Evaluation of community pharmacists' knowledge, practice and barriers towards diabetes management in Asir region, Saudi Arabia.

RATIONALE, AIMS AND OBJECTIVES: Diabetes mellitus is a global serious health problem that has a clear negative impact on economy. The high prevalence of diabetes worldwide urges for prevention and educational programs. Engagement of community pharmacists in offering various diabetes care services enables delivery of quality of care for patients and could play key role in diabetes management. The current study was designed to assess the knowledge towards diabetes among community pharmacists and to investigate their role in diabetes management through identifying different diabetes care services they provide in Asir region, Saudi Arabia. In addition, possible barriers for providing these services were evaluated. METHOD: A cross-sectional study was performed using an online self-administered anonymous survey that consisted of 4 domains: demographics, knowledge, practice and barriers related to diabetes management. RESULTS: A total of 258 pharmacists completed the survey, and one-third of respondents (34.5%) demonstrated good knowledge while 42.2% showed moderate knowledge towards diabetes. Respondents of the age group (30-39) years, males, those with bachelor's degree and those with 5 years or less of experience had higher mean knowledge. Nearly half of the participants had positive practice. The most prominent (75%) services offered by the community pharmacists were counselling on the appropriate administration, handling and storage of insulin and the appropriate time to administer oral antidiabetic drugs. Pharmacists who received training had higher mean practice scores. Lack of time, lack of diabetic patients visiting the pharmacy and low patient expectations regarding pharmacists' role in diabetes care were identified as the most important barriers they encountered. CONCLUSION: Community pharmacists of Asir region exhibited moderate knowledge and practices regarding diabetes management. Our results support the need for national advanced diabetes training programs targeting community pharmacists for providing quality of care services for diabetic patients Moreover, strategies to overcome the reported barriers are indispensable.

A cross-sectional study on the self-management of asthma and asthma control among adult asthmatic patients in the Aseer region, KSA.

Proper management of asthma is crucial for maintaining control over the disease and has a significant impact on the patient's overall condition. The purpose of this study was to determine the extent of self-management and the level of Asthma control in the patients from the Aseer region of Saudi Arabia, as well as to investigate determinants of illness control. A study was conducted using quantitative cross-sectional methods. Researchers utilised a web-based, self-administered structured questionnaire to gather data. The questionnaire included three sections: a socio-demographic section, an Asthma Self-Management Questionnaire (ASMQ), and Asthma Control Test (ACT). An analysis using the chi-square test was conducted to determine if there was a notable connection between the socio-demographic characteristics of the participants and the level of asthma control. A total of 305 responses were collected. The average score for the Asthma Self-Management Questionnaire was 5.72, which corresponds to 40.9%. Based on the scores from the Asthma Control Test, it was found that 60 patients (20.0%) had asthma that was not under control, 94 (30.0%) had asthma that was partially controlled, and 151 (50.0%) had asthma that was well controlled. Factors such as gender, non-smoking status, and having asthma for over 10 years (p ˂0.05) were found to be strongly correlated with improved disease control. Significant gaps were found in patients' awareness of the most important and critical aspects concerning the condition, medications, and preventative actions that limit asthma aggravation. To address the current situation, hospitals and clinics must make substantial efforts.

Community Pharmacists' Knowledge and Perception towards Telepharmacy Services and Willingness to Practice It in Light of COVID-19.

Background: During the COVID-19 pandemic, there was increased adoption of telepharmacy, which has proven benefits. This study was conducted to assess the knowledge and perception of the community pharmacists of Aseer region, Saudi Arabia, towards telepharmacy services and evaluate their willingness to adopt telepharmacy in clinical practice during the COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted using an online self-administered structured anonymous questionnaire on the community pharmacists of Aseer region, Saudi Arabia. It covers demographics, computer access and literacy, knowledge and perception, and willingness to practice telepharmacy. Results were expressed as frequencies, percentages, and mean. The comparison between the classes of the demographic variables and the scores was done via Kruskal-Wallis and Mann-Whitney tests. Result: About half of the pharmacists in our study showed average knowledge about telepharmacy, the practical application of telepharmacy technology, and telepharmacy guidelines with a percentage of 53%, 52%, and 47%, respectively). Majority of the participants showed high perception towards telepharmacy in Saudi Arabia, while 93% of the pharmacists in Saudi Arabia agreed that the implementation of telepharmacy technology is appropriate due to the current COVID-19 pandemic. Only a significant relation was found between gender and computer access, literacy, and perceptions towards telepharmacy with p values of 0.033 and 0.026, respectively. Conclusion: The majority of the community pharmacists exhibited a positive perception and are willing to practice the concept of telepharmacy despite having a below average knowledge of telepharmacy. A future study involving the entire kingdom of Saudi Arabia could help identify the gaps in the knowledge, perception, and willingness to practice telepharmacy on a broader scale and thus promote telepharmacy adoption in the entire kingdom.

