The status of licensed pharmacy workforce in Saudi Arabia: a 2030 economic vision perspective

Patient Satisfaction with Private Community Pharmacies versus Pharmacies in Primary Health Care Centers in Saudi Arabia

Introduction

Saudi Arabia has begun reforming its government-run health care system to increase efficiency and reduce costs. One effort is the adoption of an electronic prescribing system (Wasfaty) and outsourcing pharmaceutical services from government-run clinics to community pharmacies (CP). This study aims to compare satisfaction with pharmaceutical services offered in the two systems.

Materials and methods

This cross-sectional observational study used existing survey data collected from patients (≥15 years of age) visiting government primary health care centers from January 2022 to June 2022. Satisfaction with three pharmaceutical services (availability of medications, pharmacist's explanation of the prescription, and waiting time to get medications) were the main outcomes.

Results

The study comprised 91,317 participants, 74.06 % of them were CP/Wasfaty users. CP/Wasfaty patients had lower odds of satisfaction with the three pharmaceutical services: availability of medications (OR = 0.49, 95 % CI = 0.47-0.51), pharmacists' explanation of prescription (OR = 0.55, 95 % CI = 0.53-0.58), and waiting time to get medications (OR = 0.81, 95 % CI = 0.75-0.88). Additional findings showed variations in satisfaction levels based on demographic factors and clinic types.

Conclusions

The significant differences observed in satisfaction levels based on demographic characteristics and type of clinics visited emphasize the importance of tailoring pharmaceutical services to meet the specific needs and expectations of different patient populations.

Assessment of community pharmacists' knowledge, attitudes and their willingness to provide vaccination services in Saudi Arabia

BACKGROUND

Community pharmacists play an important role in increasing vaccination rates especially in countries where they offer vaccination services and administration. However, little is known about community pharmacist's willingness to provide vaccination services in Saudi Arabia. The objective of this study was to assess knowledge, attitudes, willingness and beliefs of community pharmacists in Saudi Arabia towards providing vaccines at pharmacies.

METHODS

A cross-sectional, online questionnaire-based study using convenience sampling (Snowball technique) was used to obtain responses from community pharmacists across Saudi Arabia. The survey collected information on participants' demographics, knowledge about vaccine, attitude towards vaccine and their attitude to be immunization providers. Bivariate analysis and multiple linear regression models were employed to assess the relationships between demographic variables and outcomes.

RESULTS

The study sample consisted of 384 community pharmacists. More than half of participants had poor knowledge about vaccines (54%). Only 8.4% of participants had good knowledge about vaccines. The results indicated that community pharmacists in the study sample have positive attitude toward vaccines and are willing to provide vaccination services. There was a significant relationship between knowledge about vaccine and attitude toward vaccines. Pharmacists with poor knowledge about vaccines had negative attitude toward vaccines as compared to those with high knowledge (β = -1.743; P-value = 0.024). Additionally, there was a significant relationship between knowledge about vaccine and attitude to be immunization providers. Pharmacists with poor knowledge about vaccines had negative attitude to be immunization providers as compared to those with high knowledge (β = -2.631; P-value = 0.002). Furthermore, a significant number of the community pharmacists reported facing critical barriers to provide vaccines including legal liability, lack of personal resources and lack of appropriate training.

CONCLUSION

Comprehensive training and certification programs for pharmacists are crucial to improve their competencies in handling and administering vaccines to increase the rate of vaccinations in Saudi Arabia.

Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators

BACKGROUND

People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals' behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention.

METHODS

Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists' behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant's preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach.

RESULTS

Twenty-six pharmacists were interviewed. Pharmacists' experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as 'key domains' including: 'Knowledge', 'Skills', 'Beliefs about capabilities', 'Goals', 'Memory, attention, and decision processes', 'Environmental context and resources', 'Social influences', and 'Behavioural regulation'.

CONCLUSIONS

Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.

An analysis of the intention of female pharmacy students to work in community pharmacy settings in Saudi Arabia using the theory of planned behavior

Objective

This study aimed to determine the intention of female Saudi pharmacy students to work in community pharmacies and the factors associated with this intention.

Methods

This cross-sectional study was conducted between April 2022 and June 2022 and included female students from pharmacy colleges in Saudi Arabia. The survey was created based on the Theory of Planned Behavior. It included items that measure student intentions, attitudes, subjective norms, and perceived behavioral control regarding working in community pharmacies in Saudi Arabia. The study also included items that assessed sociodemographic characteristics, pharmacy program degrees, training, and job preferences of students.

