Understanding patient demand for and use of antibiotics for upper respiratory tract infection: A qualitative application of the Necessity-Concerns Framework in Saudi Arabia.

Background: Reducing antimicrobial resistance (AMR) is a priority for public health. Inappropriate patient demand is an important driver of unnecessary antibiotic use. To develop an effective intervention to reduce inappropriate demand for antibiotics in upper respiratory tract infections (URTIs), it is important to identify patient perceptions that influence demand for, and appropriate use of antibiotics. Aim: To identify and describe the beliefs about antibiotics necessity and concerns that patients with URTIs have, in Riyadh, Saudi Arabia. Method: An exploratory qualitative approach was used. One-to-one, face-to-face or telephone semi-structured interviews were conducted with participants recruited using purposive sampling (based on age and gender) from primary healthcare centre in Riyadh, Saudi Arabia were conducted. Only adult patients who currently experience URTIs symptoms and agreed to participate were recruited. Recruitment for interviews continued until data saturation point was reached. The interview guide explored patients' necessity beliefs and concerns about antibiotics, AMR perceptions, and expectations from URTIs consultation. Interview transcripts were coded using QSR NVivo 12 using framework analysis informed by the Necessity-Concerns Framework to identify key motivations driving antibiotic requests and consultations. Results: the study interviewed 32 participants (44% were male, average age was 36.84). Results identified that the patients often relate their personal need for antibiotics when encountering an URTIs symptoms to the type, severity and duration of symptoms. Patients also linked antibiotics with quicker recovery, generally expressing few concerns about antibiotics mainly because of its short duration of use. However, some conveyed their concern about frequent administration of antibiotics and effect on the body's immune system function, which may make them more prone to infections in the future. Participants varied widely in their awareness of AMR; this was associated with many misconceptions, such as confusing AMR with antibiotics efficacy and tolerance. Interestingly, the interplay between necessity beliefs and concerns was observed to influence the decision to start and stop antibiotic, potentially impacting inappropriate antibiotic demand and unnecessary use. Conclusion: This study highlighted important beliefs and misconceptions about antibiotics and AMR in Saudi population which can be targeted in future interventions to reduce inappropriate demand for antibiotics and optimise appropriate usage.

Patient-reported outcome measures in Arabic-speaking populations: a systematic review.

PURPOSE: This research aimed, first, to identify, summarize, and synthesize the studies reporting the development, translation, and/or psychometric evaluation of PROMs in Arabic-speaking populations and, second, to evaluate the psychometric properties and the translation process of a sample 26 PROMs. METHODS: In 2019, PubMed, Web of Science, and SCOPUS were searched for studies reporting the development, translation, or cross-cultural adaptation of patient-reported outcome measures in Arabic-speaking populations, and those including the assessment of one or more psychometric properties as PROMs (including validity, reliability, responsiveness, interpretability) in our target populations were included. The review protocol registration number is CRD42018088991. RESULTS: The search strategy outlined above yielded a total of 3179 titles in the three databases. Of these, 174 English language studies met the inclusion criteria. One hundred thirty-six PROMs were identified. The methodological quality and translation process of PROMs reported by at least two studies (26 PROM instruments, 63 studies) were examined. Internal consistency, reliability, and construct validity were the most frequently reported psychometric properties. Structural validity, cross-cultural validity, responsiveness, and measurement error were largely unreported. The process of developing at least two independent forward translations and back translation of the instrument into the source language were reported by 32 and 43 studies, respectively. CONCLUSION: There is a need for further investigation of measurement properties of Arabic PROMs measures before routine use can be recommended in clinical practice.

A Qualitative Approach to Improving Advanced Pharmacy Practice Experiences in an ACPE International Certified Program.

Objective. To explore the opinions and recommendations of university and health care professional experts regarding the Advanced Pharmacy Practice Experiences (APPE) curriculum at the King Saud University College of Pharmacy. Methods. Forty-eight health care professionals of different backgrounds participated in a roundtable discussion during a 1-day meeting. The discussion revolved around three predefined themes: the doctor of pharmacy (PharmD) program learning outcomes, regulations and responsibilities and APPE activities and syllabi, non-clinical rotations, and assessment. The discussion was transcribed verbatim. Discussion of each theme was summarized and incorporated in the result. Results. Discussion regarding the PharmD program learning outcomes emphasized clinical outcomes with an additional focus on basic sciences. The regulations and responsibilities table incorporated guidance toward developing student professionalism. APPE activities and syllabi, non-clinical rotations and assessment recommendations encompassed crucial issues such as effective communication among the college, preceptors, and students, scheduled site visits, financial reimbursement for preceptors, student preparatory workshops, and non-clinical rotations. Conclusion. This roundtable discussion identified many of the concerns and recommendations previously encountered or currently being addressed in many of the previous studies and current accreditation standards. International candidates should consider these recommendations when applying for certification.