Medication errors in a health care facility in southern Saudi Arabia

Purpose: To identify medication errors at Aseer Central Hospital (ACH, Abha) in the southern province of Saudi Arabia. Methods: A cross-sectional retrospective study was conducted by reviewing adult patients’ records (> 15 years old) at ACH’s inpatient and outpatients settings over an 8-week period in October and November 2015. Results: We identified 113 medication errors, including 112 prescribing errors and 1 dispensing error. Most medication errors (91.2 %) in this study were for inpatient prescriptions. The most common prescribing error was medication duplication (31.2 %) followed by missing patient identifying information (25 %). Conclusion: Medication errors, mainly in inpatient prescriptions, have been fully identified at ACH. Educational interventions such as workshops could help minimize and prevent medication errors

Actitud hacia la práctica profesional entre los farmacéuticos comunitarios en Kuala Lumpur, Malasia

Objetivos: Este estudio se dirigió a evaluar las actitudes de los farmacéuticos comunitarios hacia la práctica profesional y determinar su competencia observada en diversas actividades farmacéuticas. Métodos: estudio transversal realizado en la ciudad de Kuala Lumpur. El cuestionario contenía 40 preguntas divididas en seis secciones que abordaban varios aspectos de la práctica y la información demográfica. En el estudio participaron 223 farmacéuticos con licencia que trabajan en farmacias comunitarias. Los datos se analizaron utilizando SPSS. Se utilizaron pruebas de correlación de Chi-cuadrado y Pearson para determinar la significación estadística de los datos dicotómicos. Hallazgos clave: Entre los 233 encuestados en actividades de gestión, 194 (87%) obtuvieron una puntuación buena y 5 (2,2%) obtuvieron una puntuación mala. En las actividades de dispensación, 199 (89,2%) obtuvieron la puntuación buena y 5 (2,2%) obtuvieron la puntuación mala. En las actividades de atención farmacéutica, 209 (93,7%) obtuvieron una buena puntuación y 4 (1,8%) obtuvieron una mala puntuación. En actividades inter / intraprofesionales, 108 (48,4%) puntuaron bien y 10 (4,5%) puntuaron mal. En las actividades de salud pública, 153 (68,6%) obtuvieron la puntuación buena y 6 (2,7%) obtuvieron la puntuación mala, mientras que en las actividades de mantenimiento de competencias, 160 (71,7%) obtuvieron la puntuación buena y 3 (1,3%) obtuvieron el puntaje pobre. Conclusiones: La mayor parte de los participantes obtuvo una buena actitud fue del 93,7% para las actividades de atención farmacéutica mientras que la mayor de los participantes obtuvo una mala actitud fue del 4,5% para las actividades inter / intraprofesionales. La mayoría de los participantes aceptan las actividades para mantener la competenciaObjectives: This study was directed to evaluate community pharmacists’ attitudes towards professional practice and determine their observed competence in various pharmaceutical activities. Methods: A cross-sectional study conducted in the city of Kuala Lumpur. The questionnaire contained 40 questions splitted into six sections that addressed several aspects of practice and demographic information. The study was involved in 223 licensed pharmacists who work in community pharmacies. Data were analyzed by using SPSS. Chisquare and Pearson’s correlation tests were used for statistical significance for dichotomous data. Key findings: Among the 233 respondents in managerial activities, 194 (87%) achieved the score good, and 5 (2.2%) had the score poor. In dispensing activities, 199 (89.2%) achieved the score good, and 5 (2.2%) had the score poor. In pharmaceutical care activities, 209 (93.7%) got the score good, and 4 (1.8%) got the score poor. In inter/intra professional activities, 108 (48.4%) got the score good, and 10 (4.5%) got the score poor. In public health activities, 153 (68.6%) got the score good, and 6 (2.7%) got the score poor whereas in the maintenance of competency activities, 160 (71.7%) got the score good, and 3 (1.3%) got the score poor. Conclusions: The highest of participants got a good attitude was 93.7% for pharmaceutical care activities while the highest of participants got poor attitude was 4.5% for inter/intra professional activities. The majority of the participants are accepting the activities to maintain competence.This work is supported by UCSI University, Faculty of Pharmaceutical Sciences, Kuala Lumpur Malaysi

