Evaluation of adherence to international guidelines for treating patients with type 2 diabetes mellitus in Kuwait

Clinical guidelines derived from scientific evidence provide the basis of consistent standardized prescribing. Despite an alarming increase of diabetes in Kuwait, no studies related to the quality of prescribing in diabetes were found. Before pharmaceutical care can be implemented to improve the quality of care of patients with diabetes, it is important to determine whether prescribers are compliant with comprehensive international guidelines for cardioprevention and glycaemic control. To evaluate the adherence to clinical guidelines for treating patients with type 2 diabetes mellitus in primary care centres and secondary care centres (hospitals) using a developed and validated medication assessment tool with reference to international guidelines. Setting Outpatient diabetes clinics in 8 primary care centres and 4 secondary care centres across four healthcare regions in Kuwait. A quantitative, cross-sectional study involving a sample of 652 Kuwaiti patients with type 2 diabetes, who were selected using systematic sampling from the study settings. Data were collected retrospectively from the patients’ medical records using a validated 43-criterion medication assessment tool (MATKW) designed to assess cardioprevention and treatment in patients with type 2 diabetes. Descriptive and comparative analysis was conducted using SPSS version 17. Frequency of prescribing adherence to agreed definitions of criteria derived from international guidelines. Results Overall adherence to prescribing diabetes guidelines was 77.7 % (95 % CI 76.7–78.6 %). Significantly higher prescribing adherence was found in the secondary care facilities, 82.4 % (95 % CI 81.2–83.6 %) compared to primary care 72.5 % (95 % CI 71.0–73.9 %) (p 80 % in secondary care compared to ten criteria in primary care. The documentation of patients’ records was found to be inconsistent at the study healthcare facilities. Nonoptimal achievement of target goals for HbA1c, blood pressure and BMI was prevalent among the study population. A tool such as MATKW highlights areas for review and possible improvement in prescribing adherence. Our findings reveal problem areas in prescribing practices and documentation of patients’ records. Cost-effective multifaceted interventions are needed to improve current prescribing practices and documentation

Exploring the quality of life of cosmetic users: A cross-sectional analysis from eight Arab countries in the Middle East

Background The use of cosmetic products is growing in dominance in the Arab population, making it essential to measure its effects on users. The production of cosmetics has been largely driven by consumerism and a bid to keep abreast with the latest trends in the beauty industry with less attention on how the users' quality of life (QoL) is affected. Aims This study aims to investigate the effect of cosmetic products on users' quality of life in eight Arab countries. Methods A cross-sectional study was carried out using an online data collection approach. A validated and specialist instrument tool called BeautyQoL, which consists of five domains and a total of 52 questions, was distributed to a sample of 2219 cosmetic users. Descriptive and inferential statistical analysis was done using SPSS® version 26.0. Results The mean age of participants was 34 ± 11.25 years, and more women were represented in the sample (71%) than men. The majority of respondents had oily skin type (39.6%) and tan skin tone (30.4%). QoL through cosmetic use is computed with a mean score of 51 out of 100. The users' mean score satisfaction from cosmetic use is centred on attractiveness (56.1), followed by self-confidence (51.8). Cosmetics have a statistically significant effect on participants who are young adults, women, single, and employed with high income. As the respondents' skin tone deepens from very fair to dark, the mean score for each domain significantly increases, whereas when skin type changes from very oily to dry, the mean score for each domain decreases. Conclusion The effect of cosmetics on the users' QoL is limited, contrary to the narrative commonly portrayed in cosmetics' advertisements. Therefore, the use of cosmetics among the Arab population should be from an informed perspective of their specific needs instead of conforming to the viral trends pedaled by influencers and bloggers on social media, which might be irrelevant for them.Open access publishing facilitated by Monash University, as part of the Wiley - Monash University agreement via the Council of Australian University Librarians. [Correction added on 5 July 2022, after first online publication: CAUL funding statement has been added.]Scopu

Development and validation of medication assessment tools to evaluate prescribing adherence to evidence-based guidelines for secondary prevention of coronary heart disease in post-acute coronary syndromes patients in Kuwait.

