Barriers to research productivity among gastroenterologists and hepatologists in Saudi Arabia.

BACKGROUND: Clinical research is essential for the advancement of medical knowledge and evidence-based medical practice. In this study, we aimed to identify barriers that limit research productivity among gastroenterologists in Saudi Arabia. METHODS: We conducted a national online survey targeting gastroenterologists in Saudi Arabia. Participants were asked about the patterns of their practice, their prior research activities, and potential barriers to research productivity. Univariate and multivariate analyses were performed to examine the association between different factors and research productivity. RESULTS: A total of 85 gastroenterologists completed the survey. Respondents were predominantly male physicians (90.6%) and 40% of them belonged to the age group of 40-49 years. About 85.9% had at least one prior research participation of any type. Around 67.1% of the respondents had been a primary investigator at least once in the last 5 years, while only 23.5% had been a primary investigator at a minimum average rate of once a year. Multiple barriers to research productivity were identified: insufficient research time (78.8%), lack of funding and compensation (77.6%), lack of a statistician (68.2%), insufficient research training (64.7%), lack of connection (60%), lack of technical support (57.6%), and lack of interest (31%). On univariate analysis, insufficient research time and lack of funding and compensation were significantly associated with no research participation (P <0.01 and 0.03, respectively). On multivariate analysis, lack of funding and compensation was independently associated with no research participation (adjusted OR 15.32;95% C.I 2.66, 121.58, P < 0.01). CONCLUSIONS: Barriers to research productivity are highly prevalent among gastroenterologists in Saudi Arabia. Insufficient research time and lack of funding and compensation are the most common. Interventions are needed to promote research activities.

Risk of neutropenia in inflammatory bowel disease patients treated with TNF inhibitors: A single-center, retrospective cohort study.

BACKGROUND/AIM: Tumor necrosis factor inhibitors (TNFi) have become the mainstay of treatment in moderate-to-severe cases of inflammatory bowel disease (IBD). Neutropenia has been reported in patients receiving TNFi for IBD and other diseases. In this study, we aimed to ascertain the relationship between the use of TNFi and the development of neutropenia in patients with IBD. PATIENTS AND METHODS: This is a retrospective cohort study including all adult patients with IBD receiving TNFi at a tertiary care center over an 11-year period. The primary outcome was the development of any neutropenic episode after starting a TNFi. For our secondary outcomes, we evaluated the impact of concomitant use of 5-aminosalicylic acid (5-ASA) or an immunomodulator on the risk of developing neutropenia. RESULTS: The final analysis included 281 patients. Of those included, 34.2% developed at least one episode of neutropenia while on a TNFi. The majority of these episodes (67.7%) were mild with ANC between 1000 and 1500/mm3. No significant difference was observed in the age, gender, agent used or type of IBD between those who developed neutropenia and those who did not. Concomitant use of azathioprine (OR = 2.32, 95% CI: 1.26-4.28; P = 0.007) or 5-ASA (OR = 3.15, 95% CI: 1.55-6.39; P = 0.001) were significant independent predictors of developing neutropenia. CONCLUSIONS: In this study, mild neutropenia was common among patients with IBD on TNFi. Future prospective studies are required to further clarify the significance of neutropenia in patients with IBD receiving TNFi.