Results

A total of 407 participants completed the survey. The average age was 21.8 (±1.6) years, and most participants were Saudi nationals (97.79 %). The intention of participants to work in community pharmacies after graduation was low (mean = 3.2 ± 1.8; range: 1-7). Slightly positive attitudes toward working in a community pharmacy after graduation were revealed as participants showed an overall attitude mean of 4.5 ± 1.6 (range: 1-7). Furthermore, the participants perceived a low social pressure toward working in a community pharmacy after graduation (mean of 3.3 ± 1.9; range: 1-7). The intention of female pharmacy students to work in community pharmacies was significantly predicted by attitudes (p-value < 0.0001), perceived behavioral control (p-value = 0.0017), nationality (p-value = 0.0151), residence in the Saudi Arabian region (p-value = 0.0013), monthly income (p-value = 0.0231), pharmacy degree program (p-value = 0.0035), training received in community pharmacies (p-value = 0.0145), had a relative working in a community pharmacy (p-value = 0.0257), and preference to work in community pharmacies after graduation (p-value = 0.0001).

Conclusion

Female pharmacy students in Saudi Arabia had a low intention to work in community pharmacies, a positive attitude toward working in community pharmacies, and perceived no social pressure to work in them. A positive attitude and behavioral perception of control toward working in community pharmacies were demonstrated among pharmacy students who study at a university outside Riyadh, undertaking a bachelor's degree in pharmacy, have a monthly income higher than 5000 Saudi riyals (USD 1,333.3), previously received training in community pharmacies, having a relative working in a community pharmacy, prefer to work in community pharmacies after graduation.

Exploring the knowledge, perception, and practice of community pharmacists in Saudi Arabia toward pharmacovigilance and adverse drug reaction reporting. A nationwide survey

One of the significant worldwide health problems associated with pharmacovigilance is the under-reporting of adverse drug reactions (ADRs). Reporting suspected ADRs is essential to ensure patient safety, medicine safety, and healthcare quality. The new policy in Saudi Arabia emphasizes pharmacists taking a new clinical role, which may facilitate and improve the documentation of ADRs. Therefore, this study aimed to assess the knowledge and perception of community pharmacists towards the ADRs and their reporting practice in Saudi Arabia. A cross-sectional study using a structured self-administered questionnaire was administered to community pharmacists working in Saudi Arabia. Data were analyzed using descriptive and inferential statistics to identify the association between perceptions and ADR reporting practices. A P value < of 0.05 was considered statistically significant. A response rate of 43% (n = 163) was achieved, of whom 55.2% demonstrated knowledge of PV. Only 16% of community pharmacists were aware of the responsible center for monitoring and collecting ADRs in Saudi Arabia. The key facilitator was offering incentives to pharmacists, and the lack of time was found to be a key barrier among reporter community pharmacists. Positive attitudes toward pharmacovigilance and ADR reporting were expressed by community pharmacists. The findings of this study emphasize the further need for education and training programs and simplifying the ADR reporting process used in Saudi Arabia to enhance the reporting practice.

Trends, Capacity Growth, and Current State of Community Pharmacies in Saudi Arabia: Findings and Implications of a 16-Year Retrospective Study

Purpose

Community pharmacies provide access to medicines and pharmaceutical services. Consequently, adequate availability and sufficient workforce capacity must be ensured for effective healthcare delivery. This study assessed the community pharmacy sector in Saudi Arabia, including density, workforce capacity, and evolution from 2007 to 2022.

Methods

This retrospective study measured community pharmacy infrastructure and workforce capacity using international indicators and standardized measures, including community pharmacy and community pharmacist density per 10,000 people and ratio of community pharmacists per pharmacy. Several data sources and platforms were used to collect the data including the Ministry of Health, Saudi General Authority for Statistics, and Ministry of Human Resources and Social Development.

Results

The number of community pharmacies increased by 89.30%, from 5466 in 2007 to 10,347 in 2022, and density increased from 2.25 to 3.22. However, density varied by region, from 3.97 to 1.95. The number of community pharmacists increased by 98.02%, from 10,932 in 2007 to 21,648 in 2022, and community pharmacist density increased from 4.51 to 6.73. However, the ratio of community pharmacists per pharmacy remained unchanged (2.0 in 2007 and 2.1 in 2022). Female pharmacists were first issued licenses to practice in community pharmacies in 2016, and the proportion of female pharmacists to total increased from 0.29% (n=42) in 2016 to 10.95% (n=2370) in 2022. The nationalization policy for community pharmacies was implemented in 2020, and the proportion of Saudi pharmacists increased from 3.08% (n=581) in 2019 to 19.90% (n=4306) in 2022, while proportion of expatriate pharmacists decreased from 96.92% (n=18,292) to 80.10% (n=17,342).

