Adherence to the American Diabetes Association standards of care among patients with type 2 diabetes in primary care in Saudi Arabia

To assess adherence to 11 American Diabetes Association [ADA] standards of diabetic care. We conducted this one-year historical prospective study between October 2010 and September 2011 on 450 adult type 2 diabetes patients in a primary care center in Saudi Arabia. We used the definitions of the 2010 ADA standards of diabetic care processes and targets. Four-hundred and fifty medical files were valid. The adherence to ADA process standards of measurement of glycated hemoglobin [HbA1c] was 68.7%, 92.9% for blood pressure, and 80.2% for serum lipids. Screening was lowest for nephropathy [35.6%], and highest for diabetic foot [72%]. Adherence to medications ranged between 82.2% for antiplatelets, and 92.4% for dyslipidemia. For outcome standards, 24.2% of the patients had an HbA1c <7%, and 32.2% had controlled blood pressure [<130/80 mm Hg]; and 58.5% achieved targeted low-density lipoproteins [LDL]. Only 7.2% had glycemic control in addition to controlled blood pressure and targeted LDL level. An increasing trend of patients achieving glycemic control [<7%] was shown throughout follow-up [p=0.003]. We found suboptimal adherence with many ADA standards of diabetic care among patients with type 2 diabetes treated at a primary care center in Saudi Arabia. The achievement of outcome standards, either singly or combined, is lower than the adherence rates. However, the figures show improvement in adherence during the follow-up period

prevalence of smoking and its associated factors among military personnel in Kingdom of Saudi Arabia: a national study

The aim was to measure the prevalence of smoking and identify its potential predictors among military personnel in Kingdom of Saudi Arabia [KSA]. This cross-sectional study was carried out among military personnel in the five military regions of KSA between January 2009 and January 2011. The sample of 10,500 military personnel in the Saudi Armed Forces was equally divided among the five regions with a ratio 3:7 for officers and soldiers. A multistage stratified random sampling was used to recruit participants in the four services of the armed forces in the five regions. Information on sociodemographic characteristics with a detailed history of smoking was collected by means of a self-administered questionnaire. Bivariate analysis was used to identify the factors associated with smoking, and multiple logistic regression analysis to discover its potential predictors. About 35% of the sample was current smokers, with higher rates among soldiers. The eastern region had the highest rate [43.0%], and the southern region the lowest [27.5%]. Navy personnel had a higher risk of being current smokers [40.6%], and the air defense the lowest risk [31.0%]. Multivariate analysis identified working in the navy, and low income as positive predictors of current smoking, while residing in the southern region, older age, years of education, being married, and having an officer rank were negative [protective] factors. Smoking is prevalent among military personnel in KSA, with higher rates in the Navy and Air Force, among privates, younger age group, lower education and income, and divorced/widowed status. Measures should be taken to initiate programs on smoking cessation that involve changes in the environment that is likely to promote this habit

Physicians' awareness of bisphosphonates-related osteonecrosis of the jaw

To assess the awareness and knowledge of physicians and dentists regarding bisphosphonates related osteonecrosis of the jaw [BRONJ]. A cross-sectional descriptive study was carried out in the Department of Dentistry, Riyadh Military Hospital, Kingdom of Saudi Arabia from June to September 2010. Data were collected through a self-administered questionnaire distributed among a sample of physicians and dentists at the hospital. A total of 222 valid completed responses were obtained [response rate: 82.2%]. Less than one-third of the participants [31.5%] were aware of osteonecrosis of the jaw, while slightly more than half of them were treating patients with bisphosphonates [BP]. None of the physicians had a correct response in all 4 knowledge questions. There were statistically significant associations between knowledge and qualification [p=0.019], years of experience [p=0.002], and specialty [p=0.034]. We found that physicians and dentists have low awareness and deficient knowledge regarding BRONJ, although most of them do prescribe BP to their patients. Therefore, intervention to raise awareness and knowledge among healthcare providers is needed

Patient satisfaction with primary health care services in Riyadh

To assess the level of patients satisfaction with primary health care PHC services in health centers affiliated to Riyadh Military Hospital RMH, Riyadh, Kingdom of Saudi Arabia. A cross-sectional study was conducted in 3 PHC centers, affiliated to Riyadh Military Hospital RMH, Riyadh, Kingdom of Saudi Arabia, over 2 months period in 2006, data was collected using a self-administered questionnaire to assess patients' overall satisfaction with PHC services and their level of satisfaction with 5 PHC domains: reception services, accessibility, continuity of care, communication, and enablement. Seven hundred questionnaires were distributed yielding 86.6% response rate, 39.6% of our patients were 20-30 years old, 51.5% of the respondents were females, 76.4% were married and 34.5% of them showed a medical visit frequency of a minimum of 8 times per year. The domains of PHC with the highest level of reported satisfaction was enablement 70.6%. The poorest level of satisfaction was at the continuity of care 56.3%. The mean score of satisfaction with reception was 70.0%, communication 69.2%, and accessibility to care was 62.4%. The overall satisfaction level was 64.2%. Patients of older age were more satisfied with PHC services than their younger counterparts p-value <0.001 and patients with lower education level were more satisfied p-value<0.001. Patients' satisfaction was inversely related to their average annual visit frequency to PHC centers p-value =0.015. There was no relation found between patients' satisfaction and their gender, marital status, occupational status, and their average monthly income. The level of satisfaction with PHC services in health centers affiliated to RMH is relatively low, results identified areas in which quality improvement is required, mainly accessibility and continuity of care