Exploring patient-safety culture in the community pharmacy setting: a national cross-sectional study.

OBJECTIVE: The community pharmacy is one setting that plays a crucial role in patient safety. To develop tailored patient safety improvement programs in this setting, it is essential to know the perspectives of the pharmacies' staffs on patient safety. Thus, in this study, we assessed patient-safety culture in the community pharmacy setting in Saudi Arabia. METHODS: Between January and August of 2019, we conducted a cross-sectional study among staff working in the community pharmacies in Saudi Arabia. Data on patient safety culture were collected using the Pharmacy Survey on Patient Safety Culture (PSOPSC). Analyses were performed with descriptive statistics (frequency/percentages), Fisher's Exact test, Chi-square analysis, and multivariable ordinal logistic regression with proportional odds model analysis. RESULTS: PSOPSC data from 805 community pharmacies in Saudi Arabia were received (response rate: 78%). The overall average positive response rate for the 11 dimensions of the PSOPSC survey was 60.2%, with a range from 34.8% in the dimension of Staffing, Work Pressure, and Pace to 76.4% in the dimension of Teamwork. Most participants responded positively, as in total, 504 (62.6%) of the participants rated their pharmacy as 'excellent' or 'very good' on patient safety. Gender and work experience in a pharmacy were important predictors of the overall patient safety grade. CONCLUSIONS: The study revealed that all dimensions are scope for further improvement, and critical consideration ought to be given to the areas of weakness, for the most part in the dimension of Staffing, Work Pressure, and Pace.

The relationship between trust in primary healthcare providers among patients with diabetes and levels of depression and anxiety.

BACKGROUND: Trust in healthcare providers has been shown to improve several clinical and patient-reported outcomes. However, its relationship with depression and anxiety has not been investigated among patients with chronic health conditions, such as diabetes. Therefore, the aim of this study was to examine whether trust in primary care physicians among patients with diabetes is associated with their levels of depression and/or anxiety. METHOD: Adult patients (≥18 years) with a diagnosis of diabetes, confirmed through their electronic health records, were recruited and interviewed from the primary care clinics of three public hospitals. Patient trust in primary care physicians was assessed using the Health Care Relationship (HCR) Trust scale. Depression and anxiety were assessed using the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7), respectively. Two multiple linear regression analyses were conducted to examine the association of HCR-Trust scores with PHQ-9 and GAD-7 scores controlling for age, sex, Charlson comorbidity index score, education, health literacy, annual income, nationality, duration of illness, and research site. RESULTS: The number of patients who agreed to be interviewed was 367. Most of the participants were female (61.54%) and Saudi (92.86%). High HCR-Trust scores were negatively associated with PHQ-9 scores (ß = -0.18; 95% CI: -0.23 --0.13; P = < .0001), and GAD-7 scores (ß = -0.17; 95% CI: -0.22- -0.12; P = < .0001). CONCLUSIONS: Trust in primary care physicians among patients with diabetes was associated with lower levels of depression and anxiety. Therefore, healthcare providers should adopt a patient-centered care approach that fosters trust in the relationship between their patients and themselves. Further research should explore whether interventions that foster shared decision-making and trust in healthcare providers might also improve the health outcomes of patients with diabetes.

National rates of emergency department visits associated with diabetes in Saudi Arabia, 2011-2015.

BACKGROUND: Despite the fact that diabetes is an important component of the burden of disease on the individual and on the national healthcare systems in Saudi Arabia, knowledge of the volume of emergency department (ED) visits for diabetes is unclear. OBJECTIVE: Examine changes in ED visit rates associated with diabetes. DESIGN: Retrospective. SETTINGS: Governmental hospitals. METHODS: Publicly available records of health statistics published by the Saudi Ministry of Health from 2011 through 2015 were used to extract data on ED visits related to diabetes. ED visits associated with diabetes were compared over time and by gender. We calculated diabetes-specific rates per 10000 persons for each sex category by dividing the total number of diabetes-associated ED visits in that category by the sex-specific population. We calculated the rate difference (RD) with 95% CI between 2011 and 2015. MAIN OUTCOME MEASURES: Diabetes-specific rates per 10000 persons for each sex category. RESULTS: Total annual visits to the ED for management of diabetes increased from 617683 cases in 2011 to 748605 in 2015. The annual number of ED visits associated with diabetes increased by 21% over the study period (20% for males and 23% for females). Compared to males, females had a larger increase in visit rates from 240.5 to 249.8 visits per 10000 women over the study years (RD, 9.6 per 10000 persons, 95% CI -16.4 to 26.6 versus 5.7 per 10 000 persons, 95% CI-13.6 to 18.3 ; P=.01). CONCLUSION: Although diabetes-associated ED visit rates dramatically increased in 2012, they remained relatively stable after 2012 to the end of the study period. More effective preventive diabetes programs that prevent the use of ED visits and other expensive healthcare resources among people with diabetes are needed. LIMITATIONS: We had no information on the specific indications for the reported ED visits. These estimates may represent a lower bound on ED visits associated with diabetes since the private sector was not included. CONFLICT OF INTEREST: None.

The relationship between trust in primary care physicians and medication knowledge among diabetic patients.

BACKGROUND: Patients' trust in their physicians is critical to ensuring quality in healthcare. Despite the fact that both medication knowledge and trust in healthcare providers positively correlate with improved clinical outcomes, the presence of a link between these two attributes remains to be established. OBJECTIVES: To determine whether a relationship exists between patients' trust in their primary care physicians and their medication knowledge. METHODS: Patient trust was measured using the healthcare relationship (HCR) trust scale, and the medication knowledge by the self-reported medication knowledge questionnaire. Both forms were translated into Arabic by bilingual healthcare professionals. The relationship between the self-reported medication knowledge questionnaire scores and HCR-trust scale scores was determined by multiple linear regression, controlling for confounding variables. RESULTS: Based on information collected from 293 diabetic patients, a positive relationship was identified between patients' knowledge of medications and their trust in primary care physicians (ß = 0.115; 95% confidence interval, 0.076-0.153; p < 0.0001). Medication knowledge was also positively associated with the female sex and education. CONCLUSION: A significant relationship exists between the patients' knowledge of their prescription medications and trust placed in their primary care physicians. The underlying mechanism of this association warrants further studies.