Characteristics of the clinical pharmacists' interventions at the main general tertiary care hospital in Qatar.

Medication-related problems (MRPs) are prevalent throughout healthcare systems, whereby pharmacy-based interventions are pivotal to reducing occurrence. In the Middle East, including Qatar, the professional roles of pharmacists have been expanding to improve patient safety. This study aimed to characterize and analyze pharmacist-led interventions among hospitalized patients in the leading general hospital in Qatar. A retrospective analysis of pharmacist interventions in the internal medicine ward, critical care unit, and emergency department (ED) was conducted. Data were extracted from three periods of 1 month (March 1-31, 2018, July 15-August 15, 2018, and January 1-31, 2019). A descriptive type of analysis was undertaken. A total of 340 patients with 858 interventions were analyzed. The average age of the study participants was 51 years (SD ± 17.7). The study population was predominantly male (65%). The prevailing pharmacist intervention was adding drug therapy (27%), followed by medication discontinuation (18%) and dosage adjustments (16%). This pattern was maintained across all subpopulations, e.g., gender, age, and ward, except for the ED, where cessation of medication was the most frequent intervention (4%). The two pharmacological classes associated with most interventions were anti-infective and cardiovascular agents. Pharmacist interventions effectively identify, prevent, and resolve MRPs in general inpatient settings in Qatar.

Patterns and outcomes of paracetamol poisoning management in Hamad Medical Corporation, Qatar: A retrospective cohort study.

We aimed to investigate the characteristics and clinical outcomes of paracetamol poisoning and paracetamol overdose in Qatar. This retrospective cohort study included patients admitted to the emergency department (ED). We included patients who presented with excessive paracetamol ingestion, between December 2018 and September 2019. The primary outcomes were describing the characteristics and outcomes of paracetamol overdose (from a suicidal overdose or accidental overdose, dose ≤ 150 mg/kg, when serum levels of <60 mmol/L) or dose ingested (≤75 mg/kg) with staggered ingestion poisoning due to suicidal attempt or accidental attempt, defined as the dose ingested (>150 mg/kg), acute ingestion, nomogram level more than the treatment line, or dose ingested (>75 mg/kg) with staggered ingestion, and assessing the management of excessive paracetamol ingestion. Secondary outcomes included evaluation of the time difference between ingestion and time of administration, hospitalization, and adverse drug events. Significant differences were detected between patients who presented with paracetamol overdose and those who presented with paracetamol toxicity. A total of 69 patients were analyzed, of whom 43 received paracetamol overdose (mean age 27.5 ± 11.1 years) and 26 had paracetamol poisoning (mean age 25 ± 6.22 years). Paracetamol poisoning was identified in 26% of the patients with a 24.3% history of psychiatric illness, compared to 18.6% with paracetamol overdose. More patients presented with paracetamol toxicity in the time between ingestion and obtaining serum levels compared to the overdose group. A significantly longer length of hospitalization was observed in the toxicity group. A significantly higher number of patients in the toxicity group received N-acetylcysteine (NAC). More hypotension and rashes were observed among those who received NAC in the toxicity group. Patients presenting to the ED due to paracetamol toxicity are not uncommon, and most cases occur in young adults, and few in patients with a history of psychiatric illness, suggesting that preventive approaches are highly required.

Characteristics of the clinical pharmacist interventions at the National Center for Cancer Care and Research Hospital in Qatar.

INTRODUCTION: Drug-related problems (DRPs) affect the health outcomes of patients during hospitalization. We sought to analyze the clinical pharmacist-documented interventions among hospitalized patients in the cancer hospital in Qatar. METHODS: A retrospective analysis of electronically reported clinical pharmacist interventions of patients admitted to cancer units at Hamad Medical Corporation, Qatar was conducted. Extracted data was based on an overall 3-month follow-up period; March 1-31, 2018, July 15-August 15, 2018 and January 1-31, 2019. Categorical variables were expressed as frequencies and percentages, while continuous variables were expressed as mean ± standard deviation (SD). RESULTS: A total of 281 cancer patients with 1354 interventions were included. The average age of the study participants was 47 years (SD ± 17.36). The majority of the study population was females (n = 154, 54.80%). The prevailing pharmacist intervention was the addition of a drug therapy (n = 305, 22.53%), followed by medication discontinuation (n = 288, 21.27%) and the addition of a prophylactic agent (n = 174, 12.85%). This pattern was similar across all subgroups (i.e., gender, age, ward), except for the urgent care unit, where an increase in medication dose was the third highest frequently identified intervention (n = 3, 0.22%). The two medication groups associated with the majority of interventions were the anti-infective and fluid/electrolyte agents. Most of the interventions documented were in the oncology ward (73.19%), while the urgent care unit had the least documented interventions (1.62%). CONCLUSIONS: Our analysis showed that clinical pharmacists can effectively identify and prevent DRPs among hospitalized cancer patients.

