Saudi J Clin Pharm 2022;1:87-96

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. The 2nd International Annual Conference of the SSCP Accepted Abstract: Clinical Pharmacy; Students Theme. Saudi J Clin Pharm [serial online] 2022 [cited 2023 Apr 2];1:87-96. Available from: http://www.sjcp.org/text.asp?2022/1/3/87/357711

  Theme 2: Clinical Pharmacy; Students Top

Dietary Habits Before and During COVID-19 Among Health-field Students at King Saud University

Ibrahim Alsultan, Sultan Alghadeer, Adeem Aljuadi, Khalid Alonazi, Abdullah M. Mubarak

Background: Many studies have concluded that healthy eating and physical activity improve one’s personal quality of life. However, as a result of the lockdown, there has been a shift in eating habits, physical activity, as well as quantity and quality. Due to noticeable effects of COVID-19 lockdown on dietary habits among population, no study assessed the influence of the lockdown on students, particularly health-field students. The aim of our study is to evaluate the changes on dietary habits and behaviors before and during COVID-19 among the health-field students at King Saudi University in Saudi Arabia.

Methods: A cross-sectional study using online questionnaire that contains demographic data and frequency of food consumption was conducted for a period of 3 months. Participants can choose the frequency of consumption of each item twice (before and during lockdown). For each food item, options for participants include never, once in a month, once in a week, 2–3/week, every day, and multiple times in a day.

Results: A total of 723 students completed the online questionnaire: 451 male students (62.4%) and 272 female students (37.6%). About 94.3% of the students aged from 18 to 25 years. Of the participants, 240 (33%) of them were an Applied Sciences student, whereas other percentages were distributed fairly between other colleges. Based on the body mass index, most of the students were normal weight (63.85%), followed by overweight (19.2%) and then underweight (10.1%), whereas obese were 6.9%. More than half of the students [430 (59.5%)] observed changes in weight during COVID-19 when compared with that before the pandemic.

Conclusion: Consumption of food increased during COVID-19 when compared with that before, such as eggs, sweetened and soft drink, tea and coffee, pasties and nuts, and order from a restaurant. In addition, a decrease of more than 10% in consumption during COVID-19 when compared with before the pandemic was observed in fruits, raw vegetables, or milk. Other diet elements were decreased by less than 10%. There is an observed change by more than 10% in daily intake of milk, tea, and coffee and order form restaurants. The percentage of participants who are unlikely to intake fish or milk increased by more than 10% during the pandemic, whereas tea and coffee recorded a decrease. Regarding the effect of COVID-19 lockdown, 60% of the participants agrees that nutritional behavior negatively affected during COVID-19; more than half of the participants disagree with the positive effect of lockdown on their nutrition during the pandemic. The majority (76.2%) have a concern about food hygiene during the pandemic. There was no significant change in the mean score in eggs by any healthcare group before and during COVID-19. Medicine students have the highest number of food elements with a significant change before and during COVID-19, whereas pharm D has the lowest number of food groups.

Evaluation of the Effect of Apixaban on INR in the Outpatient Population at KAMC: A Retrospective Study

Rafal Brashi, Emad Elkholy, Raghad Batarfi, Salma Alhadhrami, Braah Almutawakkil, Hashim Atallah

Background: Use of direct oral anticoagulants is progressing rapidly in current practice due to their numerous advantages. Unnecessary routine monitoring of coagulation is of paramount. Cohorts reported prolongation of prothrombin time and international normalized ratio (INR), especially with anti-factor X inhibitors, both in vitro and in clinical practice. It examined the elevations even if clinically insignificant, and this study focusses on elevation that may be of clinical importance. The aim of this article was to study the degree of clinically significant INR elevation in non-hospitalized patients who are managed by apixaban for atrial fibrillation.

Methods: This was a single-center, retrospective, observational analysis of adult patients who received at least 30 days of apixaban. The primary outcome was to test the association between apixaban use and clinically significant INR. Secondary endpoint outcomes were the incidence of an INR increase >0.3 from baseline INR and additional patient-specific factors that may influence INR elevation.

Results: Four hundred thirty-eight patients were screened in the study and 154 patients met the inclusion criteria. Apixaban use was found to be associated with a significant rise in INR levels from baseline, and the mean rise was 0.58 (95% confidence interval: 0.34–0.82, paired t-test t(152) = 4.812, P<0.001). Multiple linear regression showed insignificance of all other tested variables such as age, polypharmacy, use of CYP inhibitors, baseline INR, or renal function.

Conclusion: Apixaban use is associated with a significant increase in INR in non-hospitalized patients, although the clinical outcomes of this observation are still understudied. Although routine monitoring of INR for apixaban is generally unadvised, it is pivotal for practitioners to understand the magnitude of this phenomenon; more research is warranted to describe the clinical importance and guidance for those coagulation assays in daily practice.

Study on Awareness and Attitude of Saudi Population Toward Organ Donation: A Survey-based Study

Afrah Alshammari, Lama Alshammari, Khetam Albarrak, Rawabi Aldefeeri, Abeer Alradaddi, Aziz Unnisa

Background: Organ transplantation has become an essential therapy option for various disorders in the contemporary era. The most difficult aspect of transplantation is finding a compatible organ. Continuous efforts and strategic planning are essential to increase organ supply. The study’s goal was to analyze knowledge and attitudes of Saudi citizens on organ donation, as well as students at a health science college, and healthcare workers.

