scholarly journals Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia

BMJ Open ◽  
2018 ◽  
Vol 8 (5) ◽  
pp. e020852 ◽  
Author(s):  
Monira Alwhaibi ◽  
Bander Balkhi ◽  
Tariq M Alhawassi ◽  
Hadeel Alkofide ◽  
Nouf Alduhaim ◽  
...  
Author(s):  
Dalal Salem Al- Dossari ◽  
Mohammed Ibrahim Alnami ◽  
Naseem Akhtar Qureshi

Background: Drug prescription error is a medication error that most frequently happens in healthcare organizations and adversely affects the healthcare consumers. Most medication errors (MEs) but not all are captured and corrected before reaching the patient by designed system controls. Medication administration errors (MAEs) mostly are made by nurses but frequently reported by clinical pharmacists in hospitals in Saudi Arabia. Objective: This study aimed to analyze exclusively the voluntarily reported drug administration errors in a tertiary care hospital in Riyadh city. Methods: This cross-sectional, retrospective study evaluated consecutively collected medication administration report forms over a period of one year from January 1, 2015 to December 31, 2015. Results: The number of MAEs occurring during stage of drug administration constituted 7.1% (n=971) of total medication errors (n=13677). The maximum number of MEs (n=6838, 50%) and MAEs (n=455, 46.9%) occurred during the 4th quarter of the year 2015. The most common MAE happened to be category C (n=888, 91.5%) which means error occurred, reached the patient but without causing any harm. Concerning MAE types, the most common error included wrong frequency (40%) followed by wrong drug (17%), wrong time of administration (16%) and wrong rate of infusion (10%). Nurses made the most of the errors (92.2%) while the clinical pharmacists reported the most MAEs (75.5%). High alert medications (HAM) errors constituted 32.3% (n=314) of MAEs (n=971) and most common HAM errors included the wrong route of administration of Lanus Insulin (15%) followed by Insulin Aspart (15%), Enoxaparin (13%) and Insulin Protamine-Nvomix (12%). Look-alike and sound-alike (LASA) errors constituted 55.2% of MAEs (971/536) and most common LASA drugs identified were Gentamycin (13%), Insulin Mixtard (11%), NPH Insulin (8%) Intralipid vial (8%) and Insulin regular (6%). Conclusion: This retrospective study provides some important tentative pharmacovigilance insights into MAEs, which are partially comparable with current international trends in drug administration errors. Further studies on MAEs are warranted not only in the Kingdom of Saudi Arabia but also other Gulf countries.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029280 ◽  
Author(s):  
Bander Balkhi ◽  
Monira Alwhaibi ◽  
Nasser Alqahtani ◽  
Tariq Alhawassi ◽  
Thamir M Alshammari ◽  
...  

ObjectivesThe purpose of this study is to measure the adherence rates of oral antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM) and assess the relationship of glycaemic control and adherence to OADs after controlling for other associated factors.DesignCross-sectional retrospective study.SettingLarge tertiary hospital in the central region of Saudi Arabia.Participants5457patients aged 18 years and older diagnosed with T2DM during the period from 1 January 2016 to 31 December 2016.Primary and secondary outcome measuresThe modified medication possession ratio (mMPR) was calculated as a proxy measure for adherence of OADs. The factors associated with OADs non-adherence and medication oversupply were assessed using multinomial logistic regression models. The secondary outcomes were to measure the association between OADs adherence and glycaemic control.ResultsMajority of patients with T2DM were females (n=3400, 62.3%). The average glycated haemoglobin was 8.2±1.67. Among the study population, 48.6% had good adherence (mMPR >0.8) and 8.6% had a medication oversupply (mMPR >1.2). Good adherence was highest among those using repaglinide (71.0%) followed by pioglitazone (65.0%) and sitagliptin (59.0%). In the multivariate analysis, women with T2DM were more likely to have poor adherence (adjusted OR (AOR)=0.76, 95% CI=0.67, 0.86) compared with men. Also, medication oversupply was more likely among patients with hyperpolypharmacy (AOR=1.88, 95% CI=1.36, 2.63), comorbid osteoarthritis (AOR=1.72, 95% CI=1.20, 02.45) and non-Saudi patients (AOR=1.53, 95% CI=1.16, 2.01). However, no association was found between glycaemic control and adherence to OADs.ConclusionThe study findings support the growing concern of non-adherence to OADs among patients with T2DM in Saudi Arabia. Decision makers have to invest in behavioural interventions that will boost medication adherence rates. This is particularly important in patients with polypharmacy and high burden of comorbid conditions.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Sandra N. Ofori ◽  
Frances N. Adiukwu

