Background: Stroke is considered the second leading cause of death and the third leading cause of disability in the world. The incidence of stroke in Saudi Arabia is 43.8 per 100,000, due to the lack of knowledge and awareness of the population. This study intends to determine the level of stroke risk factor awareness among the Saudi population. Methods: A cross-sectional study was conducted in Saudi Arabia on 898 participants older than 18 years old. The validated online survey was randomly distributed and consisted of 20 questions in both English and Arabic languages to evaluate the level of awareness of stroke risk factors among the population. Results: A total of 898 participants completed the survey. The results showed that the median risk factor score was 5 (IQ 3– 8) out of 14. A total of 2.2% could recognize all 14 risk factors. Personal history of hypertension was chosen as a risk factor by the majority of the participants (81.7%) followed by personal history of stroke (74.1%) and personal history of dyslipidemia (57.2%). Conclusion: This study showed that there is an insufficient level of stroke risk factor awareness in Saudi Arabia. More than half of the participants identified the term (stroke), while only 2.2% could recognize all 14 risk factors. Hence, public education is needed to identify people with stroke risk factors.

Background: The aging process makes geriatric populations more prone to various chronic diseases. Such diseases require older patients to be on more medications than any other age group and make them more susceptible to adverse drug events related to potentially inappropriate medications (PIMs). Aim: To identify the prevalence of potentially inappropriate medications among older people and explore the most commonly prescribed PIMs in hospitalized patients. Design and Setting: A retrospective study conducted in a large tertiary hospital among patients hospitalized in a 4 year period from January 2015 to December 2018. Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (i.e., drug/drug class to be avoided in older adults). Results: The mean age was 75.17 ± 7.66 years. A total of 684 (80.6%) patients were prescribed at least one medication listed in the first-class category of the 2019 Beers Criteria. Top five drugs were proton pump inhibitors (40.3%), nonsteroidal anti-inflammatory drugs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is high among older patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers.

Background: The number of students enrolled in the colleges of pharmacy in Saudi Arabia is high, and the number of pharmacy graduates expected to join the workforce in the coming years is expected to grow. There are limited number of studies that assess factors influencing pharmacy students’ career choices in Saudi Arabia in the literature. The aim of this study was to assess the factors that influence career goals and to investigate students’ perceptions about their career goals. Methods: This study was a prospective cross-sectional survey targeting PharmD students in their last year (i.e. interns) in the academic year of 2018 – 2019. A questionnaire containing four parts and total questions of 32 was completed by interns. Data collected and analyzed using Qualtrics. This study was reviewed and approved by the Unit of Biomedical Ethics Research Committee at King Abdulaziz University. Results: 93 were reachable via email and all of them attended the interview and completed the survey (100% response rate). The most important job considerations were: work environment (67.7%), advancement opportunities (55.9%), salary (52.7%), benefits (40.9%), flexible work schedule (34%), and finally geographic region (29%). The top ranked career goal upon graduation were in industry and drug company (35.5%), clinical pharmacy (26.9%), (14%) academics/research and hospital pharmacy setting (inpatient/outpatient) (14%) each, and regulatory and community pharmacy (3.2% and 4.3%, respectively) Conclusion: This study showed that work environment, advancement opportunities, and salary were the most important job consideration for pharmacy interns. The top ranked career goals were industry and drug company followed by clinical pharmacy. Further studies across Saudi Arabia are needed to confirm our results.

Introduction: There is a very limited information and studies on the impact of adherence to chronic obstructive pulmonary disease (COPD) medications in Saudi Arabia. We hypothesized that the adherence to COPD medication in our tertiary hospital is poor and can lead to frequent ED visits and longer hospitalization stays. The purpose of this study was to assess the impact of medication adherence in patients with COPD on emergency department (ED) visits and hospitalization. Methods: A single-center retrospective observational study included patients with a COPD exacerbation, who were admitted to a tertiary teaching hospital in Jeddah, Saudi Arabia from October 2017 to November 2020. The primary outcome was the rate of emergency department (ED) visit in one year. Secondary outcomes were hospitalization after ED visit and total hospital length of stay. Medication adherence was evaluated by using Fixed Medication Possession Ratio (FMPR). Patients with score of ≥ 0.80 were classified as high-adherent groups while patients with ratio < 0.80 were on low-adherent groups. Results: A total of 266 patients enrolled in the study. Of those 266 patients, 139 patients were on high-adherent group and 127 were on low-adherent group. There was a significant difference between the high-adherent group and low-adherent group in the incidence of ED visit in one year 62 (44.6%) vs 73 (57.5%); P < 0.036, and hospitalization after the ED visit 26 (18.7%) vs 42 (33.1%); P = 0.007. However, there was no significant difference between the two groups in the total hospital length of stay. Conclusion: Among patients with COPD, there was a significant increase in ED visit per one year that leads to more hospitalization among patients with low adherence compared to patients with high adherence. This study highlights the importance of improving the medication adherence in patients with COPD.

The benefit of empiric coverage for community-acquired pneumonia (CAP) for atypical bacteria is controversial. This meta-analysis purpose was to compare the clinical failure rate between adults who empirically received atypical coverage versus those who did not. We searched PubMed and EMBASE for randomized controlled trials (RCTs), comparing the clinical failure rate of CAP associated with individual atypical bacteria between adults who received empiric atypical coverage versus those who did not. Risk differences (RDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Eight double-blind RCTs (65 patients with Legionella spp., 176 patients with M. pneumoniae, and 78 patients with C. pneumoniae) were included in the meta-analysis. The rate of clinical failure was significantly lower with empiric atypical coverage in CAP associated with Legionella spp. (RD, −42.6%; 95% CI, −69.8% to −15.4%; p-value = 0.002; I² = 0%) and Mycoplasma pneumoniae (RD, −9.5%; 95% CI, −18.9% to −0.1%; p-value = 0.048; I² = 0%), but not with Chlamydia pneumoniae (RD, 7.1%; 95% CI, −9.0% to 23.1%; p-value = 0.390; I² = 0%). This meta-analysis of RCTs found that empiric atypical coverage decreased the clinical failure rate of CAP associated with Legionella spp. and M. pneumoniae, but not with C. pneumoniae.

Background: Acute decompensated heart failure (ADHF) is associated with a high rate of hospital readmission. The aim of this study is to examine the effect of the discharge diuretic dose compared with the home diuretic dose on hospital readmission in patients with ADHF. Methods: A single center retrospective cohort study included patients with a confirmed diagnosis of ADHF with an ejection fraction of less than 40%. The sample was divided in two groups. The first group received a total daily discharge diuretic dose that was greater than the home dose; the second group received a daily discharge diuretic that was equal to or less than the home dose. The primary outcome was all-cause 30-day readmission rate. The secondary outcomes were all-cause 60-day and 90-day readmission rates. Results: A total of 206 patients met inclusion criteria; 117 patients received a higher loop diuretic dose at discharge, while 89 were discharged with a loop diuretic that was equal to or less than the home dose. Patients in the increased-dose group had an all-cause 30-day readmission rate of 20.5% compared with 37.1% of patients with equal or reduced-dose group; P = .007. Additionally, there were lower readmission rates in 60 and 90 days between the increased and equal or reduced groups (33.3% versus 52.8%, P < .017, and 41.0% versus 62.9%, P < .003, respectively. Conclusions: Among patients admitted to hospital with ADHF and reduced ejection fraction, a discharge loop diuretic dose higher than the home dose was associated with decreased all-cause 30-day, 60-day, and 90-day readmission rates.