Evaluation of patients' knowledge on warfarin in outpatient anticoagulation clinics in a teaching hospital in Qatar

To evaluate the extent and quality of the patient's education on warfarin and its possible impact on the international normalized ratio [INR]. This is a cross-sectional study using a 20-item, self administered questionnaire of knowledge, offered to patients who were taking warfarin for at least 2 months and attending the medical or cardiology anticoagulation clinics in Hamad General Hospital, Hamad Medical Corporation, State of Qatar between August 2008 to November 2008. A total of 140 patients completed the questionnaire, 116 patients [83%] reported that they received warfarin education and 61 patients [44%] had a controlled INR. Of the 79 patients with satisfactory knowledge [namely, overall score of at least 75%], 49 [62%] had a therapeutic INR compared with 12 [20%] having unsatisfactory knowledge [p<0.0001]. The lowest scores were for participants' knowledge on the effects of a missing dose and its management [42%] and for warfarin drug interactions [36%]. An integrated and multidisciplinary education program may improve the patient's knowledge on warfarin as well as patient's compliance. This might lead to a better anticoagulation control, fewer clinic visits, and decrease in healthcare service load. Special attention should be addressed to geriatric patients and to those patients with low educational level and language barriers

Prescribing pattern of acid suppressive medications for medical inpatients in a teaching hospital in Qatar

To assess the prescribing pattern of acid suppressive medications ASMs in medical inpatients in a teaching hospital in Qatar, and compare this with the American Food and Drug Administration approved indications, and published data. This study is based on a review of the patient-s medical records for the usage of ASMs, namely, histamine-2 receptor antagonists H2RAs, and proton pump inhibitors PPIs in patients admitted consecutively to the medical wards of Hamad General Hospital, Doha, Qatar from May through June 2007. The review included the type of ASM used, timing of prescription before, or during admission, risk factors for ulcer development, and indication for use. Records for patients using ASMs after discharge without justified indication were assessed 2 months later. A total of 389 patients were admitted, 206 53% received ASMs during their hospital stay, 48 12% of them were taking ASMs before admission. One hundred and eighty-four patients 89% received PPI, and 22 11% received H2RA. During admission, the usage of ASMs was justified in 70 34% patients. One hundred and twenty-nine 63% received ASMs after discharge, the usage of which was justified in only 59 46% patients. From the 70 patients receiving ASMs after discharge for unjustified indications, 30 43% patients were re-prescribed with ASMs, 2 months or more after discharge. Acid suppressive medications are prescribed in the majority of these patients without justified indication. Moreover, many of them continued their ASMs for at least 2 months after discharge

Metered dose inhaler technique among healthcare providers practising in Oman

To evaluate the correctness of metered-dose inhaler [MDI] technique in a sample of healthcare providers practicing in Oman, considering that poor inhaler technique is a common problem both in asthma patients and healthcare providers, which contributes to poor asthma control. A total of 150 healthcare providers [107 physicians, 33 nurses and 10 pharmacists] who were participants in symposia on asthma management conducted in five regions of Oman, volunteered for the study. After the participants answered a questionnaire aimed at identifying their involvement in MDI prescribing and counseling, a trained observer assessed their MDI technique using a checklist of nine steps. Of the 150 participants, 148 [99%] were involved in teaching inhaler techniques to patients, and 103 of 107 physicians [96%] had prescribed inhaled medications. However only 22 participants [15%] performed all steps correctly. Physicians performed significantly better than non-physicians [20% vs. 2%, p < 0.05] among the physicians, internists performed better [26%] than general practitioners [5%] and accident and emergency doctors [9%]. The majority of healthcare providers responsible for instructing patients on the correct MDI technique were unable to perform this technique correctly indicating the need for regular formal training programmes on inhaler techniques