Background: Colistin is an effective therapy against multidrug-resistant gram-negative bacteria. However, nephrotoxicity is a major issue with its use. Objective: We aimed to evaluate the incidence and the potential risk factors of nephrotoxicity in colistin-treated patients. Methods: A retrospective cohort study was conducted. All adult patients aged 18 years and older who received colistin for ≥72 h were included in the study, while end-stage kidney disease patients requiring dialysis or had renal transplants were excluded. The incidence and severity of acute kidney injury (AKI) were assessed based on the Kidney Disease Improving Global Outcomes (KDIGO). Result: Out of 128 patients who received colistin, 51.56% of them have experienced AKI. The incidence was increased among oldest patients (above 80) and those who did not receive the appropriate dose (p-value = 0.0003). In addition, the median time until the AKI occurred was 10 days after receiving the colistin treatment. Rates of AKI in patients with previous AKI (71.7%) were three times higher than patients who did not previously experience AKI (HR = 2.97, 95% CI [1.8–4.8]). Conclusions: Nephrotoxicity is a significant issue among patients who receive colistin in the hospital, especially among older patients and those who did not receive the appropriate dose. As a result, healthcare providers should play a major role in colistin dosing, especially among the older adult population.

Background: Caregiver burden is a serious global issue associated with the growing number of older adult patients with Alzheimer’s disease (AD). AD patients become more dependent on their caregivers and require assistance with basic daily life activities. This study aims to measure the caregiver burden of informal caregivers of AD patients and to determine their characteristics. In addition, it intends to understand caregiver coping techniques and assess their medication knowledge. Methods: This was a cross-sectional study including 148 informal caregivers mainly recruited by the Saudi Alzheimer’s Disease Association (SADA). A four-part study questionnaire was used for data collection in the Arabic Language and included the following: socio-demographic characteristics of AD patients and their caregivers, the 12-item version of the Zarit Burden Interview (ZBI), and adapted questions on coping techniques and medication knowledge. Results: A total of 148 caregivers (62% were female) participated in this study, and 79.06% were between 30 and 60 years old. The ZBI average score was 27, indicating a moderate to high burden. Caregivers reported their need for services to improve their quality of life. The medication knowledge was insufficient in most aspects except that more than half were aware of medications’ side effects. Conclusion: Our study revealed that the average burden among informal caregivers of AD patients was moderate–high.

Since the World Health Organization declared coronavirus disease (COVID-19) as a pandemic, most countries started treating their patients with various therapies. However, the data regarding their safety and effectiveness is still lacking. We aimed to evaluate the adverse drug reactions (ADRs) incidence and their predisposing factors among COVID-19 patients. A retrospective observational study that was conducted at a tertiary academic hospital from March – June 2020. Patients were included if they were ≥ 18 years old, inpatient, had a reverse transcriptase-polymerase chain reaction (PCR) positive for COVID-19, and were treated with; (lopinavir-ritonavir, hydroxychloroquine, chloroquine, favipiravir, ribavirin, or interferon-ß) either as monotherapy or combination therapy for three days or longer. The data of eligible patients were retrieved from the electronic medical records. A standardized data collection form was designed to collect patient demographics, COVID-19 severity based on the Saudi Ministry of Health management protocols, antiviral therapies, duration of therapy, and length of stay (LOS). The ADRs were identified via conducting a comprehensive review using predefined triggers and were evaluated using Naranjo Score. A total of 155 patients were included of which 123 (79.4%) were males. In our sample, the incidence proportion of ADRs per patient was 72.3%. A total of 287 ADRs were identified most of them were hepatic (n = 101, 35.2%), gastrointestinal (n = 59, 20.6%), hematological (n = 47, 16%), and endocrine (n = 45, 15%). Hydroxychloroquine was the most common drug associated with ADRs (n = 155). The length of stay (10 – 20 days) was the only statistically significant with the ADR incidence (p-value = 0.008; 95 %CI 1.216:3.568). The ADRs are prevalent among COVID-19 patients, which assure the importance of implementing active hospital-based pharmacovigilance systems.

