Attitude of primary care physicians toward patient safety in Aseer region, Saudi Arabia

The objective of this study was to assess the attitude of physicians at primary health-care centers [PHCC] in Aseer region toward patient safety. This study was conducted among working primary health-care physicians in Aseer region, Saudi Arabia, in August 2011. A self-administered questionnaire consisting of three parts was used; the first part was on the socio-demographic, academic and about the work profile of the participants. The attitude consisting of 26 questions was assessed on a Likert scale of 7 points using attitude to patients safety questionnaire-III items and the last part concerned training on "patient safety," definition and factors that contribute to medical errors. Data of the questionnaire were entered and analyzed by Statistical Package for the Social Sciences [SPSS] version 15. The total number of participants was 228 doctors who represent about 65% of the physicians at PHCC, one-third of whom had attended a course on patient safety and only 52% of whom defined medical error correctly. The best score was given for the reduction of medical errors [6.2 points], followed by role of training and learning on patient safety [6 and 5.9 points], but undergraduate training on patient safety was given the least score. Confidence to report medical errors scored 4.6 points as did reporting the errors of other people and 5.6 points for being open with the supervisor about an error made. Participants agreed that "even the most experienced and competent doctors make errors" [5.9 points], on the other hand, they disagreed that most medical errors resulted from nurses' carelessness [3.9 points] or doctors' carelessness [4 points]. This study showed that PHCC physicians in Aseer region had a positive attitude toward patient safety. Most of them need training on patient safety. Undergraduate education on patient safety which was considered a priority for making future doctors' work effective was inadequate

Experience of the health promotion clinics in Aseer region, Saudi Arabia

Health promotion is the most important element of primary health care. Therefore, it is essential for the health team to apply such activity. To describe a newly established health promotion clinic at primary health care centers, in Abha city, KSA. The study was conducted during the year 2009. The files of 429 individuals were reviewed after one year from attending the health promotion clinics in Abha city, KSA. Master sheet was designed based on the relevant items of the file. The health promotion services used in the study were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Program for the Social Sciences [SPSS]. P-values less than 0.05 were selected for statistical significance. After one year, the percentage of the individuals who intake imbalanced diet and did not perform any type of physical activity was more than 90% while 8% are currently smokers and 14% had depression. Clinical examination and investigation revealed that more than one quarter of our subjects were overweight. Obesity was 42% in males versus 51% in females [P<0.04]. Pre-hypertension and hypertension were detected among 44 and 12% respectively. About one fifth of our subjects had pre-diabetes 21% and 3% were confirmed to have diabetes mellitus. Diet and physical activity counseling was given to all participants while referral to concerned clinics was done for individuals who suffer from high blood sugar, abnormal lipid profile, obesity and depression. This study demonstrated that health promotion clinics provided by trained professional health care team can be used as a new approach for early detection and management of the common health problems in primary health care centers

Quality of hypertension care in the family practice center, Aseer region, Saudi Arabia

Hypertension [HTN] is a common health problem in Saudi Arabia. Good control depends on the quality of care, which should be supervised and monitored regularly through clinical audit. The objective of this study was to assess the quality of HTN care at Al-Manhal Family Practice, Aseer Region, Saudi Arabia. This study was conductedin 2009 at Al-Manhal Family Practice, Aseer Region, Saudi Arabia. Medical records of all hypertensive patients were extracted and reviewed using master sheets. Assessment of processes and outcomes of HTN care were based on the standards of quality assurance manual issued by the Ministry of Health. Data were entered and analyzed by SPPS, version 15. Relevant statistical tests were used accordingly and the P-value was considered significant when it was less than 0.05. A total of 295 medical records were reviewed and assessed. Most patients were Saudi, married, and about 50% were educated. Two-hundred and thirty-one records were assessed for processes and outcomes of HTN care. Weight measurement and physical examination were carried out for 99% and 97% of the patients, respectively. For 53% of the patients, blood was checked for glucose and kidney function and a lipid profile was done. More than two-thirds of the patients were overweight and obese while 46% had diabetes. Less than one half of the patients had good control of HTN. By most standards, quality of HTN care in Al-Manhal Family Practice was unsatisfactory. Most of the patients had comorbidities and poor HTN control. Essential facilities should be provided to the practice to optimize HTN care and to improve the degree of control

