scholarly journals 164. Restriction of Antimicrobials Dispensing without Prescription on a National Level: Impact on the Overall Antimicrobial Utilization in Community Pharmacies in Saudi Arabia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Khalid Eljaaly ◽  
Ahmed Al-Jedai ◽  
Yasser Almogbel ◽  
Nasser Alqahtani ◽  
Hajer Almudaiheem ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Policy Implementation ◽  
Community Pharmacy ◽  
Consumption Rate ◽  
National Level ◽  
Policy Enforcement ◽  
Defined Daily Dose ◽  
Effective Implementation ◽  
Antimicrobial Utilization ◽  
Pharmacy Setting

Abstract Background High rates of non-prescription dispending of antimicrobials has led to a significant increase in antimicrobial overuse and misuse in Saudi Arabia (SA). The objective of this study was to evaluate antimicrobial utilization following enforcement of a new prescription-only antimicrobial dispensing policy in the community pharmacy setting in SA. Methods Data were extracted from the IQVIA database between May 2017 and May 2019. Antimicrobial consumption rate based on the sales, defined daily dose in grams (DDD), DDD/1000 inhabitants’/day (DID), and antimicrobial claims for pre-policy (May 2017 to April 2018) and post-policy (June 2018 to May 2019) periods was assessed. Results Overall antimicrobial utilization slightly declined (~9-10%) in post-policy vs. pre-policy period (sales, 31,334 vs.34,492 thousand units; DDD, 183,134 vs. 202,936 thousand grams), with an increase in the number of claims (~16%) after policy implementation. There was a sudden drop in the consumption rate immediately after policy enforcement; however, the values increased subsequently, matching closely to the pre-policy values. Consumption patterns were similar in both periods. Penicillins were the most commonly used antimicrobial (sales, 14,700 - 11,648 thousand units; DDD, 71,038 - 91,227 thousand grams; DID, 2.88 - 3.78). For both the periods, the highest dip in utilization was observed in July (sales, 1,027 - 1,559 thousand units; DDD, 6,194 - 9,399 thousand grams), while the highest spike was in March/October (sales, 3,346 - 3,884 thousand units; DDD, 22,329 - 19,453 thousand grams). Conclusion Non-prescription antimicrobial utilization reduced minimally following policy implementation in the community pharmacy setting across SA. Measures to aid effective implementation of prescription-only regulations are necessary. Disclosures All Authors: No reported disclosures

The Problem of Policy Coordination in a Newly Decentralised Government: A Study of Policy Implementation in the Province of Bali, Indonesia

2018 ◽  
Vol 9 (5) ◽  
pp. 83-95
Author(s):  
Luqman H. Zainuri
Keyword(s):  
Policy Implementation ◽  
Local Governments ◽  
Political System ◽  
Local Economic Development ◽  
National Level ◽  
Radical Change ◽  
Policy Coordination ◽  
Politics And Government ◽  
Government Relations ◽  
Societal Needs

Abstract The aim of this article is to describe inter government relations resulted from disorganized political change from Autocratic political system to the Democratic one. This purpose is described through a challenge against Governor’s moratorium policy in 2010 made by three Heads of Districts within the province of Bali over the issuance of principle of building permit of new hotels and tourist accomodations. The method by which this research is conducted is exploratory. The research found that the problems of coordination in the policy emanate from a radical change in politics and government from centralised to decentralised government and termination of President Soeharto from the office. The un-coordinated political transition at the national level being faced by Indonesia has brought about serious problems on coordination of inter government institutions of the local governments. In effect, to the large extent, the performance of local governments -as it has been the case in the province of Bali-is contra productive in fulfilling societal needs of public services as well as local-economic development.

Reliability of a Modified Medication Appropriateness Index in Community Pharmacies

2003 ◽  
Vol 37 (1) ◽  
pp. 40-46
Author(s):  
Rosemin Kassam ◽  
Linda G Martin ◽  
Karen B Farris ◽  
Homero A Monsanto ◽  
Jean-Marie Kaiser
Keyword(s):  
Community Pharmacy ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Community Setting ◽  
Medication Appropriateness Index ◽  
Paired Samples ◽  
Psychometric Data ◽  
Ambulatory Patients ◽  
Pharmacy Setting ◽  
Medication Appropriateness