Pain and quality of life of patients with end-stage renal disease undergoing hemodialysis in Aseer region, Saudi Arabia.

BACKGROUND: Pain has an adverse effect on HRQoL and has social, psychological, and physical repercussions for ESRD patients. In the present study, we assessed chronic pain in ESRD patients on HD in terms of severity and interference with activity. We also assessed the impact it has on these patients, along with looking at the factors that were linked to QoL in this population. METHODS: A multicenter, cross-sectional study carried out between April and July of 2023 in the hemodialysis units of Asir Central Hospital and Khamis Mushait General Hospital. Brief Pain Inventory and European Quality of Life scale 5 dimensions (EQ-5D) scale, including its European Quality of Life visual analogue scale (EQ-VAS) component, were used to assess pain and QoL, respectively. RESULTS: A total of 97 participants were included in the final study. The average interference level of pain with daily functions was 22.5 ± 15.0 out of 70. The mean interference score was significantly higher among patients at rural areas (28.2 ± 16.3; P = 0.012), and those who undergone dialysis session for ≥ 4 times per week (31.6 ± 16.7; P = 0.026). The overall score of quality of life ranged from 20% to 92% with mean score of 36.5 ± 12.8%. The multiple linear regression analysis revealed that patients with higher BMI, more frequent dialysis sessions per week, and higher level of pain interference with daily functions demonstrated lower QoL (B= - 2.36, - 1.46, and - 0.64, respectively. CONCLUSIONS: Pain has a significant negative impact on QoL in ESRD patients undergoing HD. Patients with higher BMI, more frequent dialysis sessions, and higher level of pain interference with daily functions are at higher risk of lower QoL. These findings provide valuable information for educators, physicians, and other healthcare providers working with patients undergoing HD.

Beliefs and Barriers to COVID-19 Vaccine Acceptance in Three Countries with Different Human Development Index (HDI) Scores: A Comparative Study.

Background: As vaccination is a cornerstone strategy to prevent the spread of COVID-19, this study assessed and compared beliefs about and barriers to COVID-19 vaccination among the population of three countries with different Human Development Index (HDI) scores: Saudi Arabia (very high), India (medium), and Sudan (low). Methods: A web-based, self-administered structured questionnaire was employed to collect data from the three countries. The questionnaire contained three sections that measured sociodemographic characteristics, participants' beliefs about and attitudes toward COVID-19 vaccines, barriers to receiving COVID-19 vaccines, and scenarios in which there is a possibility to take a COVID-19 vaccine. Multinomial logistic regression was used to determine whether there was an association between the country of the participant and their beliefs about COVID-19 vaccines. Results: 972 responses were collected. The study participants from India were more likely to believe in the safety and efficacy of vaccines than those from Saudi Arabia or Sudan. Consequently, they reported more willingness to get vaccinated to avoid complications from COVID-19. Regarding barriers to COVID-19 vaccination, concerns about adverse effects and ineffectiveness of vaccines were more common among Saudi participants, while concerns about conspiracy were more common among Sudanese participants. Conclusion: COVID-19 vaccine acceptance was higher in countries with a very high to medium Human Development Index, indicating greater belief in the safety and efficacy of COVID-19 vaccines.

Sickle cell disease patients' health-related quality of life in the southern region of Saudi Arabia.

