Predictors of adherence to diabetes medicationss: multicentre study from the Eastern Province, Saudi Arabia

Background: The prevalence of diabetes mellitus disease (DM) is growing rapidly across the world, however the rate of increment is considerably high in Arab countries, which increases in them the risks of developing microvascular (e.g., retinopathy, nephropathy, and neuropathy) and macrovascular diseases (e.g., cardiovascular diseases and cerebrovascular disease). Better Adherence to diabetes medications play important role in achieving better health outcomes and preventing the complications of the disease. However, there are different factors that might affect the adherences. The aim of the study was to evaluate the predicators of the level of adherence of type 2 DM patients in the Eastern Province, KSA. Methodology: 376 participants were randomly selected from two hospitals in the Eastern Province, Saudi Arabia, and adherence towards anti-diabetic drugs was measured using the General Medication Adherence Scale (GMAS). Results: The participants included equal proportion of males and females, 79% with older than 50 years, 46% with an education of primary school or lower, and 43% with monthly income of 5000 SAR or lower. Among the participants, 22% did not have any diabetes related complications, 38% were on oral medication as well as insulin injection for diabetes and 10% had history of hospitalisation due to diabetes. Importantly, 37% (138/376) of participants were reported partial or lower adherence level, and only 42% (160/376) of participants reported high level of adherence. The degree of adherence was also lower among participants had Random blood glucose level (RBG) of 200 mg/dl or more compared to participants with RBG of 200 mg/dl or lower (p-value<0.001) (AU)

Exploring the intravenous narcotics and controlled drugs wastage and their financial impact: A descriptive single-center study.

Objective: The objectives of this study were to explore the wastage of narcotics and controlled medications and, their financial impact in a tertiary care setting over a one-year period. Methodology: The study period was of one year, i.e., October 2020 - September 2021. The venue of study was a tertiary care hospital. The narcotic medications included Fentanyl, Tramadol, Morphine, and Meperidine. The controlled medications included Midazolam, Phenobarbital, Diazepam, Ketamine and Lorazepam. The annual consumption and wastage of the narcotic and controlled medications were documented using data report generated by narcotics and controlled medication in-charge pharmacist through the hospital's online system. Data was reported using average, minimum and maximum values. Quantities of wastage is expressed in terms of ampoules. Costs per ampoule were calculated and expressed in both Saudi Riyal (SAR) and United States Dollar (USD). The study was approved by an ethics committee. Results: The annual wastage of narcotics was 3.19 % while the same for controlled medications was 21.3 %. An annual wastage of 3.81 % was reported for narcotics and controlled medications combined. The total wastage cost of narcotics and controlled medications was 15,443.1 SAR that was equivalent to USD 4085.5. Fentanyl 500mcg formulations had the highest consumption, i.e., 28,580 ampoules followed by Morphine 10 mg formulations, i.e., 27,122 ampoules. The highest ampoule wastage was observed for Morphine 10 mg formulations, i.e., 1956 ampoules. The highest % wastage was observed for Midazolam formulations, i.e., 29.3 %. Conclusion: The overall wastage was less than 5% of the total consumption, however, midazolam was observed to have the highest wastage. Shifting to prefilled syringes supplied by pharmacies, making protocols, and safely pooling costly drugs could result in significant savings.