Methods: This cross-sectional study is a survey-based study which was conducted for 6 months and surveyed 2030 participants. The questionnaire was developed with 43 questions covering various types.

Results: This current survey found an encouraging attitude among the participants. It revealed that 51.08% (1037 participants) of the participants have shown interest to donate organ, 37.53% (762 participants) of their family members have expressed interest in donating organs after death, 52.46% (1065 participants) have no knowledge whether Islam religion accepts organ donation, and 40.99% (832 participants) of the participants have confirmed that organ donation is allowed in Islam. Also, 43.10% (875 participants) of the participants know the process of registering themselves for organ donation, and 37.43% (760 participants) of them are willing to register themselves through handheld devices. Finally, the study revealed that there is a significant correlation between age group and attitude toward organ donation as younger age groups are more intended to donate organs when compared with the older age group.

Conclusion: All these significant findings reveal that the attitude of the younger generation has taken turns toward participating in organ donation program. The study has concluded that people of younger age groups are more interested in participating in organ donation, younger people are more aware about the laws governing the subject of organ donation, and the younger people also believe that the concept of organ donation should be promoted effectively.

Digoxin Therapy Knowledge and Counseling Practice Among Physicians and Pharmacists in Saudi Arabia: A Cross-sectional Survey Study

Razan Alshehri, Ghadeer Alhawsawi, Bayan Alqarni, Khawla Alshahrani, Refah Alghamdi, Rayan Alshehri, Shuruq Alsufyani

Background: Digoxin is a cardiac extract derived from the purple foxglove flower. In 1785, English chemist, botanist, and physician Sir William Withering reported that Digitalis purpurea could be used as an effective treatment for cardiac disorders including congestive heart failure. Special care is recommended among elderly patients, patients on diuretics, and in those with severely diseased myocardium, when borderline between the therapeutic and toxic dose may be predominantly narrow. The aim of this article is to assess digoxin therapy knowledge and counseling practice among physicians and pharmacists in Saudi Arabia.

Methods: A questionnaire-based cross-sectional survey was applied targeting all available physicians and pharmacists prescribing digoxin in Saudi Arabia. The questionnaire included the following data: participants sociodemographic data such as residence area, experience years, specialty, and frequency of digoxin prescription. The second section included knowledge questions regarding digoxin therapy covering basic knowledge, interaction with food and drugs, overdose-related data and management, and side effects. The questionnaire was uploaded online using social media platforms by researchers and their friends, and all eligible persons were invited to fill it after explaining the purpose and conforming their data confidentiality.

Results: A total of 617 physicians and pharmacists completed the study questionnaire. A total of 277 (44.9%) respondents were physicians and 340 (55.1%) were pharmacists. Regarding basic information, 47.6% of the study participants know that digoxin is a positive inotropic agent, and 43.8% know that digoxin is used for ventricular rate control. Five hundred and ninety-eight (96.9%) of the study participants had poor knowledge level and awareness regarding digoxin therapy, whereas only 19 (3.1%) had good knowledge level.

Conclusion: The current study revealed that both pharmacists and physicians showed very poor knowledge and awareness regarding digoxin therapy and its related counseling practice with some favor for pharmacists. The main defect was observed for food and drug interaction side effects other than gastrointestinal tract upsets and drug safety with pregnancy.

Adverse Drug Reactions Associated with Anti-infective Agents Reported to the National Pharmacovigilance Center in Saudi Arabia: A Descriptive Study

Ghadah Alshehri, Rand Alshammari, Reem Alkahtani, Raghad Alsaggabi, Wafa Almuter, Shaher Bahakeem, Mohammad Fouda

Background: A recent study has analyzed around 17,730 adverse drug reactions (ADRs) reported to National Pharmacovigilance and Drug Safety Center in the period between 2015 and 2017, which found that anti-infective agents were most commonly involved with ADRs (22.27%). While informative, these reports were not analyzed extensively in terms of their composition, seriousness, and patient group commonly involved in these ADRs. The present study, however, presents an updated and a more extensive review of anti-infective agents involved with ADRs over the period between 2018 and 2020.

Methods: A retrospective review was carried out of all ADRs involved with anti-infective agents submitted to the NPC between 2018 and 2020. A descriptive analysis was undertaken to determine the number of ADRs, and then to characterize them according to their Medical Dictionary for Regulatory Activities (MedDRA) classification, age and gender of patients involved, as well as seriousness and type of anti-infective class(es) involved. The SFDA’s Ethics Committee has exempted this study from formal ethical approval.

Results: A total of 12,567 ADRs were included, of which 53.78% occurred in males. Among all age groups, adults between the age of 45 and 64 were the ones most reported (10.89%). The most reported ADRs were classified according to the MedDRA in terms of investigations (26.76%), gastrointestinal disorders (22.76%), as well as skin and subcutaneous tissue disorders (14.88%). The level of seriousness was not specified in 91.47% of the reports. Almost 2% of ADRs were reported to require intervention to prevent permanent damage followed by ADRs that resulted in prolonged hospitalization (1%). Antibacterial medications were commonly reported (83.5%), followed by antiviral (10.9%) and antifungal medications (3.8%).

