Economic benefits of implementing patient-centered medical home among patients with hypertension

Ziyad S Almalki,1 Abrar A Alotaibi,2 Wejdan S Alzaidi,2 Afnan A Alghamdi,2 Abdulrahman M Bahowirth,3 Noura M Alsalamah4 1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Mecca, Saudi Arabia; 3Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Mecca, Saudi Arabia; 4Department of Clinical Pharmacy, College of Pharmacy, Qassim University, Buraydah, Qassim, Saudi Arabia Introduction: Despite the strong evidence of an association between adoption of the patient-centered medical home (PCMH) and improved clinical outcomes among patients with hypertension, evidence for associations between the PCMH and health care utilization and cost reduction within the general adult population with hypertension is less developed.Objective: This study was designed to examine the effect of PCMH on health service expenditures and utilization in a national sample of the US adult population who were diagnosed with hypertension.Methods: The 2010–2015 Medical Expenditure Panel Survey data were used. The study sample was limited to adults (≥18 years) diagnosed with essential hypertension. We investigated the impact of PCMH on the direct hypertension-related total and on the costs of inpatient stays, prescription medications, outpatient visits, emergency room visits, office-based services, and other medical expenditures by using log-transformed multiple linear regression models and the propensity score method.Results: Of the 18,630 adults identified with hypertension, 19.2% (n=3,583) of them had received PCMH care from 2010 to 2015. After matching, the no PCMH group showed greater mean in all hypertension-related health service costs and utilization. After adjusting for the remaining confounders, the PCMH group showed a significant association with lower total costs, office-based services, number of office-based visits, and outpatient visits compared with the control group.Conclusion: A significant relationship between experiencing PCMH care and a lower total health care expenditure was found in patients with hypertension. Keywords: PCMH, hypertension, health care expenditure, MEP

Prevalence and Determinants of Symptomatic Dry Eye Disease Among Adult Urban Residents of High-Altitude Areas of Southwest Saudi Arabia – A Survey

Saad Abbas Aldawsari,1 Nazih Alzaidi,2 Maram EA Abdalla Elsayed,3 Abdullah Ahmed Alhammadi,4 Hadeel Khaled Alharthi,1 Abdulrahman Alosaimi,5 Yahya Al-Najmi6 1Ophthalmology Department, King Faisal Medical Complex, Taif, Saudi Arabia; 2Ophthalmology Department, Alhada Military Hospital, Taif, Saudi Arabia; 3Ophthalmology Department, Jeddah Eye Hospital, Jeddah, Saudi Arabia; 4Ophthalmology Department, Asir Central hospital, Abha, Saudi Arabia; 5Ophthalmology Department, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 6Ophthalmology Department, Saggaf Eye Center, Jeddah, Saudi ArabiaCorrespondence: Yahya Al-Najmi, Ophthalmology Department, Saggaf Eye Center, Abdullah Salman St., Al Faiha’a Dist., P.O. Box: 31903, Jeddah, 21418, Saudi Arabia, Tel +966 564844281, Email [email protected]: To estimate the prevalence and determinants of Ocular Surface Disease Index (OSDI) score based dry eye disease (DED) among the adult urban population of four cities located at high altitudes in Southwest Saudi Arabia.Methods: This cross-sectional survey was held in 2023. OSDI questionnaire was used to collect the responses of the adult participants. The score was further graded into none, mild, moderate, and severe DED to estimate age-sex-adjusted DED prevalence. The OSDI score was correlated to demographic (age group, gender, education, occupation, city) and risk factors like smoking and co-morbidities.Results: Of the 401 adults, 388 (response rate of 97.8%) participated. The age-sex-adjusted prevalence of mild, moderate, and severe DED was 21.7%, 13.1%, and 32%, respectively. The median ODSI score was 22.9 [Interquartile range (IQR) 10.4; 47.9)]. The score was significantly higher in females (Mann–Whitney U-test P = 0.038), residents of Taif city (KW P = 0.05), those with primary/middle school education (Kruskal–Wallis P = 0.004), comorbidities like hypertension, asthma (KW P < 0.001) and risk factors like past refractive surgeries, arthritis (KW P = 0.013). Education status (P < 0.001) [B = − 9.0 95%] and presence of comorbidity (P = 0.022), [B = − 0.823] were significant predictors of DED.Conclusion: The prevalence of DED and severe grade was high. The level of education and presence of comorbidities significantly influenced DED in the adult urban Saudi population of cities at high altitudes.Keywords: dry eye disease, Ocular Surface Disease Inde

Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

Hazim Abdulkarim Khatib,1 Waleed Ahmed Alghamdi,2 Ahmed Hussein Subki,3 Nadeem Shafique Butt,4 Mohammed Saad Alsallum,5 Ahmed Salem Alsulaimani,6 Sara Faisal Alnajjar,7 Fahad Daifallah Alzaidi,8 Abdulrahman Ali Alasmari,9 Hussein Mesfer Alshamrani,10 Faten Al-Zaben,2 Harold G Koenig2,11,12 1Department of Internal Medicine, King Abdulaziz Hospital, Jeddah, Saudi Arabia; 2Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 4Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Neurology, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 6Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia; 7Department of Diagnostic Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 8Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 9Department of Forensic Medicine, Forensic Medicine Center, Jeddah, Saudi Arabia; 10Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 11School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China; 12Department of Psychiatry, Duke University Medical Center, Durham, NC, USACorrespondence: Waleed Ahmed Alghamdi; Harold G Koenig, Email [email protected]; [email protected]: Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah.Methods: This descriptive cross-sectional study was conducted in the city of Jeddah. The Skin Picking Scale-Revised (SPS-R) scale was administered to a convenience sample of 520 respondents. A partial least squares path model (PLS-PM) for “impairment” and “symptoms severity” subscales was assessed by evaluating the validity of measurement and structural models.Results: Skin picking behavior was reported by 28.8% (n=150). A significant level of skin picking disorder symptoms was present in 1.2% (n=6). Skin picking visual effect, depressive symptoms, and being unmarried were the only positive independent predictors of the total SPS-R score.Conclusion: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.Keywords: skin picking disorder, dermatillomania, excoriation disorder, prevalence, risk factors, The Skin Picking Scale-Revised scal