Background The medication appropriateness index (MAI) has demonstrated reliability in selected outpatient clinics where medical data were easily accessible from medical charts. However, its use in the community setting where patient data may be limited has not been examined. Objective To evaluate the usefulness of a modified MAI for use in the community pharmacy setting by testing interrater reliability using 3 different rating schemes. Methods Two raters evaluated 160 medications for 32 elderly ambulatory patients. Patient information was acquired using community pharmacist-collected medication histories. A summated MAI score, percent agreement, κ, positive agreement, negative agreement, and intraclass correlation coefficient were calculated for each criterion using 3 scoring schemes. A paired samples t-test (95% CI) was used to test interrater reliability. Results The κ statistics were >0.75 for indication and effectiveness, but good (0.41–0.66) for the remaining criteria using the Hanlon scoring scheme. The intraclass coefficients (0.82, 0.86, 0.87) and overall κ (0.65, 0.66, 0.61) were similar for the 3 schemes. Conclusions This study suggests that the modified MAI has the potential to detect medication appropriateness and inappropriateness in the community pharmacy setting; however, it is not without limitations. Because the MAI has the most clinimetric and psychometric data available, the instrument should be studied further to increase its reliability and generalizability.

scholarly journals Socioeconomic determinants and inequalities in the prevalence of non-communicable diseases in Saudi Arabia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammed Khaled Al-Hanawi
Keyword(s):  
Logistic Regression ◽  
Saudi Arabia ◽  
National Level ◽  
Communicable Diseases ◽  
School Level ◽  
Gulf Region ◽  
Non Communicable Diseases ◽  
Socioeconomic Determinants ◽  
The Government ◽  
Concentration Indices

Abstract Background Non-communicable diseases (NCDs) are increasingly becoming a challenge worldwide, causing high mortality and morbidity. Saudi Arabia has one of the highest rates of NCDs globally and the highest in the Arabian Gulf region. Epidemiological data indicate that NCDs are responsible for 70 % of all deaths in Saudi Arabia. The aim of this study was to examine the socioeconomic determinants and inequalities in the prevalence of NCDs in Saudi Arabia. Methods Data from the Saudi Family Health Survey conducted in 2018 by the General Authority for Statistics were used for this study. Univariate, bivariate, and multivariate logistic regression analyses were employed to examine the socioeconomic factors associated with the prevalence of NCDs. Moreover, the concentration curve and concentration indices were used to assess inequalities in the prevalence of NCDs. Results Among the 11,527 respondents, the prevalence of NCDs was 32.15 %. The prevalence of NCDs was higher among women and among elderly respondents aged ≥ 60 years. With respect to the determinants of the prevalence of NCDs, the logistic regression results showed that the likelihood of reporting NCDs was lower among people with a higher education (OR: 0.599, 95 % CI: 0.497–0.723, p < 0.01) compared with that of people with an education below the primary school level. Other factors significantly associated with the prevalence of NCDs were age, marital status, nationality, and region of residence. The inequality analysis showed that at the national level, the prevalence of NCDs was concentrated among less educated people (concentration index = − 0.338, p < 0.01), but with significant regional variations. Gender disaggregation showed that both income-based and education-based concentration indices were significantly negative among women, indicating that the prevalence of NCDs is concentrated among women with a lower income level and with less education. Conclusions The findings of this study are important for policymakers to combat both the increasing prevalence of and socio-economic inequalities in NCDs. The government should develop targeted intervention strategies to control NCDs and achieve health equality considering socio-economic status. Future policies should target women and the lower educated population in Saudi Arabia.

scholarly journals Group-Based Trajectory Models: Assessing Adherence to Antihypertensive Medication in Older Adults in a Community Pharmacy Setting

2017 ◽  
Vol 103 (6) ◽  
pp. 1052-1060 ◽  
Author(s):  
Paul Dillon ◽  
Derek Stewart ◽  
Susan M. Smith ◽  
Paul Gallagher ◽  
Gráinne Cousins
Keyword(s):  
Older Adults ◽  
Community Pharmacy ◽  
Antihypertensive Medication ◽  
Trajectory Models ◽  
Pharmacy Setting

Pharmacy student driven detection of adverse drug reactions in the community pharmacy setting

2010 ◽  
Vol 20 (4) ◽  
pp. 399-404 ◽  
Author(s):  
Søren Troels Christensen ◽  
Birthe Søndergaard ◽  
Per Hartvig Honoré ◽  
Ole Jannik Bjerrum
Keyword(s):  
Community Pharmacy ◽  
Adverse Drug Reactions ◽  
Pharmacy Student ◽  
Drug Reactions ◽  
Pharmacy Setting
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