Impact of Clinical Pharmacist Interventions on Economic Outcomes in a Cardiology Setting in Qatar.

We sought to investigate the economic impact of preventing adverse events in a cardiology setting in Qatar as an effect of the clinical pharmacist as an intervention. This is a retrospective study of interventions by clinical pharmacists within an adult cardiology setting in a public healthcare setting (i.e Hamad Medical Corporation). The study included interventions that took place in March 2018, July 15, 2018 to August 15, 2018, and January 2019. The economic impact was measured via calculating the total benefit, defined as the sum of the cost savings and the cost avoidance. Sensitivity analyses were adopted to confirm the robustness of the results. The pharmacist intervened in 262 patients, resulting in 845 interventions, with appropriate therapy (58.6%) and dosing/administration (30.2%) being the most frequent categories of reported interventions. Cost savings and cost avoidance resulted in QAR-11,536 (USD-3169) and QAR1,607,484 (USD 441,616), respectively, yielding a total benefit of QAR1,595,948 (USD 438,447) per 3 months and QAR6,383,792 (USD 1,753,789) per a year.

Risk of serotonin syndrome in acutely ill patients receiving linezolid and opioids concomitantly: a retrospective cohort study.

Introduction: Linezolid is an oxazolidinone antibiotic with a reversible, non-selective, monoamine oxidase inhibitory effect. Combining linezolid with serotonergic agents may increase serotonin syndrome (SS) risk.Linezolid is recommended in patients with suspected or confirmed resistant Gram-positive bacterial infections, especially if vancomycin cannot be used. However, it is unclear whether co-administration of linezolid with opioids increases the risk of serotonin syndrome. Research objective: To establish whether combining linezolid with opioids will increase the incidence of SS in acutely ill patients. Methods: This was a retrospective observational study. All adult patients who were admitted and received linezolid between March and September 2020 were included in the study. The primary outcome was the prevalence of SS, as defined by Hunter's criteria. Results: The study included 106 patients, most whom were males (91.5%). More than half of the cohort (56.6%) received a concomitant opioid agent. Morphine and fentanyl were the most prescribed opioids (37.7% and 34%, respectively). Among patients who received opioids, only one patient (1.6%) had spontaneous clonus. However, this patient developed spontaneous clonus post cardiac arrest, which made an association with the linezolid-opioids combination less likely. Conclusion: In this study, the incidence of SS was low in acutely ill patients who received concomitant linezolid and opioids. However, larger prospective studies are required to confirm this finding.

Knowledge and attitude regarding coronavirus disease 2019 (COVID-19) among hospital pharmacists in Qatar.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gained global attention because of its high transmissibility and the devastating impact on both clinical and economic outcomes. Pharmacists are among the front-line healthcare workers who contributed widely to COVID-19 pandemic control. We aim to evaluate knowledge and attitude of hospital pharmacists in Qatar about COVID-19. Methods: A descriptive cross-sectional web-based survey was distributed over a 2-months period. The study included pharmacists who are working in 10 different hospitals under Hamad Medical Corporation (HMC). The survey was developed based on information available at World Health Organization (WHO) website, Qatar Ministry of Health, and COVID-19 guideline created by HMC. The study was approved by HMC's institutional review board (MRC-01-20-1009). Data analysis was done using SPSS version 22. Results: A total of 187 pharmacists were included (response rate 33%). The overall level of knowledge was not affected by the participants' demographics (p-value ≥0.05). Pharmacists provided more correct answers to questions related to general knowledge about COVID-19 compared to questions specificto treatment aspects of the disease. More than 50% of pharmacists were using national resources as main source of information related to COVID-19. Good health practices and attitudes regarding disease control was reported by pharmacists, including preventive measures implementation and self-isolation when needed. Around 80% of pharmacists are in favor of taking influenza vaccine and COVID-19 vaccine. Conclusion: Overall, hospital pharmacists' knowledge about COVID-19 is good in relation to the disease nature and transmission. Knowledge about treatment aspects including medications needs further enhancement. Providing continuing professional development activities regarding latest information about COVID-19 and its management, and serial newsletters updates, and encouraging journal club activities for recently published research can help improve hospital pharmacist knowledge.