El patrón de prescripción de los fármacos antihipertensivos en los pacientes diabéticos de la Provincia del Sur, Reino de Arabia Saudita

Background. Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilizationpatterns of antihypertensive in this population are consistent with evidence-based practice guidelines.Objective. To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension.Design. Retrospective descriptive cross sectional.Patients / Participants. 149 patients with diabetes and hypertension from outpatient department at FamilyMedicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A.Results. Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensinconverting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%),diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%)and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patientswith coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensinreceptor blocker (25%) was most commonly prescribed.Conclusions. Patterns of antihypertensive therapy were generally consistent with international guidelines.Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number ofuntreated patients, and increasing the proportion of patients with controlled BP in this population.Antecedentes. La hipertensión es muy frecuente en los pacientes con diabetes. Existen datos limitadossobre los patrones de utilización de antihipertensivos en esta población consistentes con las guías depráctica basadas en la evidencia.Objetivo. Evaluar los patrones de utilización de antihipertensivos en los pacientes diabéticos con hipertensión.Diseño. Estudio retrospectivo descriptivo transversalPacientes / Participantes. 149 pacientes con diabetes e hipertensión, del departamento de pacientes ambulatoriosen el Hospital de Medicina Familiar, Ahaderfieda. Khamis Mushait, K.S.A.Resultados. Más del 43% de los pacientes estaban recibiendo bloqueadores del canal de calcio (CCB),el 36,2% recibían inhibidores de la enzima convertidora de angiotensina (IECA), seguido de los bloqueadoresde los receptores de angiotensina (BRA) (34,9%), diuréticos (34,2%) y bloqueadores β (16,2 %).Los pacientes en monoterapia fueron la mayoría recibiendo CCB (34,3%) e IECA (29,9%). La mayoría(55,03%) de los pacientes tratados se encontraban en regímenes de múltiples fármacos. En los pacientes con enfermedad de la arteria coronaria (CAD), se les prescribió con mayor frecuencia diurético con IECA (25%) y bloqueador de canales de calcio con bloqueador del receptor de angiotensina (25%).Conclusiones. Los patrones de utilización de antihipertensivos fueron generalmente consistentes con las directrices internacionales. Las áreas de mejora incluyen el aumento de IECA / ARB y el uso de diuréticos, disminuyendo el número de pacientes no tratados, y el aumento de la proporción de pacientes con PA controlada en esta población

EVALUATION OF MEDICATION COMPLIANCE IN PATIENTS WITH CONGESTIVE HEART FAILURE IN YEMEN

Objective: Non-compliance with heart failure medication is related to the highest mortality, morbidity, and health-care costs. The objective of this study was to evaluate medication compliance with patients with congestive heart failure. Methods:Inpatients of the cardiac care unit and medical ward of Republican Hospital, German Hospital, Revolutionary Hospital, and Chinese–Yemeni Friendship Hospital were recruited for this study. The study was conducted on patients that were diagnosed as having congestive heart failure and were receiving treatment. Questionnaires were distributed and personal interviews to evaluate the patients’ compliance was conducted to determine the reasons for their non-compliance in taking drugs. Results: Of 86 patients, 44% (n = 38) reported compliance and 56% (n = 48) reported non-compliance. The distribution of the patients in terms of sex was as follows: among men, 41% (n = 24) were compliant and 59% (n = 35) were non-compliant; among women, 52% (n = 14) were compliant and 48% (n = 13) were non-compliant. In addition, smoking status was too significantly linked with non-compliance (P = 0.001). Furthermore, the status of chewing of khat tree leaves was also significantly associated with non-compliance (P = 0.007). Conclusion: This study indicates that the reasons for non-compliance with medications among patients can be attributed to lack of education, chewing of khat tree leaves, lack of health insurance, and cigarette smoking. Therefore, healthcare professionals should create strategies to address these reasons in order to increase medication compliance with patients in heart failure

Evaluación de la prescripción y uso de medicamentos supresores de ácido en hospitales centrales en la región de Abha, Arabia Saudita