Introduction: Medication Therapy Management (MTM) is identified as a group of services provided to the patient in order to optimize the medication use in order to mitigate adverse drug reactions (ADRs), drug–drug interaction (DDI), and polypharmacy. Elderly populations above 60 years old are at high risk for Medication-related Problems (MRPs) due to several factors. Therefore, MTM programs showed good contributions globally regarding enhancing medication use in the elderly population. Thus, evident information regarding its implementation in Saudi Arabia is lacking in the literature. Objective: Our objective is to assess community pharmacists’ knowledge, attitude, and barriers to providing MTM services to the older adult population in Saudi Arabia. Methodology: A cross-sectional study has been conducted among community pharmacists across the Kingdom. It was survey-based research that was designed and conducted through (QuestionPro). The survey was distributed for the community pharmacists from Feb–May 2023 via (QuestionPro). Descriptive analysis was performed using SAS OnDemand to analyze the categorical variables and test it with the outcome of interest. Results: Out of the 528 participants who have viewed our questionnaire, 319 participants have completed the survey in 5 min average time. Most of our participants were male, holding a bachelor’s degree, and had an average working load of more than 40 h a week, respectively (84.95%, 92.48%, and 76.18%). In addition, the participants were from different regions of the Kingdom, which enhanced the generalizability of our findings. Moreover, 65.52% have reported a higher level of knowledge, while 34.48% have reported a moderate to low level of knowledge regarding MTM service. Most of those with a higher level of knowledge maintain a positive attitude regarding MTM service, its implementation, and dealing with older adult patients in the community pharmacy. In addition, lacking the time, training, and presence of a private consultation room were the top barriers to provide MTM services in the community pharmacy in Saudi Arabia. Conclusion: Educational sessions regarding MTM services among the older adult population are highly recommended for community pharmacists before its implementation.

Introduction: Potentially inappropriate medications PIMs are common among elderly population and becoming a global health issue. It has been associated with negative health consequences like preventable adverse drug reactions, hospitalization and mortality.Objectives: To investigate the most commonly potentially inappropriate medications in older adults in Saudi Arabia. Additionally, we aim to gain insights into the typical healthcare settings where healthcare providers offer services related to PIMs.Methods: This is a systematic review design using Preferred Reporting Items Systematic Reviews and Meta-Analysis (PRISMA) statement. PubMed and Google Scholar were used to search for the relevant studies using the following keywords (older adults, elderly, potentially inappropriate medications, inappropriate medications, PMIs, Saudi Arabia, Kingdom of Saudi Arabia) with no restrictions to the date of publications nor the study language.Results: Only 8 studies have met our inclusion and exclusion criteria, which was most of them were cross-sectional study design (n = 6.75%) and all of them have been conducted in hospital-based settings. In addition, the prevalence of PIMs ranged from 19% to 80% depends on the site and administration of the study. We have found that proton pump inhibitors, non-steroidal anti-inflammatory drugs, aspirin, diuretics, gastrointestinal medications, and antidepressants were the most common reported PIMs in the included studies.Conclusion: The prevalence of PIMs among the elderly in Saudi Arabia is notably high ranged from 19% to 80%, underscoring the need for additional research to assess the existing practices within this vulnerable demographic across various healthcare settings.

This study examined the level of adherence to self-care behaviors among individuals with type 2 diabetes in Saudi Arabia and its connection with depression and demographic factors. A cross-sectional survey was conducted among diabetes patients using the Patient Health Questionnaire (PHQ-9) to measure depression and the Summary of Diabetes Self-Care Activities (SDSCA) to evaluate diabetes self-care activities. Among the 252 participants who completed the survey, 43.2% were older than 55 and 59% were men. The ordinal regression model showed an association between the PHQ-9 and SDSCA scores with an OR of 0.83 (95% CI: 0.71 to 0.96, p = 0.013). The PHQ-9 score was significantly associated with blood sugar monitoring (OR: 0.90 [95% CI: 0.82 to 0.99, p = 0.003]), exercise (OR: 0.88 [95% CI: 0.79 to 0.98, p = 0.002]), and diet (OR: 0.94 [95% CI: 0.85 to 1.03, p = 0.045]). Of all the diabetes-related factors, only a history of hospitalization and receiving diabetes education were found to be associated with improved self-care behaviors. In conclusion, a negative association was found between PHQ-9 scores and the SDSCA mean score and most daily diabetic self-care behavior components.