Primary care physicians' knowledge and attitude towards prescribing medication for acute respiratory infection

This study was performed to assess primary care physicians' knowledge and attitude towards prescribing medications for acute respiratory infections [ARIs]. Aseer Region Primary Care Physicians. Cross sectional study. A cross sectional study using a self-administered, questionnaire carried out during March and April 2004, among all primary care physicians. Out of 320, 268 questionnaires were returned [response rate = 83.75%]. The mean rank of score in knowledge on ARIs was 16 [SD = 2.0] out of 21. More than 80% of respondents have heard about the National Protocol for ARIs [NP-ARIS]. One-third has attended a training course on the protocol, while a third did not want to attend such type of training. Of the 153 physicians who had copies of the protocol, 145 read it. However, only 85 physicians of those who read it comply with it. Physicians with experience more than 5 years in primary health care centres attended more training courses on the NP-ARIs [44% vs 20%, p = 0.01], had a positive attitude towards it [70% vs 60%, p = 0.04]. Those who were trained on the protocol, prescribed anti histamines and vitamin c less frequently [38% vs 60%, p = 0.04] and [38% vs 61%, p = 0.04] respectively. Over-prescribing for acute respiratory infections is a common behaviour among primary care physicians, despite their good knowledge of the health problem

Foot care among male diabetics in family practice center, Abha, Saudi Arabia

This study aims to assess the behaviors of diabetic males towards their foot care at Al-Manhal Center of Family Practice, Aseer Region, KSA. A cross-sectional study was conducted for male diabetics in the Aseer region, KSA, during the first quarter of the year 2004.A questionnaire and physical examination of the foot were used to assess their behaviors towards foot care. All the male diabetic patients [107] who attended during the study period were assessed Mean age was 58 years, mean duration of DM was 10 years. Good diabetic control was 24%, 37% did not know the negative effect of DM on the feet, 9-22% had different symptoms of diabetic foot, 53% checked their fret regularly, 31% had fungal infection while an absence of pulse was detected in 7%.This study revealed that many diabetics had negative behaviors towards foot care. There is a need for intensive health education and regular assessment in order to detect, prevent and manage diabetic foot as early as possible

Attitude and practice towards road traffic regulations among students of health sciences college in Aseer region

The objectives of this study were to assess the knowledge, attitudes and practices of male students at the Health Science College in Abha, towards road traffic regulations. This study was carried out during the second semester of the academic year 2002G among the students studying at the Health Science College for Boys in Abha, Aseer Region, Saudi Arabia. A questionnaire of 28 different questions was distributed to all available students and responded to under the direct supervision of the heads of the six departments of the college. The questionnaire consisted of three main parts; the first was about the socio-demographic and scientific data of the students; the second on the knowledge of road traffic regulations and the third dealt with attitudes and practice of driving and the use of seat belts. Two hundred thirty eight out of 297 students [80%] responded to the questionnaire in this study. The mean age of the participants was 21 years, 47% lived in cities, 70% and 72% had cars and driving licenses respectively. More than half of the students had been involved in road traffic accidents [RTAs], 22% of these had been injured in these RTAs and 13% admitted to hospital for an average of nine days. High speed was the main cause of their RTAs. The mean speed at which the students drove their cars within and outside the city boundaries were 81 KM/h and 127KM/h respectively. The degree of knowledge of road traffic regulation was moderate to high in more than 75% of the students, while more than 90% of them believed in the importance of the use of seat belts. More than 75% of the participants mentioned that they had problems with the use of seat belts, the most common of which were forgetfulness and anxiety. This study revealed that many students had been involved in RTAs as a result of driving at high speed. Most of the students had good attitudes towards the use of seat belts. The rate of compliance to the use of seat belts increased with the legislation on its use. Continuing health education and the monitoring of compliance to road traffic regulations is necessary if the incidence of RTAs is to be reduced

Health education resources availability for diabetes and hypertension at primary care settings, Asser region, Saudi Arabia

