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Background: Medication errors can result in adverse drug events (ADEs) and cause considerable patient harm. Limited data are available from Saudi Arabia and the Middle East regarding the prevalence of preventable adverse drug events (pADEs) in primary care settings. Objectives: To estimate the period prevalence of pADEs and assess the medication error severity in primary care setting in Saudi Arabia. Methods: This retrospective study is a continuation of a previous study where 117 of 2000 adult patients managed at the Family Medicine clinics of King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, were identified to have had least one medication error in the past 15 months. The electronic health records of these 117 patients were analyzed for a 3-month post-medication error period to explore the presence of pADE. Medication errors were categorized according to the National Coordinating Council for Medication Error Reporting and Prevention index (NCC MERP) and the occurrence of pADE was assessed using the NCC MERP scheme. Results: Of the included 117 patients, 9 (7.7% [95% confidence interval (CI): 2.79-12.59]) experienced pADE (Category E), while 108 (92.3% [95% CI: 87.97-98.35]) did not (Category C). All patients who experienced pADE were using over-the-counter medications and were on polypharmacy. Outcomes 2a and 2b (asthma and ß-blocker) accounted for two and four cases, respectively, while Outcomes 6 (warfarin and international normalized ratio), 7 (lithium and lithium level), 16 (new oral anti-coagulant or warfarin and antiplatelet), and 17 (acetylsalicylic acid [aspirin] and antiplatelet) each accounted for one case. Conclusions: This study provides the period prevalence of patients with pADEs from Family Medicine clinics at a major tertiary hospital of Saudi Arabia, and highlights the need for a multicenter study of clinically important medication errors at the prescribing and monitoring stages for the development of quality improvement programs.
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Purpose Advancements in internet technology are on the rise and so is the concern for its detrimental effects on youth like cyberbullying. Cyberbullying is on the rise and may cause adverse effects on mental health. The objective of the present study was to identify the prevalence of cyberbullying and its associated risk factors and to measure its association with mental health among adolescents. Methods An online self-administered questionnaire was distributed to 761 high school students aged 15 - 19 years from Riyadh, Saudi Arabia. A quantitative cross-sectional design was integrated, and logistic regression analysis was performed to determine the association. As part of assessing mental health, a questionnaire on the use of cigarettes, e-cigarettes, and hookah was also administered. Results The prevalence of cyberbullying was 18%. Although a significant association between cyberbullying and mental health status was obtained (OR = 1.04; p =0.03), the risk of Odds was found to be weak and therefore did not favor the hypothesis. The significant risk factors associated with cyberbullying include being traditionally bullied (OR= 4.76; p = <.001), e-cigarette use (OR = 2.73; p = <.001), and male gender (OR = 1.64; p = .04). Conclusion Despite the findings not favouring the hypothesis, a few striking associations were obtained in the study. Traditional bullying and e-cigarette use increased the risk of cyberbullying. This is a matter of rising concern since e-cigarette use has witnessed a surging rise in popularity. These findings may serve as early warning on the rising issue of cyberbullying and could pave way for formulating early preventive strategies and promulgate awareness by the concerned authorities.
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Background Glaucoma in adults is a leading eye disease that causes blindness. Its management is life long and both surgical and medical treatment options are available to manage this ailment. Patients and their caregiver's cooperation in instilling timely eye drops is crucial for the effective reduction of intraocular pressure (IOP) and by halting/delaying the progression of visual disabilities due to glaucoma. Periodic assessment and strict adherence to medical treatment has been found to be less than desired. It is influenced by the severity of the disease, the duration of the ailment, the number of eye drops being used, the literacy level, and the cost of medication. We present the adherence rate of topical medications and its determinants among adult Saudi glaucoma patients getting treated in 2017 in a tertiary eye center in Saudi Arabia. Methodology This cross-sectional survey was carried out from January to March 2017 at a tertiary eye hospital in Riyadh, Saudi Arabia. To undertake a cross-sectional study, we assumed that among 1300 patients visiting the eye department of a tertiary eye hospital, the level of non-adherence to glaucoma medication would be in 27% of glaucoma patients. To achieve a 95% confidence interval and an acceptable error margin of 5% for a survey, we needed to interview at least 253 participants. Results We interviewed 263 randomly selected glaucoma patients among 1236 patients visiting the eye department of the tertiary eye hospital in Riyadh, Saudi Arabia. Two-thirds of participants were school graduates, Saudi nationals, and had undergone surgery for glaucoma in the past; perhaps only YAG laser peripheral iridotomy (PI). Less than half of the participants (43%) had less than a one-year duration of glaucoma. The client-perceived subjective adherence rate to glaucoma medication was noted in 191/263 = 72.6% (95% Confidence Interval 67.2 -78.0). Of the 263 glaucoma patients, 229 judiciously abided with their follow-up appointments with ophthalmologists. Thus, the compliance to follow-up for glaucoma treatment was 87.1% (95% CI 83.0 - 91.1). Conclusion Our study with a large sample is perhaps the first one to assess compliance with medical treatment among adult Saudi glaucoma patients. The adherence rate for topical glaucoma medication measured using the subjective method was 72% among adult glaucoma patients. Adherence with the follow-up appointment with the glaucoma specialist was as high as 87%. Adherence with medical treatment found in the present study versus the literature review suggested that despite different sets of barriers, the adherence rate in Saudi adult glaucoma patients noted in our study was high. Knowledge, beliefs, and attitude are known to affect the adherence rate. In our study, education level and relatives having glaucoma were not associated with the adherence rate. This indirectly suggests that knowledge about the use of medication in the treatment of glaucoma that is gained by patients had a limited influence on adherence in our glaucoma patients. Modes of dispersing knowledge to elderly glaucoma patients and their impact on the adherence rates of medications for glaucoma management need to be further studied.
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PURPOSE: To present the level of knowledge, attitude, and practice (KAP) for glaucoma management and their determinants among adult Saudi patients. METHODS: The study was conducted between January and June 2017. Glaucoma patients from the ophthalmology clinic were interviewed. Demographics and disease-related information were noted. The questionnaire included four K questions, seven A questions, and six P squestions. The correct response of questions were summed for K, A, and P, and the percentile was calculated. K and P scores were graded as excellent (more than >75%), good (51%-75%), poor (26%-50%), and very poor (≤25%). If A score was >50%, it was termed as positive. RESULTS: We interviewed 263 adult glaucoma patients. Their mean age was 61.6 ± 14.2 years. The excellent grade of knowledge about glaucoma and its management was 63 (24% [95% confidence interval (CI) 18.8-29.1]). Poor grade of knowledge was 95 (36.1% [95% CI 30.3-41.9]). The attitude toward glaucoma and its management was positive in 89 (33.8% [95% CI 28.1-39.6]). The practice to manage glaucoma was of excellent grade in 10 (3.8% [95% CI 1.5-6.1]). The overall excellent grade of KAP glaucoma patients was 17.9% (13.2-22.5). Good practice for glaucoma management was associated with a history of glaucoma surgery (P < 0.001), longer duration of glaucoma (P = 0.02), and young age (P = 0.004). CONCLUSIONS: Low KAP about glaucoma disease and medication among Saudi glaucoma patients is a matter of concern. Strategies are needed to improve the KAP of glaucoma patients.