Objective: The aim of this study was to study and assess the indications of acid suppressive drugs and to find out percentage of irrational prescriptions with acid suppressive drugs. Material/Methods: It is a prospective observational study conducted in the Armed Forces Hospitals Southern Region and Abha Maternity Hospital, both in Abha in Assir region (Saudi Arabia). The sample size of study was 185 patients. The case sheets of the patients’ prescription order were reviewed for acid suppressive drugs prescription and relevant data was taken. Patients’ age above 18 were identified. The duration of study was 8 weeks, between May and June 2017. Results: Our results showed that the majority of the prescriptions of proton pump inhibitors (68.1%) were unjustifiable and that proton pump inhibitor was the most commonly prescribed acid suppressive drugs for the patients (97.8%). The frequency of prescribing for the autism spectrum disorders in our study was found to be higher in patients with an existing risk factor and was mostly recommended by physicians as concomitant medications (67.6%). The most common concomitant medications used with the proton pump inhibitors were non-steroidal anti-inflammatory drugs (29.2%) in which aspirin composed 13.5% of the non-steroidal anti-inflammatory drugs prescribed followed by antimicrobials (9.2%). Conclusion: Acid suppressive drugs are the most commonly prescribed drugs with no proper indications hence irrational. Based on the results of this study, creating awareness about reasonable use of acid suppressive drugs is a necessity.Objetivo: El objetivo de este estudio fue estudiar y evaluar las indicaciones de los medicamentos supresores de ácidos y averiguar el porcentaje de recetas irracionales con medicamentos supresores de ácidos. Material / Métodos: es un estudio observacional prospectivo realizado en los Hospitales de las Fuerzas Armadas del Sur y en el Hospital de Maternidad Abha, ambos en Abha en la región de Assir (Arabia Saudita). El tamaño muestral del estudio fue de 185 pacientes. Se revisaron las hojas de casos de orden de prescripción de los pacientes para la prescripción de medicamentos supresores de ácido y se tomaron los datos pertinentes. Se identificó la edad de los pacientes mayores de 18 años. La duración del estudio fue de 8 semanas, entre mayo y junio de 2017. Resultados: nuestros resultados mostraron que la mayoría de las prescripciones de inhibidores de la bomba de protones (68,1%) eran injustificables y que este era el fármaco supresor de ácido más comúnmente prescrito para los pacientes (97,8%). La frecuencia de prescripción para los trastornos del espectro autistas en nuestro estudio, fue mayor en pacientes con un factor de riesgo existente y fue recomendada principalmente por los médicos como medicamentos concomitantes (67,6%). Los medicamentos concomitantes más comunes que se usaron con los inhibidores de la bomba de protones fueron los antiinflamatorios no esteroideos (29.2%) en los cuales la aspirina supuso el 13,5% de los antiinflamatorios no esteroideos prescritos, seguidos por los antimicrobianos (9.2%) Conclusión: los medicamentos supresores de ácido son los medicamentos más comúnmente recetados sin indicaciones adecuadas, por lo que son irracionales. Basado en los resultados de este estudio, crear conciencia sobre el uso razonable de los medicamentos supresores del ácido es una necesidad

Prescribing pattern of antihypertensive drugs in diabetic patients of Southern Province, Kingdom of Saudi Arabia

Background: Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilization patterns of antihypertensive in this population are consistent with evidence-based practice guidelines. Objective: To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension. Design: Retrospective descriptive cross sectional. Patients / Participants: 149 patients with diabetes and hypertension from outpatient department at Family Medicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A. Results: Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensin converting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%), diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%) and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patients with coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensin receptor blocker (25%) was most commonly prescribed. Conclusions: Patterns of antihypertensive therapy were generally consistent with international guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population

El patrón de prescripción de los fármacos antihipertensivos en los pacientes diabéticos de la Provincia del Sur, Reino de Arabia Saudita