Conclusion: This is the first study to characterize ADRs associated with anti-infective agents. Our study showed that these anti-infective agents pose a threat to patients’ safety in our healthcare system.

Parental COVID-19 Vaccine Hesitancy for Children and its Influencing Factors: A Riyadh-based Cross-sectional Study

Rama Al-Asmi, Syed Mohammed Asdaq, Mohammed Al-Yamani, Maha Al-Rowaili, Samar AlRamly, Noor Hijazi, Hailah Alotaibi, Ashwaq AlMubarak, Kholoud AlAnezi

Background: It is well established that vaccination is the greatest clinical approach for successful prevention and control of COVID-19. Understanding the disparities in COVID-19 vaccination apprehension among parents in different societies is crucial for effective implementation of COVID-19 vaccination programs.

Methods: This is an observational cross-sectional study that was carried out in the Riyadh region of Saudi Arabia between February and April 2022. The validated pre-tested questionnaire was shared with the parents who had children between the age groups of 5 and 11 years. The collected information was analyzed using descriptive and inferential statistical methods.

Results: Of the 699 participants, 83% of the mothers were between the ages of 35 and 44 years, 67% were university educated, and only 14% were healthcare workers. A large proportion of parents with an age group of 18–34 years (P=0.001) and those with a higher income group (P=0.014) demonstrated significant vaccine hesitancy. Further, parents who received one or two doses of vaccination were significantly (P=0.02) more hesitant than those who took more than two doses of vaccination. Furthermore, a significantly (P=0.002) high percentage of parents who follow MOH guidelines for personal preventive measures were hesitant. Concerns about side effects (31.4%) and a lack of safety data (31.2%) on COVID-19 vaccines were the top 2 reasons for parents to develop vaccine hesitancy. Social media (24.3%), poor perceived immunity (16.3%), and news articles (15.5%) were the top 3 contributors to this hesitancy. Overall (up to April 2022), 41.5% of the parents were willing to vaccinate, whereas 24.7% and 33.8% were unsure or not ready, respectively, for their children’s vaccination.

Conclusion: This study indicates that there is a widespread parental COVID-19 vaccination hesitancy among residents of Riyadh. Since parents rely on social media for information, health officials should take advantage of the platform and convey accurate information to the public to increase acceptability.

Pharmacists and Pharmacy Services in COVID-19 Literature: A Bibliometirc Analysis

Omnia Khojah, Abrar Thabit, Wajd Alsulmi, Nourah Aljereb, Khadeja Almehdar, Manuel Martín, Jimmy Jose, Antonio Velez-Estevez

Background: The coronavirus disease (COVID-19) pandemic had an enormous toll on global health care and economy. Pharmacists were vital members of the healthcare system, in which they participated in a variety of ways in tackling the pandemic. Numerous papers were published discussing their roles during the pandemic. A bibliometric analysis is used to measure the impact of publications on a particular topic and assess them qualitatively and quantitatively over a specific time. This study aimed to evaluate literature concerning the roles of pharmacists and pharmacy services in COVID-19 pandemic and to identify gaps.

Methods: An electronic search was conducted on PubMed database using a specific query. Eligible publications were those published in English between January 2020 and January 2022 and discussed the role of pharmacists, pharmacies, and pharmacy departments in COVID-19 pandemic. Clinical trials, studies on pharmacy education/training, and conference abstracts were excluded.

Results: Of the 954 records retrieved, 338 (35.4%) from 67 countries were included. Most papers (n=113; 33.4%) were from the community pharmacy sector, followed by the clinical pharmacy sector (n=89; 26.3%). Sixty-one (18%) papers were multinational, mostly involving two countries. The average number of citations of the included papers was 6 times (range 0–89). The most common MeSH terms were “humans,” “hospitals,” and “telemedicine,” where the former frequently co-appeared with the terms “COVID-19” and “pharmacists.”

Conclusion: Results from this illustrate the innovative and proactive strategies developed by pharmacists during the pandemic. Pharmacists from around the world are encouraged to share their experiences for stronger healthcare systems to counter future pandemics and environmental disasters.

The Impact of Apixaban and Rivaroxaban Lead-in Dosing Compared to Parenteral Lead-in Dosing on the Treatment of Venous Thrombo-embolism: A Multicenter Cohort Study

Nirvana Alnajjar, Ghazwa Korayem, Omar Alshaya, Ahad Alawad, Rand Alotaibi, Nader Alshraim, Fatemah Hakami, Ohud Alsudyyes, Rahaf Alsoghayer, Lina Alhushan, Asma Qudayr, Majed Alyami, Omar Almohammed

Background: Around 17% of the patients diagnosed with venous thrombo-embolism (VTE) start on parenteral anticoagulation before switching to direct oral anticoagulants (DOACs). Parenteral anticoagulation lead-in is not recommended with apixaban and rivaroxaban, yet they are often used for the initial phase treatment of VTE. Given the AMPLIFY and EINSTEIN trials, patients who received multiple doses or ≥48 h of parental anticoagulation before recommended lead-in dosing were excluded; meanwhile, efficacy and safety of parenteral anticoagulation are still unpredicted. Thus, our study objective is to compare the safety and effectiveness of lead-in parental anticoagulation with recommended lead-in.

