Strategic analysis of clinical pharmacy education in Saudi Arabia

Purpose: To analyze the strategic position of clinical pharmacy education in Saudi Arabia and ensure that it meets the needs of the current industry in the country.Methods: A comprehensive and structured analysis of strengths, weaknesses, opportunities, and threats (SWOT) was performed with more than 100 clinical pharmacists, academic staff, and students as participants. An internal factor evaluation (IFE), external factor evaluation (EFE), and SWOT matrix were conducted to compare the provisions of the current system with market needs.Results: The analysis involved more than 40 academic staff members, 35 clinical pharmacists, 50 students, and several administrative staff members. The EFE and IFE were calculated as 2.06 and 2.2, respectively, and were lower than the accepted international standard. The internal and external analyses involved 37 and 20 items, respectively. Finally, a SWOT matrix was constructed to help for proposing the strategies. Several strategies were recommended to address eventual shortcomings.Conclusion: The great paradigm shifts in the pharmaceutical market warrant an equal paradigm shift in clinical pharmacy education. More strategic data are needed to further analyze the market in the next five to ten years. Adopting the current educational modality to best match the needs of the pharmaceutical market is also essential. Keywords: Clinical pharmacy, Education, SWOT analysis, Strategic plannin

Factors associated with the willingness to quit smoking among a cohort of university students in the KSA

AbstractObjectivesThe aim of this study was to determine the predictors of the willingness to quit smoking among a cohort of male Saudi students.MethodsIn this cross-sectional study, a questionnaire was administered to a cohort of male students that were recruited from three institutes of higher education. Using the retrieved data, bivariate analysis and logistic regression tests were performed to assess the factors associated with the willingness to quit smoking.ResultsOf 467 participants, 24% of respondents were current smokers, while 65% of these smokers were willing to quit smoking. In the bivariate analysis, past attempts to quit smoking and the anti-smoking messages on TV and in newspapers were significantly associated with the willingness to quit smoking. Only one variable – past attempts to quit smoking – was a significant predictor of the willingness to quit smoking, as shown by the multivariate logistic regression analysis.ConclusionThe findings of this study indicate that Saudi male students who smoke are willing to quit smoking; having unsuccessfully attempted to quit smoking in the past, they are willing to try again. Successful programs should be developed for male university students in KSA to assist them in their quest to quit smoking and maintain cessation

Impact of Computer-Aided Warfarin Dosing in a Saudi Arabian Cardiac Centre

Purpose: To compare the efficacy of computer-aided dosing using Coagclinic (a web-based software) with physician dosing in patients receiving warfarin for various cardiac indications. Methods: In order to calculate the effectiveness of physician managed anticoagulation dosing, we calculated the “percentage of time international normalized ratio, INR, was in the therapeutic range" (TTR) for a random sample of 70 patients in the center. For each patient, 4 INR values were taken at 4 consecutive visits, before and after the installation of Coagclinic. Data on the doses given by physicians were collected at each visit and compared them with the pharmacy-based computer aided dosing system data. Results: After performing paired samples t-test of doses based on the physician group with those based on the computer system (mean -1.5654 ± 2.09 ), a statistically significant difference was found (p < 0.015). Furthermore, the patients kept at TTR by physicians amounted to 26 % compared to 70 % by the software. Conclusion: The difference between TTR managed by physicians and those managed using CoagClinic™ software is statistically significant. It appears that the software improves the effectiveness of warfarin dosing in patients

Predictive and prognostic value of 256-slice computed tomography angiography in patients with suspected coronary artery diseases

Background: Coronary computed tomography angiography (CCTA) is commonly used to diagnose coronary artery diseases (CADs). We aimed to determine the utility of CCTA among patients suspected with CAD at the Prince Sultan Cardiac Center Qassim. Materials and Methods: CCTA results of 425 cardiac patients, complaining of chest pain with suspected CAD, were used to classify coronary artery stenosis into two types: obstructive if the luminal stenosis was ≥50% or nonobstructive if it was <50%. Followups were conducted through clinic or phonebased interviews to document any of the following endpoints: nonfatal myocardial infarctions (MIs) or cardiac deaths (CDs), representing the major cardiac events. All other cardiac cases, including hospitalization with unstable angina, and/or late coronary revascularization, were documented. Results: Patients with a normal coronary artery were 278 (65.5%). The number of patients with nonobstructive and obstructive diseases was 85 (20%) and 62 (14.5%), respectively. After 19.6 ± 7 months of followup, 21 cardiac events occurred in twenty patients: five major adverse events (two CDs and three nonfatal MIs), ten hospitalizations due to unstable angina, and six late coronary revascularizations. Furthermore, the cumulative allcardiacevent rates in patients with normal coronary arteries, nonobstructive CAD, and obstructive CAD were 3 (1%), 7 (8.2%), and 11 (17.7%), respectively. However, patients with normal CCTA had no major cardiac events during the followup. Conclusion: CCTA can provide valuable prognostic information on patients with suspected CAD. Patients are likely to have excellent intermediate outcomes if the coronary arteries are confirmed to be normal by CCTA