The aim of this study was to evaluate the availability of health materials and means on diabetes and hypertension at PHCCs in Aseer region, Saudi Arabia. This study was carried out in PHCCs in Aseer region. A questionnaire was distributed to all PHCCs in the region. The questionnaire elicited information on the total population served, the number of diabetic and hypertensive patients, and the availability of health materials for diabetes and hypertension. Data were entered and analyzed by using SPSS. A total of 242 PHCCs out of 245 responded to this questionnaire. There were 20 health educators [8%].Availability of health education materials ranged between 10 to 50%. Health education programs for Diabetes and hypertension were available in more than 90% of PHCCs. This study revealed that most of PHCCs in Aseer region lacked essential health education materials and means for diabetes and hypertension and, therefore were in urgent need of these materials from the Health Education Department, private health sectors and drug companies

Prescribing patterns for acute respiratory infections in primary health care, Aseer region, Saudi Arabia

The objective of this study was to identify the patterns of prescribing for Acute respiratory infections in patients attending primary health care centers in the Aseer region, southwestern Saudi Arabia . This study was conducted at primary health care centers in the Aseer region during November 2003. A master sheet designed by the investigator was distributed to all the working physicians in the primary health care center in the Aseer region. The master sheet included the age, sex, complaints, signs, clinical diagnosis and the type of medications prescribed. Physicians were asked to include all patients attending on 17[th]P November 2003, and send the master sheet to the Technical Supervision Unit at Primary Care Department, General Directorate of Health Affairs. Data of the master sheet was entered and analyzed by using SPSS. The total number of patients attending with acute respiratory infections [ARIs] was 3000 which represented 25% of the patients attending primary health care centers that day. Children formed 60% of the total number of cases. Regarding symptoms and signs, it was found that 70% had a cough, 59% had a runny nose, and 43% had a sore throat. The common cold was the most common diagnosis [42%]. Antipyretics, antihistamines, antibiotics and antitussives were prescribed for 78%, 48%, 45% and 25% respectively. Statistical analysis using logistic regression revealed that the higher the temperature, the more severe the throat congestion and the presence of exudates on pharynx, the higher the likelihood to prescribe antibiotics. In this study, it was found that the prescription of all drugs for ARIs was still high in spite of the fact that these conditions are self-limiting. To rationalize prescribing for ARI, implementation of the national protocol for diagnosis and treatment of ARIs is mandatory. Further studies to explore the physician's knowledge, attitudes and behavior concerning prescribing for ARI is strongly recommended

Resource availability for care of hypertensives at primary health settings southwestern Saudi Arabia

To assess the availability of resources required for hypertension care at primary health care centers in Aseer region, Southwestern Saudi Arabia. This study was carried out at primary health care settings in Aseer region, Kingdom of Saudi Arabia [KSA], during during September 2001 by distributing a questionnaire to all the technical directors of primary health care centers [PHCCs] in Aseer region, KSA. The questionaire composed of 4 main parts that dealt with profile of these PHCCs and the degree of availability of the essential resources for care of hypertension. Data of the questionnaire was entered and analyzed by using statistical package for social sciences. Ninty-nine% of PHCCs responded to the questionnaire. The total served population was more than 970,000. The total registered hypertensive patient was 13087 patients. Seventy-five% of PHCCs have chronic diseases mini-clinics, 90% have appointment system and management protocol for hypertension. Availability of health education materials, diagnostic tools and antihypertensive drugs ranged from 10-81.4%. This study found that many essential resources for hypertension care were not adequately available. Urgent provision of these items is considered a priority in order to introduce good health care for hypertensive patients in Aseer region, KSA

Impact of a Mini-Clinic on Diabetic Care at a Primary Health Care Center in Southern Saudi Arabia

