The Value of Online Medication Rating Systems to Older Adults and Their Association with Self-Reported Outcomes

The Internet is a powerful and very popular vehicle for distributing judgment-free health information to patients. Multiple studies have examined the role of online health information as well as physician-rating websites in health care. Studies have examined the value of online drug information for patients and the value of the online drug information for patients. However, no study has examined the usefulness or value of online medication rating websites in facilitating physician-patient communication or participant-reported outcomes. In this study, the value of online medication rating websites to older adults in facilitating communication with their physicians using a newly developed tool was assessed. Additionally, the participant-reported outcomes of quality of life, satisfaction with physician communication, beliefs about medications, and medication adherence plus the relationship between the older adults’ actual ratings of their antihypertensive medications and their self-reported outcomes were examined. Older adults with poor quality of life were more likely to view the online medication rating websites more favorably than participants who enjoy good quality of life. Participants who liked to share health decisions with their physicians were also more likely to have favorable views of the online websites. In addition, older adults with hypertension, who highly rated their antihypertensive medication regimens, were more likely to have good physical quality of life, high satisfaction with physician communication, positive beliefs about medications, and high medication adherence. Older adults with poor quality of life were more likely to be unsatisfied with their antihypertensive medications, have multiple comorbidities, limited health literacy, low satisfaction with their communication with their physicians, take multiple medications, and were more likely to view online medication rating websites favorably compared to their counterparts with good quality of life. Online medication rating websites may play an important role in enhancing physician-patient communication particularly among this segment of the patient population

Arabic translation and cultural adaptation of Liverpool Adverse Events Profile (LAEP) among a sample of epileptic older adults

Purpose: To validate and culturally adapt Liverpool Adverse Events Profile (LAEP) in Arabic among a sample of elderly patients with epilepsy.Methods: The face and content validity of the Arabic version of LAEP was ensured by a group of healthcare professionals. Undemented elderly patients (≥ 60 years) with seizure disorders, who are on a single antiepileptic drug (AED), were recruited from two tertiary care centers in Riyadh, Saudi Arabia. Factor analysis was performed to check the construct validity. The reliability was measured using Cronbach’s alpha method.Results: Seventy-four patients met the inclusion criteria and were interviewed. Most of the participants had generalized seizures (67.57 %), and were either illiterate or with elementary school education (62.16 %). Their mean age was 68.9 years, and 51.35 % were male. About two-thirds of the participants were on either carbamazepine or levetiracetam (66.22 %). Six factors were extracted from the Arabic version of LAEP. Cronbach’s alpha of the Arabic version of LAEP was 0.84. The mean overall LAEP score was 28.9.Conclusion: The Arabic version of LAEP demonstrates good validity and reliability. Similar studies should examine its validity and reliability among different epileptic patient populations.Keywords: Adverse drug event, Epilepsy, Older adults, Cronbach’s alpha, Liverpool Adverse Events Profile, Seizure disorders, Carbamazepine, Levetiraceta

The characteristics and distribution of emergency medical services in Saudi Arabia

BACKGROUND: Emergency medical services (EMS) play an essential role in treating and transporting patients to hospitals or between hospitals. EMS providers must be distributed wisely across all regions of the country to meet healthcare needs during normal times and disasters. No previous study has investigated the characteristics and distribution of the EMS workforce in Saudi Arabia. OBJECTIVES: Examine the characteristics and distribution of the EMS workforce in Saudi Arabia to identify gaps and areas in need of improvement. Also, explore the sociodemographic and educational characteristics of licensed EMS providers in Saudi Arabia. DESIGN: Cross-sectional SETTINGS: EMS in Saudi Arabia METHODS: We included all licensed EMS providers in Saudi Arabia as of 23 December 2020 who were registered in the Saudi Commission for Health Specialties (SCFHS) database. Sociodemographics, where they earned certification, and their job affiliations were collected and categorized. MAIN OUTCOME MEASURES: EMS workforce distribution, gender, and EMS provider-to-population ratio. SAMPLE SIZE: 18 336 EMS providers; 8812 (48.1%) with documented job affiliations. RESULTS: The EMS provider-to-population ratio is very low. In Saudi Arabia, in general, the ratio is 1:3871 (based on n=8812 providers), which is low compared to the 1:1400 ratio for Australian EMS provider-to-population, for example. That makes it a challenge for EMS providers to meet the population’s needs, especially in times of disaster. The low ratio may have contributed to the delayed response time in Saudi Arabia (13 minutes for critical cases) which does not meet the international standard response time (8 minutes maximum). Also, only 3.5% of the total EMS providers registered were females, and the clear majority of all EMS providers were technicians. CONCLUSIONS: The growth in the EMS workforce, including the recruitment of more females into the workforce and more EMS specialists compared to EMS technicians and health assistants, is critical to reaching a satisfactory EMS provider-to-population ratio. LIMITATIONS: Most noteworthy of the limitations of this research are the insufficient statistics describing EMS distribution in Saudi Arabia, the lack of previous studies on the research topic in Saudi Arabia, and job affiliation not accurately recorded in the SCFHS database. CONFLICT OF INTEREST: None

Drug shortages in Saudi Arabia: Root causes and recommendations

Drug shortages are a multifaceted problem that has been recurring in Saudi Arabia over the past decade with its significant negative impact on patient care. However, there is a dearth of evidence about possible domestic reasons, if any, behind this recurring problem. Recently, the Pharmacy Education Unit at King Saud University College of Pharmacy has called for a meeting with multiple stakeholders from academia, pharmaceutical care, pharmaceutical industry, purchasing and planning, and regulatory bodies to unveil the root domestic causes of the drug shortages in the Kingdom. Four major topics were used to guide the discussion in this meeting, including: current situation of drug shortages in Saudi Arabia, major factors contributing to drug shortages, challenges and obstacles to improve drug supply, and stakeholders’ recommendations to manage drug shortages. The meeting was audio-recorded and transcribed into verbatim by five authors. The text was then reviewed and analyzed to identify different themes by the first and third authors. Multiple causes were identified and several recommendations were proposed. The main domestic causes of drug shortages that were explored in this study included poor medication supply chain management, lack of government regulation that mandates early notification of drug shortages, a government procurement policy that does not keep pace with the changes in the pharmaceutical market, low profit margins of some essential drugs, weak and ineffective law-violation penalties against pharmaceutical companies and licensed drug importers and distributors, and overdependence on drug imports. The participants have also proposed multiple recommendations to address drug shortages. Policy makers should consider these factors that contribute to drug shortages in Saudi Arabia as well as the recommendations when designing future initiatives and interventions to prevent drug shortages. Keywords: Shortage, Drugs, Patient safet