Continuous quality improvement regulations for community pharmacy practice in the United States.

OBJECTIVES: In the United States, medication errors are considered to be the cause of 7000 deaths annually. Continuous quality improvement (CQI) is a management process that focuses on continually and systematically evaluating the organization's work process. In community pharmacy, CQI leads to enhanced patient safety through a reduction in medication errors and quality-related events (QREs). There is limited information about the variations in CQI regulations required by State Boards of Pharmacy (SBPs) for community pharmacy across the country. The objective of this study is to comprehensively describe CQI regulations required by SBPs for community pharmacy practice in the United States. METHODS: This was a cross-sectional study. Information regarding SBPs community pharmacy CQI regulations was collected electronically by surveying a representative of each SBP. In addition, a review of State Pharmacy Laws published online complemented the survey data. The percentage of states with CQI regulations for community pharmacy was estimated. RESULTS: Of the 50 Boards, 16 require pharmacies to maintain CQI programs to monitor and prevent QREs in community pharmacy. The most common elements of CQI programs include the management of known, alleged, and suspected medication errors that reach the patient (73%) and regular reviews of the pharmacy's aggregate data of medication errors or incidents (73%). The North Dakota SBP regulation is the most comprehensive, followed by that of Iowa, Maryland, Massachusetts, and Montana. CONCLUSION: There is wide variation among SBP CQI regulations for community pharmacy practice. Standardization of CQI programs across Boards, including a national database for reporting medication errors and QREs would enhance patient safety.

Prevalence of diabetic peripheral neuropathy among type II diabetic patients in King Fahd University Hospital, Khobar, Kingdom of Saudi Arabia.

Background: Diabetic peripheral neuropathies (DPN) are a common complication of diabetes mellitus (DM). DPN can be either painless or painful.General objective: To determine the prevalence of DPN among DM type II patients at King Fahd University Hospital (KFUH), Al-Khobar, Kingdom of Saudi Arabia (KSA).Specific objectives: To see the association between the prevalence of DPN and patient demographics and body mass index (BMI).To assess the relationship between the prevalence of DPN and DM type II and duration of disease.To provide awareness and education of DPN by pamphlets to the recruited diabetic patients at KFUH, Al-Khobar, KSA.Methods: questionnaire-based cross-sectional study, recruited DM type II patients from the internal medicine outpatient clinics at KFUH, Khobar, KSA. The investigators recorded patients' demographics (age, sex, and nationality), height, weight, and BMI, diabetes duration in years and laboratory results of fasting blood glucose (FBG), Hemoglobin A1C and the Michigan Neuropathy Screening Instrument (MNSI) has been applied.Results: among 187 recruited patients with type II DM, the prevalence of DPN was 37.4%. The mean age range of the sample was 56.4 ± 11.2 years. Females to males were 62.6% vs 37.4%. Saudis represented a great proportion of the participants constituting nearly 95.2%. The mean BMI of patients was 33.6 ± 7.08 kg/m2. The mean FBG was 161.4 ± 62.9 mg/dL while the mean value of HbA1c was 8.11%±1.63%. HbA1c levels were significantly associated with DPN. Duration of DM of more than 1 year and FBG levels were significant predictors for patients to have DPN. Other socio-demographic variables such as age, gender, nationality, and BMI levels were not significantly associated with DPN.Conclusion: DPN affects 37.4% of type II diabetic patients at King Fahd University Hospital in Saudi Arabia. Approximately 60% of patients were not aware of the importance of daily foot care. Thus, foot care pamphlets were distributed to patients.

Pattern of childhood brucellosis in Najran, south Saudi Arabia in 2013-2017.

BACKGROUND: With more than 500,000 new cases annually, human brucellosis is the commonest zoonotic disease worldwide. In some endemic countries, its prevalence is more than 10 per 100,000 population. OBJECTIVE: The aim of this study was to determine the magnitude of the problem and the clinical features, laboratory findings, treatment given and complications seen in children with brucellosis in Najran City, Kingdom of Saudi Arabia. METHODS: This is a case-series study by analysis of data of children known or diagnosed to have brucellosis for the last 4 years in Najran City. Data was obtained by reviewing the hospital records of the Maternity and Children Hospital and Najran Armed Forces Hospital in Najran during the period from 2013 to 2017. The statistical analysis was carried out using SPSS version 16.0. Since it was the first report of brucellosis on the study population, we used descriptive statistics (frequency, proportion, mean, and standard deviation) for presenting the findings. RESULTS: We studied 57 diagnosed cases of child brucellosis throughout the past 4 years in Najran, south Saudi Arabia with an average number of about 12 cases per year. Of the cases, 15.8% reported a history of ingestion of raw milk and dairy product and only 1.8% of them reported a history of animal contact while 82.4% confirmed unknown mode of transmission. Fever was the only finding in 36.8%, fever and arthralgia 21.1%, and fever and myalgia 19.3%. Two thirds of the cases were diagnosed by standard agglutination test (SAT). Hepatosplenomegaly was found in 10.5%. Rifampicin was the antibiotic of choice and 70.2% of cases have been cured but 3.5% relapsed and 1.8% died from complications. CONCLUSIONS: Results suggest brucellosis be considered in every child living in an endemic area, showing symptoms of fever and having a history of ingestion of raw milk and dairy product and/or animal contact.Prevention should rely on health education of the public about different issues of the disease including boiling raw milk.