Physicians' attitudes and confidence toward dementia care: A cross-sectional study at primary healthcare facilities in the Eastern Province, Saudi Arabia.

BACKGROUND: Primary care physicians play an essential role in the health of older adults as they are frequently the first point of contact. Their positive attitude and knowledge influence the quality of care provided to patients with dementia and their caregivers. This study examined the attitudes of primary care physicians towards dementia care and their confidence in their own dementia-care skills. MATERIALS AND METHODS: This cross-sectional study was conducted among 316 primary care physicians working in Eastern Province of Saudi Arabia. Data were collected using a structured questionnaire that included questions related to demographic characteristics, Dementia Care Attitude Scale (DCAS) to assess attitudes towards dementia, and Confidence in Dementia Care Skills (CDCS) Scale to measure confidence. Data were analyzed using SPSS version 29; mean and standard deviation (SD) were computed for continuous and categorical variables were described using frequencies and percentages. Mann Whitney U test and Kruskal Wallis test were used to compare attitude and confidence scores by categorical variables. RESULTS: The mean DCAS score was 36.4 ± 5.41 out of 50. On a scale ranging from 15 to 75, the mean CDCS was 51.89 ± 10.20. A statistically significant (P < 0.05) relation was found between confidence and professional rank, knowing close relatives with dementia, and number of dementia and elderly patients treated. Overall, 78.9% of physicians lacked confidence to prescribe memory medications; 32% felt that dementia management was generally more frustrating than rewarding. CONCLUSION: Primary care physicians had a positive attitude toward caring for patients with dementia. However, they lacked confidence in their dementia care skills in several areas. The confidence in their diagnostic skills was higher than their management skills. Most challenging skills were recognizing and managing behavioral symptoms of dementia. Need to develop educational and training interventions that target healthcare providers to help improving dementia care in primary care settings.

Academic Burnout, Stress, and the Role of Resilience in a Sample of Saudi Arabian Medical Students.

Background: Medical school can be difficult and stressful. Academic burnout is described as exhaustion from curricular activities. Medical students are more likely to experience anxiety. Objective: This study investigated the level of academic burnout and stress as well as their level of resilience. Methods: Saudi medical students were surveyed in a cross-sectional questionnaire-based study. We used the following scales: Perceived Stress Scale, Maslach Burnout Inventory-Student Survey, and the Connor-Davidson Brief Resilience Scale to assess stress, academic burnout, and resilience respectively. Results: The mean score for emotional exhaustion, 20.23 ± 6.8, indicated a high level of burnout among students. The students reported a moderate level of stress. Females, students who were single or lived away from home had higher levels of burnout in certain domains. Students with a higher level of resilience experienced less stress and burnout. Conclusion: Academic burnout has a negative impact on mental health. Effective interventions should be designed to assist students to cope better with stress and also identify solutions to avoid burnout. More research is needed to investigate the social and environmental factors contributing to medical student burnout.

Risk of Obstructive Sleep Apnea and its Relation to Cognitive Functions Among Saudi Older Adults.

Background: The association between obstructive sleep apnea (OSA) and cognitive decline among older adults is a still a topic of debate. Objective: The aim of this study was to determine the association between risk of OSA and cognitive function among Saudi older adults. Methods: This was a cross-sectional community-based study conducted between July and October 2022. Participants were recruited from gathering areas where older adults are likely attending such as district centers, waiting areas of shopping malls, and mosques. Questionnaires were completed using face-to-face interviews. The questionnaire included questions of sociodemographics, sleep pattern and health status. A validated Arabic version of Athens insomnia scale, STOP-BANG questionnaire, and St. Louis University mental status (SLUMS) questionnaire were used. A multi-Linear regression model was used to determine the association between cognitive functions and OSA. Results: A total of 343 participants were recruited in this study, of which 86% were male. The mean age was 65±9 years. 65% of participants with high risk of sleep apnea were diagnosed with either dementia or mild cognitive impairment (MCI). Most of the participants who were illiterate (83%) had dementia, while only 4% of participants with higher education had dementia. Conclusion: Dementia and mild cognitive impairment is prevalent among Saudi older adults with high risk of OSA. Clinicians and patients should be aware of the risk of developing dementia in patients with OSA, especially if remain untreated.

Adherence to the monitoring of metabolic syndrome in patients receiving antipsychotics in outpatient clinics in Saudi Arabia.

BACKGROUND: Monitoring protocols have been developed because patients taking atypical antipsychotics are more prone to developing metabolic syndrome, which leads to possible increased mortality and morbidity. The aim of this study was to assess the degree of adherence to the recommendations of metabolic syndrome monitoring. MATERIALS AND METHODS: This study was conducted in two large psychiatric facilities in the Eastern Province of Saudi Arabia. A retrospective analysis of the medical records of 350 patients taking antipsychotic medications was done, and an assessment was made of the frequency of metabolic monitoring at each of the intervals as suggested by the American Diabetes Association. Data was analyzed using SPSS; descriptive statistics. were computed and Chi-square test was used to determine statistical significance for association between categorical variable. RESULTS: The mean age of the patients was 34.9 ± 18 years; 64.6% were males. Olanzapine was the most prescribed medication (43.7%, n = 153), followed by quetiapine (17.4%, n = 61). Only one-third of the patients (29.6%) completed all the baseline parameters. Documentation of baseline parameters was low for glucose level (38.9%), lipid panel (17.3%), weight (25.2%), and waist circumference (1.4%). Adherence to yearly monitoring was much lower than at baseline (mean percentage: 29.6% vs. 1.7%). Furthermore, 45% of the patients were classified as obese and 10% had metabolic comorbidity. CONCLUSION: Individuals with mental illness who were taking antipsychotics did not undergo proper metabolic screening during antipsychotic treatment. Barriers to adherence to the monitoring guidelines should be examined and addressed. Giving assistance to practitioners to recall the required laboratory tests and vitals at certain intervals could help improve metabolic monitoring practices.

A Comprehensive Monitoring of Clozapine and Related Components in Clinical Practices. Saudi Arabian Scenario.

Objectives: Clozapine is considered as effective medication for treatment resistant schizophrenia. Due to its potential severe adverse effects' clozapine is underused in the clinical settings. Information's on clinical use and monitoring of clozapine is lacking in middle east. This research analysis clozapine prescription and monitoring patterns a in a university teaching hospital in Saudi Arabia. Experimental design: A retrospective observational study was conducted in the psychiatric department of a university hospital in Saudi Arabia. Patients on treatment with clozapine for minimum one year were reviewed and assessed for clozapine mandatory and non-mandatory requirements and its correlated factors. Observation: Majority of patients were male [(n = 36) 63%] and the average age of was 36.8 ± 12.3. TRS schizophrenia[(n = 49),85%] was the common indications. Prior to initiation of clozapine all recommended guidelines was followed for all patients (100%). In addition to the blood monitoring and vitals LFT (80.75%) and weight (87.77%) were frequently measured. Hematological work up performed routinely throughout initial 18 weeks (71.9 %) and every month (59.6%). Weight gain (29.8%) was the most documented adverse effects. Conclusion: The current study explored experiences with clozapine prescribing practices in a university hospital KSA and suggest that clozapine prescription is completely adhered with already existing guidelines in terms of dosing and monitoring. There exist a careful balance of benefit and risk in term of adverse reaction of clozapine in the local population.