This study aimed to determine the prevalence of unrecognized depressive symptoms and its associated risk factors among patients with diabetes and/or hypertension attending medical outpatient clinics of a tertiary health centre in southern Nigeria. A cross-sectional study design was employed to assess 200 randomly selected patients attending the clinics. Questionnaires were administered to obtain sociodemographic and medical history data. The perceived stress scale (PSS) was used to determine the presence of subjective psychological stress and PHQ-9 was used to screen for depression. The prevalence of depressive symptoms was 54.9% with 16.5% categorised as having major depression. After adjusting for confounding variables, age younger than 60 years was associated with less odds of having depressive symptoms (AOR 0.32, 95% CI 0.17, 0.62; p=0.001), while only significant psychological stress increased the odds of having depressive symptoms (AOR 2.78, 95% CI 1.37, 5.64; p=0.005). The prevalence of depression among the study participants is high and has the potential to significantly impact the control of their disease and ultimately contribute to the high cardiovascular risk faced by this population.


2019 ◽  
pp. 001857871988231
Author(s):  
Oluwaseun Egunsola ◽  
Sheraz Ali ◽  
Dalal S. Al-Dossari ◽  
Rahsid Hamoud Alnajrani

Background: The peculiarities of medication errors (MEs) among the pediatric population in the Middle East have not been adequately explored. In this study, we describe the MEs reported at the largest tertiary hospital in Saudi Arabia. Methods: This study is a retrospective analysis of MEs reported by health care professionals at a large tertiary hospital in Saudi Arabia between 2015 and 2016. Results: There were a total of 9123 MEs involving 84 different medications. In total, 109 382 drugs were ordered. Thus, 8.3 MEs per 100 prescriptions were reported during the study period. Thirty-nine errors (0.4%) reached the patient, but did not cause any harm. Transcribing errors accounted for more than half of the MEs (n = 4856, 53.2%). Physicians were the least likely to report an ME (n = 159, 1.7%), whereas pharmacists reported more MEs than any other health care professional (n = 4924, 54%). The most common drug causes of MEs were paracetamol, salbutamol, and amoxicillin, which accounted for 21.0%, 16.6%, and 12.4% of MEs, respectively, over the study period. Conclusions: Medication errors are common in pediatric care, especially for drugs such as paracetamol and amoxicillin that are frequently prescribed. Transcription error was common in this study and is more likely to be reported by pharmacists.


Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 91 ◽  
Author(s):  
Waqas Sami ◽  
Khalid M Alabdulwahhab ◽  
Mohd Rashid Ab Hamid ◽  
Tariq A. Alasbali ◽  
Fahd Al Alwadani ◽  
...  