Cardiovascular diseases are estimated to cause 46% of all mortalities in Kuwait. The aim of evidence-based clinical practice has led to an increased interest in the design of medication assessment tools (MATs) to identify deviations from evidence-based practice, and eventually provide the basis of consistent standardized prescribing. This study was designed to develop and validate MATs using quality standards extracted from international guidelines to evaluate prescribing practices in secondary prevention of coronary heart disease in patients with post-acute coronary syndrome (STEMI or NSTEACS]. International guidelines were reviewed to develop two MATs (MATSTEMI and MATNSTEACS). Face and content validity of the developed tools was performed with three MAT experts and thirteen cardiologists. Two quantitative approaches were used to determine content validity: (i) Content Validity Ratio (CVR) and the average of CVR values; and (ii) Content validity index at item level (I-CVI) and scale-level of the tool (S-CVI/Ave) with the average approach. Criteria with a CVR<0.54 and I-CVI <70% were eliminated. Ultimately, feasibility testing of both MATs was performed on 66 patients' records as a pilot study. The initial developed MATSTEMI and MATNSTEACS consisted of eighteen and twelve medication-related criteria, respectively. Face validity resulted in dividing each MAT into five dimensions. In the MATSTEMI, three criteria had CVR values < 0.54 and I-CVIs < 70%. Two criteria were eliminated and one was retained. This resulted in sixteen criteria with average CVR 0.85 and S-CVI/Ave 92.3%. In the MATNSTEACS, one criterion was eliminated. This resulted in eleven criteria with average CVR 0.93 and S-CVI/Ave 96.5%. The overall adherence scores to the MATSTEMI and MATNSTEACS were 64.1% (95% CI: 57.8-69.9%) and 62.0% (95% CI: 53.4-69.9%), respectively. It was judged as intermediate adherence for both MATs. MATSTEMI and MATNSTEACS were developed and validated to be utilized for optimizing medication therapy management and improving therapeutic interventions

An exploratory study investigating pharmacists’ opinions on their contributions to the delivery of pharmaceutical care to patients with type 2 diabetes in Kuwait.

This article looks at an exploratory study investigating pharmacists’ opinions on their contributions to the delivery of pharmaceutical care to patients with type 2 diabetes in Kuwai

Clinical pharmacy in Kuwait: Services provided, perceptions and barriers

Introduction: Pharmacy practice has considerably evolved from a dispensing role to a patient-centered profession. Kuwait has minimal clinical pharmacy services established in its healthcare settings. Objectives: The objectives of this study were to document existing clinical pharmacy services in public hospitals, identify barriers to their implementation and assess perceptions regarding pharmacists providing clinical services. Material & Method: A cross sectional study using self-administered questionnaires among a total of 166 pharmacists and 284 physicians across 6 public hospitals in Kuwait was conducted. Results: Over half of pharmacists (54%) provided clinical services, with the most common service being education and drug information (86%). Forty percent (40%) of the pharmacists reported that clinical services offered were of their own initiative but most of them (71%) were not sure whether they would offer additional services in the future. The majority of physicians were receptive to an expanded patient-centered role of the pharmacist (97%), believed pharmacists add to patient clinical care (92%) and considered pharmacists members of the healthcare team (96%). Major barriers reported by pharmacists to implement clinical pharmacy services included lack of policy (49%), time (36%) and clinical skills (28%), which is similar to barriers reported by physicians. Conclusion: Although clinical pharmacy is in its infancy in Kuwait, it is well perceived and requested by physicians. Major barriers must be addressed and in this context, having a national framework for pharmacy practice from Ministry of Health, supported by cutting edge education and a pro-active professional association would be key assets to evolve the practice in Kuwait. Keywords: Clinical pharmacy, Implementation, Kuwait, Perceptions, Barriers, Service

Attitudes and perceptions towards hypoglycaemia in patients with diabetes mellitus: A multinational cross-sectional study.

BackgroundPreventing hypoglycaemia is an essential component of diabetes self-management that is affected by patients' attitudes and perceptions. This study aimed to explore the hypoglycaemia problem-solving ability of patients who have diabetes mellitus and factors that determine their attitudes and perceptions towards their previous events.MethodologyA cross-sectional study was conducted between October 2017 and May 2018 in three Arab countries (Jordan, Saudi Arabia and Kuwait) in patients with diabetes mellitus, who were prescribed antidiabetic therapy and had experienced hypoglycaemic events in the past six months. The Hypoglycaemia Problem-Solving Scale was used in this study. This scale contains two subscales, problem orientation (six questions) and problem-solving skills (eighteen questions), using a five-point Likert scale (range 0-4). Multiple linear regression analysis was used to identify predictors of hypoglycaemia problem-solving abilities.ResultsA total of 895 patients participated in this study from the three countries (300 in Jordan, 302 in Saudi Arabia, and 293 in Kuwait). The average age of the patients was 53.5 years (standard deviation = 13.7) and 52.4% (n = 469) were males. Patients had moderate overall problem-solving ability with a median score of 63.00 (interquartile range = 13.00). Patients' problem-solving skills score (68.1%) was better than their problem-orientation skills score (58.3%). The highest sub-scale scores were for detection control, setting problem-solving goals, and evaluating strategies, 75.0%. The lowest sub-scale score was for problem-solving perception and immediate management, 50.0%. Older age, being educated, being married, having T2DM, prescribed insulin therapy, and not having been admitted to hospital for hypoglycaemia were important predictors of patients' problem-solving ability (p ConclusionsHealthcare professionals are advised to provide more education to patients on how to self-manage hypoglycaemic events. Specifically, they should focus on the overall problem-solving perception of hypoglycaemia and its immediate management