Association of Vitamin D Level with the Severity of Coronary Artery Disease in Saudi Patients Presenting with Acute Coronary Syndrome

Background: Vitamin D plays several vital roles in the body and its impact on cardiovascular outcome is of great concern to cardiac specialists. This study investigated the influences of Vitamin D levels on coronary artery stenosis (CAS). Subjects and Method: A case study involving 248 patients (74% ,184 males); mean age of 57±13 years in which serum levels of vitamin D were measured in Saudi patients admitted to King Saud Medical Hospital with acute coronary syndrome. Coronary arteries were classified angiographically as normal, non-obstructive or obstructive coronary stenosis when there is more than 70% luminal stenosis. The relationship between vitamin D levels and coronary stenosis was assessed using SPSS software. Results: The findings show that the mean (standard deviation; SD) levels of vitamin-D was (14.3 7.3 ng/ml. Most of the patients (205 [82.7%]) were found to have low serum vitamin-D level. Of 248 patients recruited for this study, 70 (28%) of them had unstable angina, 85 (34.5%) had ST-segment elevation myocardial infarction and 93 (37.5%) had non-ST-segment elevation myocardial infarction. Likewise, 58 patients (23.4%) had three vessel disease, 75 (30.2%) had two vessel disease, 76 (30.4%) had one vessel disease, 29 (12%) had a non-obstructive coronary artery stenosis and 10 (4%) had visually normal coronary arteries. Vitamin-D level was not a significant predictor of the degree of coronary luminal stenosis (p=0.15).However, a low vitamin-D level in individuals older than 55 years was a significant predictor of non-obstructive coronary artery stenosis [odds ratio (OD) =2.63, 95% confidence interval (CI):1.21-5.55, p=0.015]. Conclusions: It is concluded that low vitamin-D level does not correlate with the severity of coronary stenosis, but normal level in patients older than 55 years is associated with decreased severity of coronary stenosis

Fat volume measurements as a predictor of image noise in coronary computed tomography angiography

Introduction: Image noise can negatively affect the overall quality of coronary computed tomography angiography (CCTA). Objectives: The purpose of this study was to evaluate the relationship between image noise and fat volumes in the chest wall. We also aimed to compare these with other patient-specific predictors of image noise, such as body weight (BW) and body mass index (BMI). Methods: We undertook a cross-sectional, single-center study. A tube voltage of 100 kV was used for patients with BW 30 HU had significantly higher SFV (75 ± 33 vs. 51 ± 24, p < 0.0001) and TFV (2206 ± 927 vs. 1815 ± 737, p < 0.01) compared with patients having noise ≤30 HU, whereas BW and BMI showed no significant difference (78 ± 13 vs. 81 ± 14, p < 0.34) and (28.7 ± 4.7 vs. 26.8 ± 3.8, p < 0.19), respectively. Linear regression analysis showed that image noise has better correlation with SFV (R = 0.399; p < 0.0001); and TFV (R = 0, p < 0.009) than BMI (R = 0.154, p < 0.039) and BW (R = –0.102, p = 0.12). Conclusions: Fat volume measurements of the chest wall can predict CCTA image noise better than other patient-specific predictors, such as BW and BMI. Keywords: Body mass index, Body weight, Coronary computed tomography angiography, Image noise, Fat volume

Are cardiac patients in Saudi Arabia provided adequate instructions when they should not drive?

Objective: Driving capability can be significantly affected by different heath disorders; cardiovascular diseases (CVDs) should be considered when assessing patients for medical fitness to drive (MFTD). The aim of this study was to evaluate the awareness of Saudi patients about driving recommendations and to assess the incidence of motor vehicle accidents (MVAs) among cardiac patients. Materials and Methods: We conducted a cross-sectional survey-based study. Male patients diagnosed with CVDs and who were visiting outpatient departments were invited to complete a questionnaire regarding their awareness of driving recommendations. Patients’ demographics, clinical diagnosis, echocardiography parameters, and time-to-CVD diagnosis were all obtained from the patients’ medical records. Women were excluded because it was illegal for women to drive in Saudi Arabia during the study period. Results: In total, 800 men were included, with a mean age of 54 ± 12 years. Driving counseling had been provided to 241 participants (30%). Of these, 207 (25%) were advised not to drive for a period of between one week and six months. Five percent of the patients had a history of MVAs during the follow-up period of 6.2 ± 4 years. We found that the presence of a dyspnea ≥2, according to the New York Heart Association (NYHA), and a history of loss of consciousness (syncope/pre-syncope) were significantly associated with accidents (46% vs. 20%, P < 0.0001 and 41% vs. 10%, P < 0.0001, respectively). Conclusion: Patient–physician discussion about MFTD was only performed with 30% of the patients with CVDs in Saudi Arabia. Dyspnea NYHA class ≥2 or a prior history of syncope were significantly associated with the incidence of MVAs