Background. Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilization patterns of antihypertensive in this population are consistent with evidence-based practice guidelines. Objective. To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension. Design. Retrospective descriptive cross sectional. Patients / Participants. 149 patients with diabetes and hypertension from outpatient department at Family Medicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A. Results. Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensin converting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%), diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%) and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patients with coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensin receptor blocker (25%) was most commonly prescribed. Conclusions. Patterns of antihypertensive therapy were generally consistent with international guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population. Keywords: Hypertension, Diabetes, Antihypertensive agents.Antecedentes. La hipertensión es muy frecuente en los pacientes con diabetes. Existen datos limitados sobre los patrones de utilización de antihipertensivos en esta población consistentes con las guías de práctica basadas en la evidencia. Objetivo. Evaluar los patrones de utilización de antihipertensivos en los pacientes diabéticos con hipertensión . Diseño. Estudio retrospectivo descriptivo transversal. Pacientes / Participantes. 149 pacientes con diabetes e hipertensión, del departamento de pacientes ambulatorios en el Hospital de Medicina Familiar, Ahaderfieda. Khamis Mushait, K.S.A. Resultados. Más del 43% de los pacientes estaban recibiendo bloqueadores del canal de calcio (CCB), el 36,2% recibían inhibidores de la enzima convertidora de angiotensina (IECA), seguido de los bloqueadores de los receptores de angiotensina (BRA) (34,9%), diuréticos (34,2%) y bloqueadores β (16,2 %). Los pacientes en monoterapia fueron la mayoría recibiendo CCB (34,3%) e IECA (29,9%). La mayoría (55,03%) de los pacientes tratados se encontraban en regímenes de múltiples fármacos. En los pacientes con enfermedad de la arteria coronaria (CAD), se les prescribió con mayor frecuencia diurético con IECA (25%) y bloqueador de canales de calcio con bloqueador del receptor de angiotensina (25%). Conclusiones. Los patrones de utilización de antihipertensivos fueron generalmente consistentes con las directrices internacionales. Las áreas de mejora incluyen el aumento de IECA / ARB y el uso de diuréticos, disminuyendo el número de pacientes no tratados, y el aumento de la proporción de pacientes con PA controlada en esta población

Quantitative methods in the analysis of clozapine in human matrices – A scoping review

Clozapine (CLZ) has retained its clinical utility in the management of schizophrenia despite the discovery of novel antipsychotics, as it possesses unique efficacy in the setting of treatment resistant schizophrenia while causing minimal extrapyramidal symptoms. However, these benefits are offset by the risk of agranulocytosis and other side effects, and therapeutic drug monitoring (TDM) is routinely recommended for patients undergoing treatment with CLZ. A multitude of approaches for the quantification of CLZ have been developed for different settings such as TDM, quality control of pharmaceutical dosage forms, and toxicology studies. Primarily, these approaches fall under one of three branches of analysis, namely, chromatography, electrochemical analysis, and spectrophotometry. This study provides a scoping review of the recent advances in the methods of quantification for CLZ and highlights the potential utility of novel methods in the field of drug quantification

Dispensing errors in hospital pharmacies in Yemen: an exploratory study

Aims. This study aimed to describe the dispensing errors that occurred during the dispensing process in selected hospital pharmacies in Sana'a, Yemen, and to describe their types and causes. Methodology. A prospective study was carried out in selected hospital pharmacies in Yemen over 40 days using a validated tool. Results. A total of 9000 dispensed prescriptions were evaluated for the dispensing errors, and 2.13% dispensing errors were identified. Wrong dosage form (134/192), incorrect strength (24/192), wrong drug (18/192), incorrect quantity, wrong instructions written and drug available in the pharmacy but not given (6/192) and dispensing expired drugs (3/192) were the dispensing errors reported in this study. Poor handwriting, similar drug names, similar drug packaging, fatigue, heavy work, workforce issues, and poor communication were the most commonly reported causes of dispensing errors. Conclusion. There is a wide variation in the rates of prevalence of medication errors observed during this prospective study. Dispensing errors were the most common. This variation may be attributed to the nature and heterogeneity of the prescription’s sources. Study results indicate that medication errors imposed an extraordinary challenge to the healthcare system in Yemen and post significant potential harm to the patient in light of the current economic, social and security conditions. Well-designed nationwide future studies aimed at investigating the causes of medication errors to guide the design of interventions aimed at reducing their burden on the national healthcare system is highly recommended