BACKGROUND: Research that focuses on the health-related quality of life of patients with sickle cell disease remains challenging in Saudi Arabia. AIMS: This study aims to assess the health-related quality of life of sickle cell disease patients and determine the factors that contribute to a poorer quality of life in the Asir Region or southern region, compared with other regions in Saudi Arabia. METHODS: Sickle cell disease patients attending Asir General Hospital and Abu Aresh General Hospital were consecutively invited to enrol in the study from November 2019 to April 2020. The Medical Outcomes Study (SF-36) questionnaire was used to assess the health-related quality of life of patients with sickle cell disease. RESULTS: This study included 107 individuals (22 males and 85 females) with sickle cell disease, with a mean age of 25 ± 7.851. The mean physical health summary and mental health summary were 60.6 ± 23.4 and 52.12 ± 22.37, respectively. Exercise and family support affected the physical health, mental health and vitality scores positively, while swelling and fever had a negative effect on physical and mental health. Furthermore, more educated patients demonstrated significantly better mental health than uneducated or less educated patients (P = .031). CONCLUSION: Patients with sickle cell disease exhibited a poor health-related quality of life. Interventions such as a comprehensive center for sickle cell disease should consider improvements in health-related quality of life important outcomes.

The Knowledge and Attitude of the Community from the Aseer Region, Saudi Arabia, Toward COVID-19 and Their Precautionary Measures Against the Disease.

BACKGROUND: Community adherence to current control measures is one of the vital factors that determines the success of controlling the spread of COVID-19. This adherence depends on the knowledge and attitude of a community toward COVID-19 and their precautionary measures against the disease. OBJECTIVE: This study aims to evaluate the knowledge and attitude of the community from the Aseer Region, Saudi Arabia, toward COVID-19 and their precautionary measures against the disease. METHODS: The descriptive cross-sectional study involved an online sample of participants from the Aseer Region, Saudi Arabia, who were recruited based on a nonprobability convenience sampling method from April to May 2020. The self-administered online questionnaire comprised four parts: the first included the demographic details of the participants; the second consisted of 11 closed-ended questions that assessed the participants' knowledge of COVID-19; the third contained six closed-ended questions that assessed the participants' overall attitude toward COVID-19; and the fourth comprised six closed-ended questions on the participants' precautionary measures against COVID-19. The data were analyzed using Statistisoftware SPSS 21.0. RESULTS: Altogether, 740 participants completed the online questionnaire. The mean knowledge score concerning COVID-19 was 8.08 ± 1.765. Graduate participants scored significantly higher for all knowledge items than those from other educational levels. Furthermore, the main source of COVID-19 information was the Ministry of Health website 661 (89.3%). The mean attitude score regarding COVID-19 was 9.74 ± 1.935, whereas the mean precautionary measures score was 10.09 ± 1.91. University-educated participants scored significantly higher for all knowledge items than those from other educational levels. Female participants had significantly higher precautionary measures scores than male participants. CONCLUSION: This study confirms that residents of the Aseer Region have high knowledge of, demonstrate a positive attitude toward, and use appropriate precautionary measures against COVID-19, which is associated with obtaining information about the virus from the Ministry of Health website.

Effective method of evaluating myocardial iron concentration in pediatric patients with thalassemia major.

BACKGROUND: The use of T2* magnetic resonance imaging (MRI) has been promoted by recent studies as a noninvasive method for the detection of iron overload in thalassemia major patients. This study aims to estimate the iron load in the heart and liver of thalassemia major patients using T2* MRI and to determine its correlation with the left ventricle ejection fraction and serum ferritin level. METHODS: Forty ß-Thalassemia major patients were included in the study. We evaluated the serum ferritin level, echocardiography, cardiac T2*, myocardial iron concentration (MIC), liver iron concentration (LIC) and hepatic T2* in all patients. CMR T2* findings were categorized as normal cardiac T2* (T2* >20 ms) or abnormal cardiac T2* (T2* <20 ms). RESULTS: The study found that 85% of patients had a normal cardiac T2* value. The median serum ferritin level was 2189. A significant inverse correlation was found between the serum ferritin level and the cardiac T2* (r=-0.381, =0.015); however, the correlations between serum ferritin and the hepatic T2* and liver iron concentration were statistically non-significant (P=0.539 and P=0.637, respectively). Additionally, the LVEF correlation was statistically non-significant with SF, hepatic T2* and cardiac T2*. CONCLUSION: Regardless of the serum ferritin level or left ventricle function, a cardiac T2* MRI should be done for all patients with ß-Thalassemia major in order to estimate the myocardial iron concentration.