Background and Objectives: There is a paucity of literature on the dietary attitude (DA) of patients with type 2 diabetes in the Kingdom of Saudi Arabia (KSA). Although the prevalence of diabetes mellitus (DM) is high in Gulf countries, there remains a lack of understanding of the importance of dietary behavior in diabetes management among patients. Understanding the behavior of patients with diabetes towards the disease requires knowledge of their DA. Therefore, this study aimed to assess and evaluate the DA of type 2 diabetes patients, and it is the first of its kind in the KSA. Material and Methods: An analytical cross-sectional study was conducted among 350 patients with type 2 diabetes. A self-administered DA questionnaire was used to collect the data. Psychometric properties of the questionnaire were assessed by face validity, content validity, exploratory factor analysis, and internal consistency reliability. The data were collected using a systematic random sampling technique. Results: The overall DA of the patients was inappropriate (p = 0.014). Patients had an inappropriate DA towards food selection (p = 0.003), healthy choices (p = 0.005), food restraint (p < 0.001), health impact (p < 0.001), and food categorization (p = 0.033). A poor DA was also observed in relation to the consumption of red meat (p <0.001), rice (p < 0.001), soup and sauces (p = 0.040), dairy products (p = 0.015), and junk food (p < 0.001). Conclusions: It is highly recommended that patients with diabetes receive counseling with an empowerment approach, as this can bring about changes in their dietary behavior, which is deeply rooted in their daily routine. Healthcare providers should also be well-informed about patients’ attitudes and beliefs towards diabetes to design tailored educational and salutary programs for this specific community. Diabetes self-management educational programs should also be provided on a regular basis with a special emphasis on diet and its related components.


2020 ◽  
Vol 8 (E) ◽  
pp. 325-330
Author(s):  
Sultan M. Alshahrani ◽  
Moferrah Alzahran ◽  
Khaled Alakhali ◽  
Easwaran Vigneshwaran ◽  
Mir Javid Iqbal ◽  
...  

BACKGROUND: Diabetes mellitus (DM) is a major health-care burden worldwide. AIM: The aim of the study was to explore how the quality of life (QoL) of DM patients could be affected in the Aseer Province of the Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional, multicenter study in DM patients of both sexes and all age groups in Aseer Province were done using a validated self-administered questionnaire. The study was conducted between April 1, 2018 and November 25, 2018. RESULTS: A total of 418 patients completed our questionnaire, of which 240 (58%) were male and 178 (42%) were female. Furthermore, 50.23% were married and 104 (24.16%) were illiterate. We found that 403 (96.42%) respondents had type-2 DM and 315 (75.35%) had a family history of DM. In addition, 132 (31.57%) respondents were on monotherapy whereas only 61 (14.59%) were using combination therapy. Hypertension was the most prevalent comorbidity (166, 39.71%) and peripheral neuropathy the most prevalent complication of DM (157, 37.56%). CONCLUSION: DM had a significant impact on QoL among patients from Aseer Province in KSA. Our study underscores the importance of generating data on QoL among DM patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julia Brandenberger ◽  
Christian Pohl ◽  
Florian Vogt ◽  
Thorkild Tylleskär ◽  
Nicole Ritz

Abstract Background Asylum-seeking children represent an increasing and vulnerable group of patients whose health needs are largely unmet. Data on the health care provision to asylum-seeking children in European contexts is scarce. In this study we compare the health care provided to recent asylum-seeking and non-asylum-seeking children at a Swiss tertiary hospital. Methods We performed a cross-sectional retrospective study in a pediatric tertiary care hospital in Basel, Switzerland. All patients and visits from January 2016 to December 2017 were identified, using administrative and medical electronic health records. The asylum-seeking status was systematically assessed and the patients were allocated accordingly in the two study groups. Results A total of 202,316 visits by 55,789 patients were included, of which asylum-seeking patients accounted for 1674 (1%) visits by 439 (1%) individuals. The emergency department recorded the highest number of visits in both groups with a lower proportion in asylum-seeking compared to non-asylum-seeking children: 19% (317/1674) and 32% (64,315/200,642) respectively. The median number of visits per patient was 1 (IQR 1–2) in the asylum-seeking and 2 (IQR 1–4) in the non-asylum-seeking children. Hospital admissions were more common in asylum-seeking compared to non-asylum-seeking patients with 11% (184/1674) and 7% (14,692/200,642). Frequent visits (> 15 visits per patient) accounted for 48% (807/1674) of total visits in asylum-seeking and 25% (49,886/200,642) of total visits in non-asylum-seeking patients. Conclusions Hospital visits by asylum-seeking children represented a small proportion of all visits. The emergency department had the highest number of visits in all patients but was less frequently used by asylum-seeking children. Frequent care suggests that asylum-seeking patients also present with more complex diseases. Further studies are needed, focusing on asylum-seeking children with medical complexity.


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