NEEDS AND UTILIZATION OF DRUG-INFORMATION RESOURCES OF HEALTHCARE PROVIDERS IN AN ACADEMIC TERTIARY CARE CENTER

Objective: To investigate the drug-related information needs of healthcare providers (HCPs), their utilization of drug information resources as well as the main factors influencing the selection of resources.Methods: A total of 393 HCPs were conveniently selected and invited to complete a questionnaire. Stratified sampling was used for the three subpopulations of physicians, pharmacists, and nurses. The questionnaire was coded, validated, and analyzed using the Statistical Package for the Social Sciences (SAS version 9.2).Results: Of 450 HCPs approached, 393 completed the questionnaire (response rate 87%). Information related to drug dosage/administration, indications, and interactions is the most frequently required, 47%, 44%, and 34%, respectively. The majority of the sample perceived the Internet (69.47%) and electronic databases (67.43%) as “very useful.” Printed materials (46.56%) and Personal Digital Assistants (PDAs) (44.78%) or calling the pharmacy (43.26%) were also useful resources of information followed by using electronic books and journals (38.42%) and asking colleagues (32.32%). The majority (53.18%) described consulting a clinical pharmacist as “very useful.” However, 16% of the nurse group and 35% of the physician group were not aware of the existence of the Drug Information Center (DIC) and more than 8% of the participants consider calling the DIC about drug-related information “not useful”.Conclusion: Digital resources are used by HCPs more frequently than traditional resources, consulting a clinical pharmacist or calling the DIC. Providing reliable electronic resources and raising the awareness of HCPs regarding the role of a clinical pharmacist and DIC for patient-specific therapies should be instituted

Assessment of medication adherence in Saudi patients with type II diabetes mellitus in Khobar city, Saudi Arabia

Objective: Medication adherence is defined as taking medications as advised and prescribed by health care professionals for stated duration. Diabetes mellitus (DM) is one of the most common chronic illnesses in Saudi Arabia. This study aimed to document medication adherence in Saudi patients with type 2 diabetes. Methods: A quantitative cross-sectional study was conducted in Saudi out-patients with type 2 DM in the city of Khobar, Saudi Arabia. The study used the General Medication Adherence Scale (GMAS) to document medication adherence in this population. Data was analyzed through SPSS version 23. Study was ethically approved. Results: Data was collected from 212 patients. Few patients (35.8%) had high adherence to anti diabetic medications. The correlation between HbA1c level and adherence score was negative and significantly strong (ρ = -0.413, p < 0.0001). Most patients (N = 126, 59.4%) modified their medication therapy during month of Ramadan and on Eid occassion. Education level was not a determinant of adherence in this population. Conclusion: This study highlighted that medication adherence is influenced by religious and social factors. Patient counseling is required to improve patient beliefs and increase awareness of adhering to prescribed anti diabetic pharmacotherapy. A pharmacist can play constructive role of a disease educator and patient counselor

A Fatal Case of Meningitis Complicating Chronic Otitis Media and Base of Skull Osteomyelitis due to Carbapenemase (OXA-48)-Producing Klebsiella pneumoniae

Abstract Osteomyelitis of the base of the skull is a rare but life-threatening disease. Although Klebsiella pneumoniae is not a pathogen that is frequently associated with this infection, the clinical course can rapidly progress to meningitis. Here, we describe a case of chronic otitis media, secondary to OXA-48K . pneumoniae, which was complicated by osteomyelitis of the base of the skull and fatal meningitis