The aim of this study was to assess the impact of a mini-clinic on the quality of diabetic care at a Primary Health Care Center in Aseer region, Kingdom of Saudi Arabia. All the files of diabetics in Wasat Abha Primary Health Care Center were reviewed at the end of 1997 for diabetic process based on a scoring system of 11 items. Diabetic outcomes were evaluated in accordance with Quality Assurance Protocol. Data of all the files was entered into and analyzed by Statistical Package for Social Sciences. Relevant statistical tests were used. Files of 198 patients were evaluated, 61.6% were male, 90.4% were married, and 50% were educated. The mean duration of diabetes was 7.1 years. All the 11 items of diabetic process improved significantly except for measuring blood pressure, weight and cholesterol. However, the mean of the total score increased significantly from 5.7 points to 8.2 points [P=0.00]. The measured diabetic outcomes improved significantly for the provision of diabetic card, health education pamphlets, diabetic control and obesity. Ten% of the diabetics were found to have at least one complication. Diabetic retinopathy [8.4%], impotence [8.2%], and cardiovascular [3.6] were the most prevalent recorded complications. Establishment of diabetic mini-clinic at Wasat Abha Primary Health Care Center improved the process and the outcomes of diabetic care. Further large and countrywide studies are suggested to evaluate the cost-effectiveness of such types of clinics on diabetic care

Availability of resources of diabetic care in primary health care settings in Aseer region, Saudi Arabia

The objective of this study is to evaluate the availability of resources of diabetes care in primary health care settings in Aseer region, Southwest, Kingdom of Saudi Arabia. This study was conducted during September 2001 by distributing a questionnaire to all technical directors of primary health care centers [PHCCs] in Aseer region. The questionnaire, designed by the authors, contained 6 sections that dealt with the necessary structures of diabetic care in the region in addition to the data base of PHCC such as served population, distance from the hospital, and total working physicians and nurses at the PHCC. The data from the questionnaire was entered and analyzed using Statistical Package for Social Sciences. Two hundred and forty-two PHCC technical directors responded to the questionnaire. Total served population by PHCC was 970,306 individuals. Total working physicians were 391 and nurses were 902. Diabetics represented 2.7% of the total served population. More than 90% of PHCCs have diabetic files, registers, appointment system and protocol for diagnosis and treatment of diabetes. Oral hypoglycemic agents were always available at 55% of PHCCs while metformin was not available at 52% of PHCCs. Diabetic identification cards were available in 80.4% of PHCCs while the health education means were less available, except for health education programs was available at 97.5% of PHCCs. At least, 40% of PHCCs were provided financially or by different means of health education through community health committees. This study revealed that resource items for diabetic care are inadequate in particular drugs and laboratory facilities. Establishment of a diabetes committee in Aseer region is a priority in order to manage such shortages and to plan, supervise and coordinate the diabetic care in the region

Cost of the drugs dispensed from primary health care centers for summer visitors to Aseer Region

Recognize the patterns and the cost of the drugs dispensed to summer visitors who attended Primary Health Care Centers [PHCCs] in Aseer region. This study was conducted in Aseer region during the summer of 1998. The investigators designed and distributed special forms on which were blanks for names, age, sex, diagnosis and drugs that were prescribed for summer visitors who attended PHCCS in Aseer region. At the end of season, all the forms were collected and analyzed manually by well-trained nurses and assistant pharmacists. The cost of the drugs was calculated according to the price list provided by the Medical Supply Department. A total of 96327 forms were evaluated. These represented 25% of the total number of prescriptions issued by PHCC physicians during the summer season. The total cost of the dispensed drugs was estimated as 190533 SR [50808$]. About 20% of what was dispensed was for summer visitors who had utilized the PHCC services in Aseer region. Antibiotics and painkillers cost 42% and 21% of the total cost respectively. This study showed that the cost of drugs for summer visitors in Aseer region was 20.5% of the total drug cost. This additional cost should be considered in planning the drug budget

Barriers to compliance among diabetics in Asir region

The objective of this study was to explore the barriers to compliance with medical advice among the diabetic patients attending Wasat Abha Primary Health Care Center in Asir region, Saudi Arabia. A total of 100 diabetic patients who were labeled as poor compliants were interviewed to look for the underlying barriers to comply with appointment, drug and diet. Forty percent of total diabetics were labeled as poor compliants. Twenty three percent were poorly compliant to diet, 21% to appointments and 19% to drugs. The most common reasons for poor compliance were unavailability of drugs at the primary health care center, social and behavioral barriers. Non-compliance is high among diabetics, this requires more research to understand and tackle the underlying reasons