ABSTRACT
BACKGROUND: Therapeutic drug monitoring (TDM) is the widely used tool in neuropsychiatric disorders. It is a valuable tool for tailoring the dose, preventing adverse drug reactions, and testing the drug adherence, therapeutic nonresponse, pharmacokinetic, and drug-drug interactions. TDM is most useful for individualized pharmacotherapy in bipolar disorders. But there exists a death of information on TDM of mood stabilizers in real-life scenario. Hence, this study aimed to assess the use and indication of TDM for mood stabilizers in a university hospital. MATERIALS AND METHODS: A descriptive, retrospective, study was carried in a university teaching hospital in Dammam metropolitan region of Saudi Arabia. Patients were included in the study if they had a mood stabilizer with serum level drawn between January 2017 to December 2018. The patient list was collected from "QuadraMed" health information system. TDM details such as values of each TDM, reason for the TDM, and number of TDM for 1 year have been documented. RESULT: A total of 200 patients received 242 mood stabilizers during the study period. Gender distribution was almost equal in the study population male (52%) versus female (48%). Average age of the patients was 40 years (range = 17-87 years). A total of 41.5% (n = 83) patients were diagnosed with bipolar type 1. Valproic acid (n = 139 [57.9%]) and lithium (n = 54 [22.3%]) were the most commonly used mood stabilizers. Majority (80%) of the bipolar patients were managed with single mood stabilizers. A total of 613 TDM was ordered for the 200 patients during the study period. The average number of TDM per patient during the study period was 3 (range = 1-39). Validation of the therapeutic level (n = 140), lack of clinical response (n = 51), and change in the dose (n = 34) are the documented reasons for TDM. CONCLUSION: This study highlights the common and specific reasons for TDM of mood stabilizers in routine clinical practice. More extensive study on a larger sample size in the prospective basis is required to find out the rationality of TDM orders and its outcome for the development of the polices.
ABSTRACT
BACKGROUND: The demographic profile and clinical manifestations of mood disorder subtypes can differ across regions; however, there is a lack of studies from Saudi Arabia on the sociodemographic characteristics of adult Saudi patients with mood disorder subtypes. OBJECTIVE: The study aims to explore the sociodemographic profile of adult Saudi patients with different types of mood disorders. METHODS: This retrospective study analyzed the data of all adult Saudi patients (aged ≥18 years) who were diagnosed with a mood disorder and attended the psychiatric outpatient clinic at King Fahd Hospital of the University (KFHU), Al Khobar, Saudi Arabia, between 1982 and 2011. Patients with psychiatric comorbidity were not included in the analyses. Major depressive disorder (depression), bipolar disorder, adjustment disorder and dysthymia were the four subtypes of mood disorder identified in the sample, and all eligible patients were categorized accordingly. RESULTS: A total of 340 patients were included in this study. Slightly less than half (42.4%) the study population were aged 18-30 years. Further, 58% of the patients were females, 67.6% were married and 58.8% were unemployed. Depression was the most common mood disorder (~73%). Of the patients with bipolar disorder (n = 38), more than half were male and aged 18-30 years (~58% each); these percentages were higher than that observed in other subtypes. CONCLUSION: This study found that among patients at KFHU, depression is the most common mood disorder and that most patients are females. In contrast, bipolar disorder is more common among males. Further in-depth studies in a larger sample size may provide better patient profiling, which can be used for developing effective screening programs.
ABSTRACT
BACKGROUND: Faculty members are crucial elements of an educational institution, and their job satisfaction is likely essential for success of the educational process. Leadership support, work conditions and perceived job security could be factors affecting academic job satisfaction. OBJECTIVE: The aim of the study was to investigate the effect of leadership support, work conditions and perceived job security on the overall academic job satisfaction of faculty. MATERIALS AND METHODS: A cross-sectional survey, using a structured questionnaire, was conducted to determine the effect of leadership support, work conditions and perceived job security on academic job satisfaction among faculty and teaching staff at the College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Multiple regression analysis was performed to examine the significance of these relationships at 95% confidence interval and P < 0.05 level of significance. RESULTS: Leadership support (ß = 0.187, t = 2.714, P = 0.007), work conditions (ß = 0.199, t = 2.628, P= 0.009) and perceived job security (ß = 0.264, t = 3.369, P = 0.001) were found to be significantly associated with overall academic job satisfaction. CONCLUSION: The results of this study support the hypothesis that faculty and teaching staff working with supportive leaders and favorable work conditions as well as having an optimized sense of perceived job security demonstrate significantly higher levels of overall academic job satisfaction. These findings provide input for policymakers, and their implementation could enhance an institution's vitality and performance, and thus enable it to fulfill its goals.