Conclusion

The findings showed that the community pharmacy sector in Saudi Arabia recently experienced substantial growth comparable to high-income countries. However, further improvements are required in some regions to increase community pharmacy density. Moreover, the ratio of pharmacists per pharmacy should be improved to meet the healthcare system needs.

Pharmacists' perceptions about providing COVID-19 vaccines in community settings

Background

Community pharmacists were underutilized in Saudi Arabia. At the start of the coronavirus disease 2019 (COVID-19) outbreak, global healthcare systems experienced significant pressure. To combat the pandemic effectively, there was a need to involve other healthcare providers, such as community pharmacists. As a result, community pharmacists were enlisted to provide vaccines.

Objectives

This study aims to explore community pharmacists' perceptions about providing COVID-19 vaccines in Saudi community settings.

Methods

Ethical approval was granted by the Research Ethics Committee of King Faisal University in January 2022. A qualitative methodology was used to explore the opinions of community pharmacists. Semi-structured interviews were conducted via face-to-face qualitative interviewing. Participants were recruited purposively and represented different types of community pharmacy settings.

Results

A total of 15 face-to-face individual interviews were conducted. The cohort included pharmacists who provided the service (n = 5) and those who did not (n = 10). The results showed that providing the service in a community setting was advantageous to patients, community pharmacy sector, and healthcare system. Moreover, the participants identified several barriers to providing the service.

Conclusion

Although providing the service had several advantages to several parties, the identified barriers need to be considered for the service to be provided appropriately.

Community pharmacists' knowledge, prospective and practice towards health related illness at Hajj and Umrah: A cross sectional study

Objectives

To assess the community pharmacists' (CPs) knowledge, attitude, and perception of health-related illness among pilgrims, and to investigate the common diseases and the pattern of medications dispensed by CPs during Hajj and Umrah seasons.

Method

A cross-sectional study was carried out in Riyadh, Saudi Arabia over two months in 2022, through electronic platform using prevalidated questionnaires adopted from the literature. The questionnaires were divided into 4 sections assessing the CP's knowledge, attitude, and perception about health-related illness, common dispensed agents, and required vaccination during Hajj and Umrah.

Results

A total of 544 CPs, mostly between the age of 31-40 (69.9%), participated in this research. About 87.9% of the CPs received a pilgrim after performing their rituals coming to the pharmacy complaining of infection or health problem. In this study, 99.8%(n = 544), 99.6%(n = 543), and 92.7% (n = 505) of the CPs identified influenza, food poisoning, and diarrhea/gastroenteritis as the most common issues during the Hajj & Umrah season respectively. As results, anti-diarrheal agents (96.3%), painkillers (87.3%), inhalers (89.4%), and sunscreens (88.3%) were the most requested pharmaceutical agents. Additionally, 96.7%(n = 527) of the CPs agreed that vaccination is safe to be given to Hajj and Umrah pilgrims particularly for those aged ≥ 65 years, and 89.4%(n = 487) of them reported awareness of vaccines that are required by Saudi Ministry of Health. Both Influenza and meningococcal meningitis vaccines were identified by 99.8% of the CPs, but polio vaccine was identified by 33.9%.

Conclusion

Community pharmacists provided pharmaceutical care services for Hajj and Umrah pilgrims. The majority of CPs had adequate knowledge about viral diseases during Hajj and Umrah and their requirement for vaccination.

Migraine Management in Community Pharmacies: Knowledge, Attitude and Practice Patterns of Pharmacists in Saudi Arabia

In Saudi Arabia, community pharmacies offer healthcare services for different conditions. However, clarity of the competence of pharmacists in managing migraines is lacking. This study aimed to explore the current knowledge, attitude, and practice patterns of community pharmacists concerning migraine management in the northwestern part of Saudi Arabia. A cross-sectional study was carried out between June and September 2022 among 215 Saudi community pharmacists. Data analysis was performed by descriptive and inferential statistics using SPSS version 27. Most community pharmacists (87.9%) feel that migraine management is essential to their practice, and 83.3% suggest between one and five over-the-counter (OTC) migraine products daily. Among the study pharmacists, 83.7% feel migraine patients should try OTC before prescription medications. Only 9.3% of the community pharmacists do not believe that migraine is a neurological disorder. The medications most prescribed for migraine were triptans, representing 52.1% of prescriptions. There were significant differences between the gender of the pharmacists and their knowledge, attitude, and practice overall score (p-value = 0.04). Male pharmacists exhibited higher knowledge, attitude, and practice scores than female pharmacists. Although many community pharmacists acknowledge their expertise and involvement in managing migraines, there is a requirement for further education and training to enhance their capacity to offer complete care to migraine patients. Pharmacists should also consider non-pharmacological interventions and complementary therapies when treating migraine symptoms.

