Self-monitoring of blood pressure and the role of community pharmacists in Kuwait

To determine the types of devices for self-monitoring of blood pressure available to consumers in Kuwait and the pharmacists' knowledge and level of information provided to consumers when purchasing such devices. It was possible to contact 196 of the 230 eligible pharmacies from five governorates in Kuwait. Ten of these were used to pretest the questionnaire and six declined to participate. Another six did not carry any blood pressure monitoring devices and hence were excluded. Data was then collected from pharmacists at the 174 remaining community pharmacies via face-to-face structured interview of the respondents at their work sites. Of the 174 pharmacists, 173 [99.4%] claimed to offer or provide advice to clients at the time of purchasing devices, 117 [67.1%] of them stating that they did so even if the patients did not ask. Although 147 [84.5%] respondents correctly identified the mercury sphygmomanometer as the most reliable device for measuring blood pressure, less than half [86,49.4%] claimed to know how to check the accuracy of the devices they sold. Only 25 [14.4%] pharmacists could actually identify the correct procedure for checking the accuracy of the devices and only 25 [14.4%] pharmacists could correctly identify cutoff points for systolic and diastolic blood pressure delineating clinical hypertension. Only 1 pharmacist could correctly name a reference source for blood pressure measurement. There is a need for improvement of community pharmacists' competence in supporting patients and in providing them with information regarding devices for measuring blood pressure in Kuwait

Dyspepsia and helicobacter pylori infection: analysis of 200 Kuwaiti patients referred for endoscopy

Dyspepsia is a very common symptom, and is the reason for most referrals for esophagogastroduodenoscopy [EGD]. Peptic ulcer disease [PUD], gastroesophageal reflux and gastric cancer account for a minority of such patients. However, the majority have no significant endoscopic abnormalities [non-ulcer dyspepsia]. Recently, infection with Helicobacter pylori [HP] has been implicated in the pathogenesis of PUD and gastric cancer. Since HP can be diagnosed by noninvasive techniques, it has been suggested that endoscopy should be restricted to HP-positive patients who do not respond to empirical therapy with antimicrobials. The aim of this study was to establish the prevalence of HP among Kuwaiti dyspeptic patients referred for endoscopy and to determine whether demographic and clinical screening, or the presence of HP, can help distinguish groups of patients with significant gastroduodenal pathology from those with non-ulcer dyspepsia. Two hundred randomly selected Kuwaiti patients referred for endoscopy were evaluated prospectively. A detailed personal interview was conducted to establish the demographic and clinical profile of each patient and a diagnostic EGD was performed after the interview. Finally, antral mucosal biopsies were taken to determine the presence of HP. The pre-coded data were analyzed. Results: The main endoscopic findings were normal [32%], non-erosive antral gastritis [26%], duodenitis [17.5%], duodenal ulcer [11.5%], deformed bulb [4%], esophagitis [7%], and erosive gastritis [2%]. The demographic and clinical characteristics of patients did not correlate with endoscopic findings. The overall prevalence of HP infection was 88.5%. There were no statistically significant differences in the prevalence of HP among patients with various endoscopic findings. HP infection is common in Kuwaiti dyspeptic patients referred for endoscopy, irrespective of their demographic and clinical features or the underlying cause of dyspepsia. Noninvasive methods to detect HP are not valid alternatives to endoscopy in the work-up of dyspeptic patients