Methods: A multi-center retrospective observational cohort study included adult patients admitted to the hospital with acute VTE and treated with either apixaban or rivaroxaban for VTE. Patients were grouped into “recommended lead-in dosing” group, including patients who received an appropriate lead-in dose of apixaban and rivaroxaban. The second group of patients who received parenteral lead-in dose was enrolled the “parenteral lead-in dosing.” Patient’s data were compared in both groups using an unpaired t-test for continuous variables and the χ2 test for categorical variables.

Results: A total of 389 patients were included. The recommended lead-in dosing group included 296 patients, whereas 93 patients were in the parenteral lead-in group. VTE recurrence during hospitalization and within 30 days was numerically higher in the parenteral lead-in group compared with the recommended lead-in group (3.3% vs. 0.6%, P-value =0.09 and 1.1% vs. 0.7%, P = 0.560). The major bleeding rate during hospitalization was significantly higher among the parenteral lead-in group than the recommended lead-in (14.0% vs. 3.7%; P < 0.001).

Conclusion: Parenteral anticoagulation lead-in before starting maintenance apixaban and rivaroxaban showed a significantly higher risk of bleeding and VTE recurrence than the recommended lead-in. Clinicians should assess the risk of bleeding and VTE recurrence before immediately starting parenteral lead-in over starting lead-in apixaban or rivaroxaban doses.

Persistence of Symptoms Following Infection with COVID-19 Among Patients with Type 1 and Type 2 Diabetes Mellitus in Saudi Arabia

Ghadeer Alhawsawi, Razan Alshehri, Saran Aldharman, Abdulrahman Abukhudair, Abdulmajeed Alshehri, Maram Alghamdi, Khawlah Alshahrani

Background: Information about the persistence of COVID-19-related complications in diabetic patients, their associations with the type of diabetes mellitus (DM), and the role of uncontrolled DM with the complications remains elusive in Saudi Arabia. This study aims to fill this gap.

Methods: This is a simple randomized, cross-sectional, questionnaire-based study among patients with type 1 and 2 DM following infection with COVID-19 in Saudi Arabia.

Results: A total of 674 participants were included in the present study. Among the COVID-19 symptoms, fatigue (65.6%) was the most frequently reported, followed by headache (62.3%) and cough (59.8%). About 44% of the patients reported high blood sugar levels, including 25.5% of the patients with elevated fasting (>126 mg/dL) and 18.5% with elevated post-prandial (>200 mg/dL) glucose levels. We also report that age > 55 years [odds ratio (OR)= 1.66 (1.01–2.56), P=0.045], antidiabetic medications [OR= 2.10 (1.82–3.91), P=0.022], multiple comorbidities [OR= 3.21 (1.98–4.85), P=0.005], chest pain [OR= 2.54 (0.96–3.81), P=0.003], and joint pain [OR= 1.64 (0.73–2.94), P = 0.025] were independently associated with COVID-19-related complications in diabetic patients.

Conclusion: Fatigue, headache, and cough are the most common persistent symptoms among diabetic patients with COVID-19 infection. Advanced age and use of antidiabetic medications were independently associated with COVID-19-related complications in diabetic patients.

The Differences in Patients’ Characteristics and Medication Adherence Between Mobile Application Users and Non-users: A Single-center Cross-sectional Study

Asrar Alanazi, Ghadah Assiri, Dalal Alabdulkarim, Nadin Alanazi, Sarah Altamimi, Mansour Mahmoud

Background: Adherence to medication is an ongoing challenge, and the level of adherence has been reported to be either poor or unsatisfactory. The effect of providing patients with online access to their own medical records through a patient portal or mobile application on medication adherence was evaluated in some studies in the USA and Europe. However, the results should be interpreted with cautions.

Methods: This was a cross-sectional study of a randomly selected sample of patients refilling their medications either through the mobile application “MNG-HA Care” or by phone call to a government-funded multispecialty hospital in Riyadh, Saudi Arabia. Data were collected through an online survey. Medication adherence was assessed using the five-item Medication Adherence Report Scale (MARS-5).

Results: A total of 280 respondents were recruited, of which 212 accessed the mobile application (mobile application users) [mean age was 48.8 years (standard deviation (SD): 17.8) and 64.2% were adherent to their medications] and 68 of the respondents used a phone call for refills (mobile application non-users) [mean age was 53.8 years (SD: 18.2) and 77.9% were adherent to their medications]. The most common self-reported reasons for using the application were to book an appointment and to request a medication refill. The most common self-reported reasons for not using the application were respondents’ lack of knowledge about the availability of the application and preference to speak directly to the healthcare provider. Those patients using the “MNG-HA Care” application and accessing their medication list had significant 49% lower odds of being adherent than non-users (odds ratio: 0.51; 95% confidence interval: 0.268–0.959; P-value: 0.037).

Conclusion: More randomized control research and further studies combining subjective and objective adherence measures need to be conducted on the impact of using mobile applications on medication adherence.