NEEDS AND UTILIZATION OF DRUG-INFORMATION RESOURCES OF HEALTHCARE PROVIDERS IN AN ACADEMIC TERTIARY CARE CENTER

Objective: To investigate the drug-related information needs of healthcare providers (HCPs), their utilization of drug information resources as well as the main factors influencing the selection of resources.Methods: A total of 393 HCPs were conveniently selected and invited to complete a questionnaire. Stratified sampling was used for the three subpopulations of physicians, pharmacists, and nurses. The questionnaire was coded, validated, and analyzed using the Statistical Package for the Social Sciences (SAS version 9.2).Results: Of 450 HCPs approached, 393 completed the questionnaire (response rate 87%). Information related to drug dosage/administration, indications, and interactions is the most frequently required, 47%, 44%, and 34%, respectively. The majority of the sample perceived the Internet (69.47%) and electronic databases (67.43%) as “very useful.” Printed materials (46.56%) and Personal Digital Assistants (PDAs) (44.78%) or calling the pharmacy (43.26%) were also useful resources of information followed by using electronic books and journals (38.42%) and asking colleagues (32.32%). The majority (53.18%) described consulting a clinical pharmacist as “very useful.” However, 16% of the nurse group and 35% of the physician group were not aware of the existence of the Drug Information Center (DIC) and more than 8% of the participants consider calling the DIC about drug-related information “not useful”.Conclusion: Digital resources are used by HCPs more frequently than traditional resources, consulting a clinical pharmacist or calling the DIC. Providing reliable electronic resources and raising the awareness of HCPs regarding the role of a clinical pharmacist and DIC for patient-specific therapies should be instituted.</jats:p

Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 Years and Older

Abstract Introduction Tuberculosis (TB) is a significant contributor to morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential. Method Clinical, radiological features, treatment, and outcome of patients aged 75 and above who were diagnosed with tuberculosis at King Abdulaziz Medical City in Riyadh in the period between January 2015 to December 2021wereevaluated retrospectively. Results Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol was achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p = 0.007). Conclusion Tuberculosis is associated with high mortality in patients above the age of 75. There is still a substantial delay in TB diagnosis in the elderly. RIPE regimen is frequently changed due to side effects. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population are needed to define the most effective therapeutic approach

<i>Candida</i>Bloodstream Infection: Changing Pattern of Occurrence and Antifungal Susceptibility over 10 Years in a Tertiary Care Saudi Hospital

Background.Candidahas emerged as one of the most important pathogens that cause bloodstream infection (BSI).Understanding the currentCandidaBSI trends, the dominant species causing disease and the mortality associated with this infection are crucial to optimize therapeutic and prophylaxis measures.Objectives. To study the epidemiology and to evaluate the risk factors, prognostic factors, and mortality associated with candidemia and to compare these findings with previously published studies from Saudi Arabia.Design. A retrospective medical record review.Setting. Tertiary hospital in Riyadh.Patients and Methods. The analysis included all cases ofCandidablood stream infection who are &gt;18 years old over the period from 2013 to 2018. Continuous variables were compared using the parametricT-test while categorical variables were compared using the Chi-squared test.Main Outcome Measure. Incidence, resistance, and hospital outcomes inCandidablood stream infection.Sample Size. 324 patients.Results. Three hundred and twenty-four episodes ofCandidablood stream infections were identified. Median age of patients was 49.7 SD ± 28.1 years, and 53% of patients were males. More than half of the patients had an underlying disease involving the abdomen or laparotomy, 78% had an indwelling intravenous catheter, and 62% had suffered a bacterial infection within 2 weeks prior to candidemia.Candida albicansrepresents 33% of all isolates with decreasing trend overtime. There was an increase in the number of nonalbicans Candidaovertime withCandida tropicalisin the lead (20%). Use of broad spectrum antibiotics (82%), prior ICU admission (60%) and use of central venous catheters (58%) were the most prevalent predisposing factors of candidemia. Azole resistance was variable overtime. Resistance to caspofungin remained very low (1.9%). Fourteen days crude mortality was 37% for ICU patients and 26.7% in non-ICU patients, while hospital crude mortality was 64.4% and 46.7%, respectively.Conclusion. There is an increasing trend of nonalbicans Candidablood stream infection. Fluconazole resistance remained low toC. albicans. Most isolates remain susceptible to caspofungin, voriconazole, and amphotericin B.Candidabloodstream infection is associated with high 14-day hospital mortality.</jats:p