A randomized controlled trial evaluating the effects of amlodipine on myocardial iron deposition in pediatric patients with thalassemia major.

BACKGROUND: Mortality rates increase due to iron deposition in the cardiac muscles of thalassemia major (TM) patients. Iron overload cardiomyopathy could be treated with a combination therapy of an iron chelator and an L-type calcium channel blocker. We designed a randomized controlled study to assess the potential of amlodipine, alongside chelation, in reducing myocardial iron concentration in TM patients compared with a placebo. OBJECTIVES: This study aims to estimate the change in myocardial iron concentration (MIC) determined by magnetic resonance imaging after 6 months of treatment with amlodipine, as well as measuring the changes in the secondary outcomes (liver iron concentration (LIC), serum ferritin level (SF), and left ventricle ejection fraction (LVEF)) of study participants. METHODS: A single, randomized, placebo-controlled trial was performed in 40 ß-Thalassemia major patients aged between 6 and 20 years old, who received either oral amlodipine 2.5-5 mg/day or a placebo, in addition to a Deferasirox chelation regimen in a 1:1 allocation ratio. RESULTS: After 6 months, a significant reduction was noted in the MIC of patients receiving amlodipine (n=20), compared with the patients receiving the placebo (n=20). At baseline, the mean was 0.76±0.11 mg/g dry weight, while at 6 months, the mean was 0.51±0.07 mg/g dry weight (p<0.001). Also, there was a significant change in the myocardial T2* after 6 months; the amlodipine increased the myocardial T2* from 40.63±5.45 ms at baseline to 43.25±5.35 ms (p<0.001). However, amlodipine did not significantly affect the secondary outcomes by the end of the study. CONCLUSION: The addition of amlodipine to the standard chelation therapy in transfusion-dependent thalassemia major patients improves myocardial iron overload without increasing the adverse effects.

Community Pharmacists' Knowledge, Attitudes, and Practice of Herbal Medicines in Asir Region, Kingdom of Saudi Arabia.

BACKGROUND: A dramatic increase in the use of natural products and herbal medicines has been observed globally. Simultaneously, there has been an increase in safety concerns regarding the extensive use of these herbal remedies among health care practitioners. The urban and rural populations of Saudi Arabia still rely on traditional Arabic herbal medicines for the treatment of various diseases. OBJECTIVES: This study aimed to evaluate community pharmacists' knowledge, attitudes, and practices of herbal medicines in the Asir region, Saudi Arabia. METHODS: An online cross-sectional study was conducted among 233 community pharmacists using a structured questionnaire. RESULTS: Pharmacists showed considerable knowledge of the indications of herbal products, with an average score of 84% correct answers, total P value < 0.05 and < 0.001. They were also knowledgeable about contraindications, side effects, and interactions, with an average score of 75% correct answers, total P value < 0.05 and < 0.001. Community pharmacists had a positive attitude towards herbal products, as 71% of them "agreed" or "strongly agreed" that herbal products were efficacious and 77% of them "agreed" or "strongly agreed" that those products should be sold only in a pharmacy. Herbal products were "often" or "always" dispensed by 67.3% of pharmacists in a pharmacy. CONCLUSION: Pharmacists generally exhibited good knowledge, a positive attitude, and effective practice towards herbal products. However, continuing education programs are needed to train pharmacists in providing client counseling on herbal medicine usage and dispensing them.

Pharmacy students' perceptions towards online learning in a Saudi Pharmacy School.

OBJECTIVES: The aim of the study was to evaluate previous exposure to online learning and preference for learning through pre-recorded online lectures with or without live active learning among pharmacy students in their fifth year. METHODS: An anonymous online survey was self-administered to fifth-year students enrolled on the Graduation Research Project Course. RESULTS: The response rate was 100%. Ninety-seven percent of students had previous experience with at least one online course during their pharmacy undergraduate curriculum; 76% of the courses were science courses. The majority of respondents preferred face-to-face, in-class lectures to online lectures, but 17% expressed no preference. CONCLUSION: Pharmacy students expressed some interest in online learning methods within the pharmacy curriculum.