The Level of Burden Among Caregivers of Patients with Alzheimer’s Disease in Saudi Arabia

Yasmin AlQadheeb, Amal Badawoud, Fawaz Alotaibi, Shahad Alzahrani, Razan Alghamdi, Elaf Alanazi, Sarah Alfozan, Norah Aljafer

Background: The older adult population in Saudi Arabia follows the growing aging trends worldwide; it is expected to reach 9.3% of the population by 2030. Therefore, as the population keeps getting older, an increase in aging-associated diseases, like Alzheimer’s, is speculated. The caregiver burden is a serious global issue associated with the rise of aging populations, especially in developed countries. Studies concerning caregiver burden and the necessities requested by care providers are consistent with the Saudi Health Transformation Strategy (2030). This study aims to measure the caregiver burden of informal caregivers of Alzheimer’s disease (AD) patients and to determine their characteristics. In addition, it intends to understand the caregiver’s coping techniques and to assess their medication knowledge.

Methods: A cross-sectional study was conducted from December 2021 to January 2022, which includes 148 informal caregivers mainly recruited by the Saudi Alzheimer’s Disease Association. A four-part study questionnaire was used for data collection: sociodemographic characteristics of AD patients and their caregivers, the 12-item Arabic version of the Zarit Burden Interview (ZBI), and adapted questions on coping techniques and medication knowledge.

Results: A total of 148 caregivers (62% females and 37.8% males) participated in this study, and 79.06% were between 30 and 60 years old. The ZBI average score was 27, indicating a moderate-to-high burden. Apart from the need for services to improve the quality of life of caregivers and patients, there were no notable findings in measuring coping techniques. Additionally, medication knowledge was insufficient in most aspects except that more than half were aware of the medications’ side effects and how to deal with them.

Conclusion: Our study revealed that the average burden among the informal caregivers of AD patients was moderate–high.

A Comparison Between Medical and Pharmacy Students’ Knowledge and Skills of Pharmacology and Pharmacotherapy

Kholod Almutairi, Waleed Altowayan

Background: Knowledge of pharmacology and pharmacotherapy is essential for pharmacy and medical students to improve care and to achieve high levels of patient satisfaction. Differences in knowledge and skills of pharmacology and pharmacotherapy and medical students impair the collaboration between the two groups. These differences could be improved if pharmacists and physicians received a combined education program in pharmacology and pharmacotherapeutics.

Methods: This study is a cross-sectional survey designed using Google Forms and conducted online for students attending pharmacy and medical college at Qassim University. A face and content validity questionnaire was used for the 14-item survey. A convenience sampling method was used. The data were analyzed by using the SPSS program. The independent χ2 test was used to compare variables.

Results: A total of 63 respondents, 37 pharmacy and 26 medical students, were involved and completed the survey from November 2021 to January 2022. Pharmacy students scored higher in pharmacology than medical students, whereas medical students scored higher in pharmacotherapy.

Conclusion: Pharmacy students have more pharmacology knowledge, whereas medical students are more advanced in pharmacotherapy knowledge. Therefore, they can use these results to develop a joint program to improve these differences and enhance the quality of education.

Assessing the Prevalence and Characteristics of Self-reported Penicillin Allergy in Saudi Arabian Population: A Nationwide Cross-sectional Study

Lina Alshehri, Shuroug A. Alowais, Sumaya N. Almohareb, Khalid Bin Saleh, Ibrahim M. Asiri, Hisham A. Badreldin, Lena Alqazlan, Maram Albasseet, Lolwa Fetyani, Areej M. Almutairi

Background: Penicillin allergy, being among the most commonly reported, can lead to overuse of broad-spectrum antibiotics contributing to the growing problem of multidrug resistance. It is essential to know allergy history as some circumstances may allow penicillin to be reinitiated. Despite available evidence, specific data about penicillin allergy in Saudi Arabia are limited. This study focussed on assessing the prevalence and characteristics of penicillin allergy in the Saudi Arabian population.

Methods: An electronic self-administered questionnaire was distributed using social media platforms in January 2022. It was directed toward the Saudi Arabian general population aged 18 years or older residing in Saudi Arabia. Variables about respondent demographics as well as type and characteristics of the allergy were collected.

Results: Two thousand and twenty-two participants completed the survey. One hundred and ninety-three (9.5%) reported allergy to penicillin with the most commonly reported allergy being anaphylaxis in 89 participants (46.1%). Non-anaphylaxis reactions were reported by 69 participants (35.8%), in which rash had been the most common. Twenty-two participants (11.4%) were identified to have a not true allergy either due to the reported reaction being a tolerability issue or due to reporting a non-penicillin type agent, and 13 participants (6.7%) reported an unknown reaction. About 38% reported that the allergy occurred more than 10 years ago. The most frequently reported agents were penicillin in 80 participants, amoxicillin/clavulanate in 60 participants, and amoxicillin in 37 participants.

Conclusion: The percentage of participants who reported penicillin allergy is similar to what is reported in other studies. Knowing the prevalence and characteristics of the allergy can set the ground for starting in-hospital penicillin de-labeling programs, as well as providing evidence to rechallenge specific patients requiring penicillin as first-line agents.

