Knowledge and Perception Towards Psychotropic Drugs Among the General Population in Saudi Arabia

Eatedal M Al-Shareef,1 Alaa M Kadah Salim,1 Nada M Al-Farrah,1 Bader M Al-Murad,1 Adnan A Moallem,1 Mohammed A Radwan,1 Salman Hakami,2 Asim M Alshanberi,1,3 Mohammed Shaikhomer,4 Safaa M Alsanosi5 1General Medicine Program, Batterjee Medical College, Jeddah, 21442, Saudi Arabia; 2Department of Psychiatry, Mental Health Hospital, Ministry of Health, Jeddah, Saudi Arabia; 3Department of Community Medicine and Pilgrims Health Care, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia; 4Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Pharmacology and Toxicology Faculty of Medicine, Umm Al Qura University, Makkah, Saudi ArabiaCorrespondence: Safaa M Alsanosi, Email [email protected]: Mental health is crucial to overall well-being. Despite an increase in mental disorders over the past few decades, public awareness remains slow-growing, and stigmatization towards psychotropic medications persists. Therefore, this study aimed to identify knowledge and perceptions of psychotropic drugs among the general population in the Makkah Region, Saudi Arabia.Methods: A questionnaire-based cross-sectional study was conducted among adults aged 18 years old and older, living in the Makkah Region, Saudi Arabia, from 1 January to 30 April 2024. Descriptive statistics were used to describe participants’ characteristics, and categorical variables were reported as frequencies and percentages. A Chi-square test was used to examine the relationships between variables.Results: A total of 717 participants were involved in the study: (52%) were from Jeddah, (25.9%) were from Taif, and (22%) were from Makkah. The mean age was 33.9 years, and 67.1% were females. Among the participants, (20.8%) had experienced a psychiatric illness, (41.7%) had a member of the family who suffered from a psychiatric illness, (39.5%) had a family member who used a psychiatric drug, and only 25 (7%) had a child suffering from a psychiatric illness. Specifically, 20.8% of those with a psychiatric illness demonstrated good knowledge (P=0.001), 16.1% of those with a family history of psychiatric illness had good knowledge (P=0.007), 16.3% with family use of psychiatric drugs had good knowledge (P=0.006), and 24.5% of those who used psychiatric drugs had high knowledge (P=0.001). Overall, (40.6%) of participants had a low level of knowledge and perception about psychotropic drugs, (47.8%) had a moderate knowledge and perception level, and only (11.6%) had high knowledge and perception.Conclusion: Psychological well-being is crucial for health, but misconceptions persist, acting as barriers that impede people from seeking and accepting necessary psychiatric care. The findings highlight the need for targeted public education and healthcare professional training to improve Confirmed understanding and reduce stigma around psychotropic drugs in Saudi Arabia. A multifaceted approach involving policy development, community outreach, and ongoing research is essential for enhancing mental health outcomes and treatment accessibility.Keywords: knowledge, perception, psychotropic drugs, Saudi Arabi

Medical Students’ Knowledge and Perceptions of Herbal Medicine in Saudi Arabia: Should Medical Schools Take Immediate Action?

Majd Almech,1 Abdulrahim Alissa,1 Ragad Adel Baghdadi,2 Jakleen Z Abujamai,1 Waleed Hafiz,3 Hassan Alwafi,4 Mohammed Shaikhomer,5 Asim M Alshanberi,1,6 Maram H Alshareef,6 Safaa M Alsanosi4 1General Medicine Program, Batterjee Medical College, Jeddah, 21442, Saudi Arabia; 2Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; 3Department of Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; 4Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia; 5Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Community Medicine and Pilgrims Health Care, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi ArabiaCorrespondence: Safaa M Alsanosi, Email [email protected]: Herbal medicine is integral to Saudi Arabia’s Vision 2030, which seeks to improve the healthcare system and promote alternative practices while ensuring safety through education and research. This study aims to evaluate medical students’ knowledge and perceptions regarding herbal medicine in Saudi Arabia.Methods: A cross-sectional study was conducted among medical students in three medical colleges in Saudi Arabia over a six-month period from 1 February to 31 July 2024. Descriptive statistics were used to describe the participants’ characteristics, and categorical variables were reported as frequencies and percentages. A chi-square test was used to test the relationships between variables. A p-value of < 0.05 was taken to indicate statistical significance.Results: In total, 592 participants were included in the study. Females represented 65.7% of the participants. While 72.6% of the students agreed that medical students lack proper knowledge about the use of herbal medicines, 64.9% preferred having an elective course in complementary medicine (including herbal medicine). Also, 40.9% of students use herbal medicine believing they do not require expert knowledge and can safely experiment with various herbs, and 22.3% use it because they perceive it as having no side effects due to its natural ingredients. The most reported sources of information included family and friends (53.2%), whereas traditional herbalists (Attar) were the most reported sources of herbs (49.3%). The most used herbs among medical students were ginger (83%), turmeric (48.1%), chamomile (46.3%), and myrrh (26.5%). Only 37.7% of students who used herbs had an overall good knowledge and perception of them (P = 0.001). Gender showed a significant relationship with herb use among the students: 95.4% of female students used herbs, compared with 92.6% of male students (P = 0.049).Conclusion: A considerable proportion of medical students demonstrated insufficient knowledge and perception regarding the use of herbal medicine. To improve their understanding, it is essential to integrate comprehensive courses, organize workshops led by experts, promote research and clinical experiences, and establish patient education initiatives.Keywords: medical students’, herbal medicine, Saudi Arabia, medical school

