Generic Substitutions and Therapeutic Interchanges in Hospital Pharmacies: A Qualitative Study from Western Saudi Arabia.

Background: The aim of the present study was to understand hospital pharmacists' views and practices regarding generic substitution and therapeutic interchange. Method: This was a qualitative study involving pharmacists from three Western Saudi governorates: Taif, Makkah, and Jeddah. It included respondents from the Ministry of Health (MoH), military and private hospitals. Pharmacists were selected using a convenient sampling technique and data were collected using a structured face-to-face interview. Results: Fifty-seven pharmacists agreed to participate in this study. In MoH and private hospitals, generic substitution is a pharmacist-initiated act, while therapeutic interchange requires physician approval. Medication unavailability, side effects, patient characteristics, outcomes, and economic status justified most substitution decisions. In military hospitals, both types of substitutions are controlled by an auto-switch policy and physicians should be informed. In all hospitals, there are policies regulating substitution. Medications eligible for interchange mentioned by pharmacists from different hospitals were comparable to some extent. Pharmacists from the private sector considered substitution a supportive economic measure for both hospitals and patients. Most pharmacists highlighted that patient convenience and physician approval are the most challenging situations in substitution practice. Conclusions: An enhanced understanding of substitution and knowledge about medications included in the hospital formulary will be valuable support to the implementation of substitution practice which responds to the patients' needs to improve their outcomes.

Home Drug Delivery Service from the Perspective of Community Pharmacy Staff in Saudi Arabia.

Background: In response to COVID-19, many big pharmacy chains in Saudi Arabia have started to provide home drug delivery services. This study aims to understand home drug delivery service from the perspective of community pharmacists in Saudi Arabia. Also, the study investigates the obstacles that may limit the use of home drug delivery service. Methods: A cross-sectional self-reported survey was distributed from February 2021 to May 2021. Descriptive analysis of sociodemographic characteristics was conducted and presented. Frequencies and percentages were calculated for all variables. Results: A total of 965 community pharmacists were surveyed. Most of the pharmacists, (73.5%) were young, aged 23 to 34 years old. The vast majority of the participants, (93.6%), said that the service will improve drug adherence. The lack of required knowledge and skills among pharmacists could be the main obstacle to implement home drug delivery service (34%). A shortage in the number of community pharmacists was the second main obstacle (24%). Conclusion: Home delivery services in the future may largely replace the tradition of going in person to the pharmacy. There are obstacles that may limit the full use of the service like shortage in number of pharmacists and the lack of required training.

Cost-Benefit Analysis of Interventions to Mitigate the Monkeypox Virus.

When a viral outbreak occurs, governments are obligated to protect their citizens from the diverse adverse effects of the disease. Health policymakers often have several interventions to consider based on the health of the population, as well as the cascading social and economic consequences of the possible mitigation strategies. The current outbreak of the monkeypox virus has elicited debate on the best mitigation strategy, especially given that most world economies are still recovering from the harsh economic effects of the COVID-19 pandemic. This paper sought to analyze the costs and benefits of three possible strategies and determine which option has the best health outcomes and positive economic effects. A case study of Jeddah was performed, whereby a model was simulated to determine the number of infections over 28 days based on one case of the monkeypox virus. Findings reveal that the vaccination provides the best intervention, as it effectively reduces the transmission rate and prevents loss of lives in the city. From the model, only three people were infected over the research period, while no deaths were reported. Although vaccination incurs a huge direct cost at the beginning, in the long run, it saves the economy from the disease's financial burden in terms of productivity loss from work absenteeism and premature deaths.

Community Pharmacists' Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services.

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists' soft skills, clear policies and authorization for offering this type of service are also needed.