The Incidence and Impact of Potassium Disturbances Among COVID-19 Patients with Heart Failure

Abdulaziz Almatrafi, Abdullah Alshammari, Aseel Alharbi, Khalid Mahboob

Background: In December 2019, the newly discovered strain of coronavirus (COVID-19) had become broadly distributed and affects most of the world. The CDC (Centers for Disease Control) reported that more than 200 million people are infected with COVID-19 worldwide. Heart failure, which impairs the ability of the heart to pump enough blood to achieve metabolic body demand, is associated with electrolytes disturbances, especially hyperkalemia. Data regarding the incidence and impact of potassium disturbances in COVID-19 patients with heart failure are lacking. Our aim of the study is to know the incidence of potassium disturbances in COVID-19 patients with heart failure during hospitalization.

Methods: This is a cross-sectional, observational study in patients admitted to King Abdullah Medical City, Makkah, Saudi Arabia, between March 2020 and March 2021.

Results: In the study, the incidence of patients with hyperkalemia and hypokalemia were 46% and 24%, respectively. Regarding hyperkalemia and comorbid conditions, incidence of hyperkalemia in patients with diabetes mellitus was 45.2%, hypertension 48.4%, and acute kidney injury (AKI) 59.5%, which was statistically significant (P = 0.022). Furthermore, incidence of hyperkalemia for patients who take tocilizumab was 56.3%, dexamethasone 41.7%, favipiravir 41.9%, angiotensin-converting enzyme inhibitors (ACEIs) 32%, and angiotensin receptor-neprilysin inhibitor (ARNI) 100%, which was statistically significant (P = 0.027). Also, hyperkalemia was seen in patients on spironolactone 50% and furosemide 46.9%. Moreover, the incidence of hypokalemia in patients who have diabetes mellitus was 24.2%, hypertension 21.9%, AKI 18.9%, and incidence for those who take tocilizumab was 37.3%, dexamethasone 30.6%, favipiravir 23.3%, ACEIs 24%, ARNI 25%, spironolactone 25%, and furosemide 23.4%.

Conclusion: Heart failure and AKI are considered strong risk factors associated with increased risks of hyperkalemia in COVID-19 patients.

Impact of Cardiovascular Disease on COVID-19 Infections in Hail Region

Reham Alharbi, Sirajudheen Anwar, Atheer Alhamazani, Atheer Alshammari

Background: The World Health Organization declared the 2019 new coronavirus disease (COVID-19) a pandemic on March 12, 2020, after it was discovered in Wuhan, China. Recent investigations have found that individuals with underlying comorbidities have been disproportionately impacted by COVID-19. The aim of this research is to assess the impact of cardiovascular diseases on COVID-19 patients.

Methods: This study retrospectively investigated 146 patients with confirmed COVID-19 infection and a history of cardiovascular diseases. The data were collected from medical records from King Salman Specialist Hospital, Hail, Saudi Arabia from October 2020 to December 2021.

Results: The average age of the 146 COVID-19 patients with cardiovascular disease was 66.82 ± 12.59. The mean time spent in the hospital was 11.49 ± 10.30 days. The mean respiratory rate was 21.83 times/min. The types of cardiovascular diseases found in this study were 18 diseases. The most common heart disease was hypertension [n=94 (64.4%)], followed by ischemic heart disease [n= 25 (17.1%)]. More than 88% of the heart disease participants with Covid-19 were overweight/obese. None of the cardiac diseases, comorbidities, or body mass index (BMI) groupings had an accusation or association with intensive care unit (ICU) admission, according to the findings. Furthermore, there were no variations in medians across discharge statuses as a result of age or BMI. Low oxygen levels caused patients to be admitted to the ICU for mechanical ventilation.

Conclusion: Our findings indicate that BMI and age had a correlation to the mortality whereas cardiac, other comorbidities, or BMI groupings contributed equally to the ICU admission when compared with non-comorbid patients. Moreover, our findings shed light on comorbid diseases that may have an effect on the direction and management of COVID-19 patients.

Awareness and Attitude Among General Population Toward Vaccination After COVID Pandemic

Nada Alsuhebany, Khawla M. Kahtani, Lama I. Alnashwan, Saeed M. Alay, Mohammed G. Alamri, Ghaida K. Alhathlol, Atheer Aldairem, Sumaya Almohareb, Shuroug Alowais

Background: Vaccination is considered as one of the essential methods that benefit public health immunity. Despite these successes of vaccination in preventing lethal diseases, vaccine awareness, knowledge, and acceptance are still unremarkable. The objective of this study was to evaluate whether the public awareness has changed toward the general vaccinations during the COVID-19 pandemic. Influenza (flu) vaccine, human papillomavirus (HPV) vaccine, pneumococcal vaccine, and tetanus, diphtheria, and pertussis (Tdap) vaccines were selected in this study as they are the most recommended non-mandatory vaccines by the Centers for Disease Control.

Methods: This study was a cross-sectional questionnaire with 37 questions and consisted of three main sections: perception and awareness; attitudes and beliefs; and demographic information. The survey was distributed through social media applications. The data were collected from June 9th to 19th, 2022. The required sample size is a minimum of 400 responses.