Predictors of Infections and Mortality in Adult Patients Undergoing Extracorporeal Membrane Oxygenation

Abstract Background Extracorporeal membrane oxygenation (ECMO) has been used in various clinical settings, such as acute respiratory distress syndrome, cardiogenic shock and refractory septic shock. One of the associated risks is acquisition of infections during bypass because of the multiple cannulation sites. The purpose of this study was to evaluate the predictors of healthcare associated infections (HAI) and mortality in adult patients on ECMO. Methods This was a retrospective descriptive study at a 1550 bed University- affiliated tertiary medical center in Miami, Florida. We looked at patients over 18 years old on ECMO for > 48 hours between January 1–August 31, 2016. The presence of an infection before ECMO placement or acquired during ECMO support were noted. Only culture- proven infections were included. The primary outcome was to identify risk factors associated with HAI or mortality. Results 40 patients undergoing ECMO during the study period were identified. 25 patients met the inclusion criteria and were included in the analysis. During a total of 364 ECMO days, 12 patients out of 25 had microbiologically proven infection (48 %). There were 7 ventilator associated pneumonias (41%), 5 bacteremias (29%), 2 pleural empyemas (12%), 2 Clostridium difficile colitis (12%) and 1 mediastinitis (6%). Candida species were the predominant blood isolates (60%). The rate of infection per 1,000 ECMO days was 46.7. The overall in-hospital mortality was 64%. There was no impact of infection on mortality, length of ICU,or hospital stay. ECMO use for 7 days. (P-value 0.0136, OR 0.089, CI: 0.01–0.6). Charlson-comorbidity score of 5 or more was associated with higher episodes of bacteremia (P = 0.0023, OR = 16, CI = 1.38–185.41). Conclusion Infections did not have an impact on mortality. Patients on ECMO for less than 8 days had less episodes of infections. Patients with Charlson-comorbidity index of 5 or more were associated with higher episodes of bacteremia. Further prospective cohort studies are necessary to address causality and to determine infection and mortality predictors that can be modified for patients undergoing ECMO. Disclosures All authors: No reported disclosures

Improving HCV Cure Rates in HIV-Coinfected Patients-A Real-World Perspective

Objectives: To study rates and predictors of hepatitis C virus (HCV) cure among HIV/HCV-coinfected patients, and then to evaluate the effect of attendance at clinic visits on HCV cure. Methods: Retrospective cohort study of adult HIV/HCV-coinfected patients who initiated and completed treatment for HCV with direct-acting antivirals (DAAs) between January 1, 2014, and June 30, 2015. Results: Eighty-four participants reported completing treatment. The median age was 58 years (interquartile ratio, 50-66); 88% were male and 50% were black. One-third were cirrhotic and half were HCV-treatment-experienced. The most commonly used regimen was sofosbuvir/ledipasvir (40%) followed by simeprevir/sofosbuvir (30%). Cure was achieved in 83.3%, 11.9% relapsed, and 2.3% experienced virological breakthrough. Two patients (2.3%) did not complete treatment based on pill counts and follow-up visit documentation. In multivariable analysis, cure was associated with attendance at follow-up clinic visits (odds ratio [OR], 9.0; 95% CI, 2.91-163) and with use of an integrase-based HIV regimen versus other non-integrase regimens, such as non-nucleoside analogues or protease inhibitors (OR, 6.22; 95% CI 1.81-141). Age, race, genotype, presence of cirrhosis, prior HCV treatment, HCV regimen, and pre-treatment CD4 counts were not associated with cure. Conclusions: Real-world HCV cure rates with DAAs in HCV/HIV coinfection are lower than those seen in clinical trials. Cure is associated with attendance at follow-up clinic visits and with use of an integrase-based HIV regimen. Future studies should evaluate best antiretroviral regimens, predictors of attendance at follow-up visits, impact of different monitoring protocols on medication adherence, and interventions to ensure adequate models of HIV/HCV care