Adverse drug reaction reporting by hospital pharmacists in Saudi Arabia

To study hospital pharmacists attitude and behavior toward reporting of adverse drug reactions [ADRs] in different hospitals throughout Saudi Arabia. This is a descriptive study on a sample of 510 hospital pharmacists who were asked to answer a self-administered questionnaire. The first section of questions sought to obtain pharmacists and pharmacy demographics, references available and continuing education activity. It also covered general questions that were intended to measure the extent of the respondent's knowledge regarding the Saudi ADR reporting system and pharmacists' behavior toward it. Another section of the questionnaire explored pharmacist's attitude to reporting and factors that may affect their attitude. The response rate by pharmacists was 67.1% in which more than half were Saudi pharmacists [56.7%]. The study showed that 45.6% of pharmacists were aware of the ADR reporting program in Saudi Arabia. Almost all the respondents considered the reporting of ADR to be an essential part of their professional responsibility and acknowledge the importance of reporting. Only 7% of pharmacists in the study submitted an ADR report to the Ministry of Health, while 23.1% of them claimed they submitted an ADR report to their hospitals. The study also showed many barriers affecting ADR reporting by hospital pharmacists such as insufficient clinical knowledge [42.7%], all serious side effects are detected before marketing [35.7%], unknown address of the reporting agency [33.6%], reporting form not available [33.3%], do not know how to report [22.6%] and finally the form is complicated to be filled [17.3%]. When looking at the factors that could encourage ADR reporting, the study showed that the publication of an ADR bulletin [64.3%] and receiving a feedback from the program [64.1%] are important factors to be considered. Hospital pharmacists in Saudi Arabia seem to have a good knowledge regarding the country's ADR reporting system but they are still considered underreporting. Many barriers were identified in the study that is negatively affecting ADR reporting. The results highlight the importance of promoting and improving the current ADR reporting system in Saudi Arabia and try to overcome any barrier that could prevent such progress

Attitude of community pharmacists in Saudi Arabia towards adverse drug reaction

To assess the attitude and behavior of community pharmacists in Saudi Arabia regarding the reporting of adverse drug reactions [ADR]. A self-administered questionnaire was delivered to a stratified random sample of 240 community pharmacies in Riyadh city. The questionnaire comprised of 27 questions. The first twenty five questions covered pharmacists and pharmacy demographics, references available and continuing education activity, general questions aimed at establishing the extent of the respondent's knowledge about the Saudi ADR reporting system and pharmacists' behavior. One question consisted of twenty-seven item exploring the pharmacist's attitude to reporting and the factors that either positively or negatively, affecting his attitude. The total response rate was 71.7% [172/240]. Most of the respondents were expatriate employees [99.4%] with the remainder Saudi pharmacy owners. Only 21 pharmacists [13.2%] were aware of the ADR reporting program in Saudi Arabia. Ninety-seven percent of the respondents considered the reporting of ADRs to be an integral part of their professional duties and all respondents acknowledged the importance of reporting. Four percent of pharmacists surveyed claimed that they had submitted ADR report to the Ministry of Health [MOH] and 6.3% of pharmacists claimed that they submitted ADR report to the pharmaceutical company. Several barriers identified, that prevent pharmacists from reporting ADR include, unknown address [68%], reporting form not available [62.8%], do not know how to report [41.7%] and uncertainty concerning causal relationship between ADR and the drug [30.1%]. Eighty four percent of respondents mentioned receiving a feedback from the program would encourage them to report and 83.7% of respondents indicated that publication of ADR bulletin will be important to stimulate reporting. In addition, Twenty nine percent of the suggestions mentioned educating and training of the pharmacist about the program as an important element that will improve pharmacists' participation in reporting ADR. The majority of pharmacists surveyed [86.8%] were not aware of the ADRs reporting program in Saudi Arabia and only twenty-nine percent of pharmacists were aware that pharmacists in Saudi Arabia could report an ADR to MOH. The results emphasized the importance of establishing continuing efforts to promote ADR reporting program and to overcome the barriers identified by the study

Physicians and pharmacists adherence to presecribing guidelines of controlled psychotropic drugs. A study in private sector, Riyadh, Saudi Arabia

To assess the adherence of physicians and pharmacists in private sector to the guidelines of controlled psychotropic medications [CPM], the practicality of the guidelines and the degree of enforcement and follow-up of these guidelines stipulated by the Ministry of Health. The present study was performed in ten private community pharmacies [PCPs] and six private hospital pharmacies authorized to dispense CPM in Riyadh city. Data collection form was used to assess pharmacy records for CPM, and to collect data on prescription parameters in order to assess whether the prescriptions are properly written and dispensed. A twenty% random sample of prescriptions dispensed in each pharmacy, during January 1999 to September 2001 were collected through a systematic random sampling to assess the degree of physicians and pharmacists compliance to the guidelines laid down by the MOH. The pharmacists' opinions on the practicality of the guidelines and degree of enforcement and follow up were assessed prospectively through questionnaire. An analysis of 2077 prescriptions revealed that 54% of patients were male and the mean age was 37.7 years [ +/- 14.4]. Degree of physicians' adherence to guidelines was poor in documenting patient's full name in the prescription [12,5%], use of generic name of the drug when prescribing [12.1%], duration of treatment [22.4%] and quantity to be dispensed were specified in 52.2% of prescriptions. Moreover, prescribing drugs in class 1 and 2 for maximum of two weeks was observed only in 3.1% of prescriptions. Pharmacists documented the details of prescriptions dispensed in 90.5% and stamped 76.4% of prescriptions dispensed. Furthermore, the pharmacist write his/her name and sign the prescription upon dispensing in 62.7% of situations and in 7% of situations pharmacists dispensed prescriptions after the seven days period. About 69% of pharmacies were inspected only once during the year 2001 and prescriptions were repeated for the same patients within 14 days period in 3% of prescriptions. The most commonly prescribed drugs are alprazolam [41.6%], bromazepam [16.1%], diazepam [9.2%] and chlordiazepoxide [8.8%]. Several recommendations emerged from this study that could help MOH to gain better insight to control CPM. The MOH should review the current guidelines to address the problems raised by pharmacists, distribute the guidelines to all pharmacies, improve the inspection process, introduce electronic prescribing for CPM, and setting up a national computer network. The MOH, pharmacists and physicians should agree on the minimum standards of CPM prescription and the documentation procedures, which must be adhered to by both physicians and pharmacists. Finally, a national survey of psychotropic drugs prescribing should be conducted and consumption trend analyzed and compared with other countries