Results: We received a total of 1070 responses, of which 1045 (97.7%) participants agreed to be part of the study. Among the 1045 participants, 584 (55.9%) were female, and 993 (95%) were Saudi. The public awareness toward vaccines during COVID-19 shows that the highest percentage of awareness was toward flu vaccine (98.2%), followed by HPV vaccine (40.7%), Tdap (37.2%), and lastly pneumococcal vaccine (17%). Approximately 75% of the participants reported that they would take the flu vaccine if they knew the benefits of reducing hospitalization and intensive care unit admissions. Most participants (70%) expressed that they would take HPV vaccine if they knew about the benefits in reducing cervical cancer and other cancers; however, only around 4% of the participants received the HPV vaccine.

Conclusion: The survey showed that participants are willing to receive vaccines if they were aware of the general benefits of these vaccines. Health education and campaigns toward non-mandatory vaccinations such as flu, HPV, pneumococcal, and Tdap are needed.

Public Knowledge, Attitudes, and Practices Toward the Proper Administration of Eye/Nose Drops, Inhalers, and Subcutaneous Injections: A Cross-sectional Study in Eastern Region, KSA

Latifa Alsowaigh, Nora Alsuwaigh

Background: The use and administration of eye/nose drops, subcutaneous injections, and inhalers should be performed properly to maximize the therapeutic effects, as well as minimize side effects. In fact, poor adherence to ocular treatment regimen could lead to poor therapeutic effects. While in case of the inhalers, which have been in use in the treatment of chronic respiratory diseases for decades, they require proper technique to ensure appropriate dose delivery to the lungs; inadequate administration of these dosage forms will lead to everlasting problems.

Methods: A cross-sectional observational survey was conducted online. All the relevant data were collected using a standardized questionnaire. The questionnaire comprised three sections: demographic characteristics of the participants, the public knowledge about these dosage forms, and the use of these dosage forms.

Results: The preliminary result is obtained from 618 participants who were included in the study, out of which 504 were females (81.6%) and 114 (18.4) were males. For the proper correct use of eye drops, the majority of the participants were well educated. However, there were some points, which were misunderstood. For subcutaneous injections, only 144 (23.3%) participants benefit from them, and they were properly instructed on the appropriate administration with few points left out. Finally, for the knowledge and accuracy of the inhalers usage, only 244 (36.25%) participants used them and although they were well instructed about the correct using, they were not following these instructions fully.

Conclusion: These results indicate that most participants were educated about these dosage forms properly with some important points left out. Thus, there is a need of counseling on the appropriate use of dosage forms as an essential step toward optimal treatment.

Pharmacists’ Identification, Support, and Perceived Barriers in Providing Care for Patients with Limited Medication Literacy in Saudi Arabia

Bayan Alsultan, Faten Alhomoud, Hawra Alsadah, Marwah Alamer

Background: Poor medication literacy may lead to serious health risks such as poor health outcomes, adverse drug reactions, and ineffective therapy. However, nothing is known about how pharmacists identify patients with limited medication literacy, what support they provide to those patients, and what are the perceived barriers in providing care for patients with limited medication literacy in order to provide a proper tailor patient counseling and improve their medication use.

Objective: The current study aimed at evaluating (1) how pharmacists identify patients with limited medication literacy, (2) what support they provide to those patients, and (3) what are the perceived barriers in providing care for patients with limited medication literacy before and after completing a learning module.

Methods: A descriptive cross-sectional survey study was conducted among Arabic-speaking pharmacists living in Saudi Arabia and working in primary care, secondary care, or community pharmacy with direct patient care. A convenient sample of 318 pharmacists were recruited and given an online pre-module survey 3 to fill out. Then, an online access to 8 min Arabic learning module was given to the pharmacists to watch. One month later, a post-module survey 3 was distributed among pharmacists to complete. Pre- and post-responses were quantified and compared using descriptive statistics to assess pharmacists’ current practice related to medication literacy using SPSS software, version 27.

Results: The pre-module survey was completed by 318 participants, and the post-module survey was completed by 68 participants. The term medication literacy was understood by 96% of the pharmacists in the pre-module survey and by 99% in the post-module survey. In the pre-module survey, patients’ medication literacy level was assessed by 79% of the pharmacists, whereas in the post-module survey, patients’ medication literacy level was assessed by 82% of the pharmacists. About 75% and 93% of the pharmacists used counseling strategies when dealing with limited medication literacy patients in the pre-module and post-module survey, respectively. Ninety-three percent of the pharmacists reported that learning module was useful to the clinical practice. The most commonly used strategies for evaluating medication literacy level among patients in the pre- and post-module survey were patients’ demonstrated understanding of medications and patients’ verbal communication. The most commonly used strategy for counseling patients with inadequate medication literacy is giving vital information first, or by itself and using a simple language. Time constraint was the biggest obstacle in evaluating patients’ medication literacy level in the pre- (82%) and post-module survey (88%) and in providing consultation for patients with limited medication literacy in the pre- (80%) and post-module survey (85%). Discussing the counseling strategies with colleagues by participating in interactive small group meetings was the most commonly reported method to encourage pharmacists when counseling patients with limited medication literacy in the pre- (65%) and post-module survey (71%).

Conclusion: Although pharmacists showed a great level of understanding of medication literacy, some of them did not regularly evaluate patients’ medication literacy and did not know what approaches to follow in counseling low literacy patients. Thus, educational interventions to pharmacists on medication literacy are required.

Impact of COVID-19 on Depression and Sleep Quality Among Population in Saudi Arabia

Sara Almutiri

Background: Coronavirus disease 2019 (COVID-19), a new communicable disease, is caused by the new strains of severe acute respiratory syndrome coronavirus. First diagnosis was reported in December 2019 which occurred in Wuhan, China. Later, on March 11, WHO made the assessment that COVID-19 could be characterized as a pandemic. In response to the rapid spread of COVID-19 and increasing number of cases all over the world, governments and health institutions implement many measures to control the spread of the pandemic. These measures and the increase in day-to-day movement restriction and number of confirmed cases may affect individual’s mental health negatively.

Methods: Using an online-based cross-sectional adapted survey, we aimed to assess the impact of COVID-19 on mental health and sleep quality among Saudi general population. We collected responses from a total of 272 participants.

Results: The overall results show the prevalence of 37.9% for Generalized Anxiety Disorder, 43.1% for depression, and a higher percentage of 72.1% for poor sleep quality among Saudi population. All participants older than 45 were having good sleep quality, with no anxiety, and only 12.5% of them were having depressive symptoms. Participants who spend more than 1 h a day focussing on COVID-19 updates were at higher prevalence for anxiety and depression. Females, younger people, and students were significantly at higher risk for anxiety, depression, and poor sleep quality.

Conclusion: Our study suggests that in addition to the physical harm caused by COVID-19, there is a negative impact on mental health and sleep quality among the general population in Saudi Arabia. Our findings emphasize the need for governments to adopt new strategies for promoting mental wellness and provide psychological interventions nationwide.

Patients’ Knowledge and Use of Oral Non-steroidal Anti-inflammatory Drugs in King Fahad Specialist Hospital Rheumatology Clinic

Ashwaq Alharbi

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most potent anti-inflammatory agents known to act by blocking the cyclooxygenase enzyme from producing prostaglandins; the reduction of prostaglandin production is connected to the adverse effects of NSAIDs, making their use in certain illness conditions questionable. However, because it is widely used in rheumatic disorders, assessing the patients’ knowledge in using oral NSAIDs will help determine the knowledge gap to educate both providers and patients to allow open communication regarding oral NSAIDs use to prevent the misuse and reduce harmful side effects.

Methods: A descriptive cross-sectional study was conducted among patients who attended the rheumatology clinic at King Fahad Specialist Hospital in Qassim. A face-to-face interview questionnaire assessed their knowledge of oral NSAIDs.

Results: Eighty-four participants were interviewed. The majority of the participants took diclofenac. About 51.2% of the patients denied having discussions of oral NSAIDs with their providers. Nearly two-thirds of the patients claimed that they had read the instructions on the drug leaflet. Half of the respondents determined their dose by consulting the physician. Approximately 98.5% of the female participants stated that they did not use oral NSAIDs during pregnancy. Female patients were significantly more aware of the side effects than males.

Conclusion: The patient’s knowledge related to the use of oral NSAIDs was not that satisfactory. There is an urgent need to educate the public regarding the appropriate use of these drugs.

Evaluation of Medication Shortage Impact on Patient Satisfaction, Experience, and Clinical Outcomes Using Reported Patients’ Complaints in a Tertiary Care Hospital

Ghaidaa Qadi, Abubakr Awad, Fwzan Abdulhaq, Hebah Tantawi, Lujain Samarin, Mohamed Al-Haij, Toqa Alrehaili, Zahra Alabbad

Background: Medication shortages have become a global concern for patients, families, and healthcare providers. This problem adversely affects patient care and prescribing practices leading to decreased patient satisfaction, experience, and clinical outcomes.

Methods: In a cross-sectional study, data were collected using purposive sampling of patients who filed a complaint about medication shortage between January 2017 and July 2021. Medical records of those patients were retrospectively traced. Physicians and pharmacists participated in this study by describing the current state for shortage impact on a survey distributed in August 2021. Data were analyzed using SPSS.

Results: Around 300 patients were included. Cardiac, antihypertensive, and antineoplastics medications were the most frequently encountered medication shortage classes (26.7% and 12.7%, respectively). Most of the physicians (96.4%) indicated a treatment plan impact of shortage, whereas 87.2% said that their patients needed change of treatment protocols. Pharmacists stated that formulary medications were more frequently under shortage (83.3%), whereas around 51% thought that the approval duration of the non-formulary medications is the most detrimental factor. The majority of the pharmacists were facing problems with finding alternatives for oncology and neurology medications (40% and 16.7%, respectively). Patients’ experience varied from sadness (26.9%) to anger (59.6%); most of them being unsatisfied with alternatives and methods for communication.

Conclusion: Medication shortage results in adverse consequences, decreased patient satisfaction, and lower clinical outcomes and poses a financial burden; these mandate the development of permanent and continuous plans to overcome these shortages and mitigate their consequences.


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