Which aspects of job determine satisfaction among pharmacists working in Saudi pharmacy settings?

OBJECTIVE

The aim of this study was to evaluate the impact of several employment-related aspects on overall job satisfaction among pharmacists working in Saudi pharmacy settings.

METHODS

A cross-sectional survey was conducted for a period of 1-month (December 2020) among pharmacists working in community pharmacies located in 3 cities of Saudi Arabia. Convenience sampling was employed, and the data was collected using the English version of Job Satisfaction Survey (JSS) questionnaire. The data was analyzed using IBM SPSS version 23. Descriptive statistics such as mean ([Formula: see text]) and 95% confidence interval range were used to report continuous data; frequency (%) and sample counts (N) were used to report categorical data. Bivariate analyses were conducted using chi square (χ2) test. A multiple linear regression model was formulated to report the employment aspects that determined overall job satisfaction of pharmacists. The study was approved by an ethics committee.

RESULTS

A total of 241 samples were analyzed. Less than a quarter of pharmacists (N = 54, 22.4%) were satisfied with their job. The overall job satisfaction score was 130.74 out of 199. The sub-scales for co-workers and communication had scores > 15.8 out of 24; subscale for operating conditions had score > 12.5 out of 20. The subscales for promotion and rewards had scores < 14 out of 24. The aspects of communication, fringe benefits and nature of work had the highest contribution towards overall job satisfaction. For a unit increase in score for communication, fringe benefits, and nature of work, the overall job satisfaction score increased by 0.204, 0.2, and 0.199, respectively.

CONCLUSION

A very small number of pharmacists seemed satisfied with their job. Satisfaction with communication, nature of work and fringe benefits contributed the most toward overall job satisfaction. Results of this study could provide the means for human resource managers and organizational policy makers to delve into the determinants of satisfaction among pharmacists working in community settings.

An analysis of pharmacy workforce capacity in Saudi Arabia

Background: Previous reports have highlighted the core issues with the intelligence of the national pharmacy workforce reliance on non-native pharmacists, despite the increasing supply of local pharmacy graduates; limited participation of female pharmacists in the workforce; and inadequate proportions of pharmacists in primary healthcare centres, resulting in pharmaceutical services being provided without a pharmacist's supervision. Methods: The current study used a retrospective cross-sectional design and data was collected from January to May 2023. Data was retrieved from the Health Statistics Yearbook, 2017, 2018, 2019, 2020 and 2021. The data included the total number of pharmacists, the number of Saudi pharmacists, the number of foreign pharmacists, the distribution of the proportions of male and female pharmacists, and the distribution of the workforce by region, sector and nationality. Data was also obtained relating to pharmacy education, including the number of pharmacy colleges, the number of pharmacy students and the number of pharmacy graduates. Results and conclusion: The capacity of the pharmacy workforce, meaning the number of pharmacists per 10,000 population, fluctuated between 2017 and 2021, with the lowest number being in 2020, a mere 7.9 pharmacists per 10,000 population. However, in 2021, the overall density of pharmacists increased to (9.04), which is above the global average (7.36 per 10,000 population). The proportion of women working in the pharmacy profession increased from 12% to 22%, and in community pharmacies from 0.3% to 7.2%, between 2016 and 2021. Another issue that still exists is a lack of proportionate and imbalance in the distribution of the pharmacy workforce across the regions. The renationalisation initiatives increased the overall proportion of Saudi pharmacists to 39% in 2021, compared to 22% in 2016. There is a need for a policy mechanism that will overcome the identified issues.

Suspected inappropriate use of prescription and non-prescription drugs among requesting customers: A Saudi community pharmacists' perspective

Background

Inappropriate use of medications is a global health concern, and this is attributed to the increased accessibility to prescription and non-prescription (over-the-counter) drugs at community pharmacies. We investigated the inappropriate use of prescription and non-prescription drugs in community pharmacies based on the perspectives of the community pharmacists in Saudi Arabia.

Methods

This was a questionnaire-based, cross-sectional survey which employed convenient sampling (snowball technique) to recruit participants. Being a licensed practicing pharmacist in a retail chain or an independent community pharmacy was the inclusion criteria. Participants were asked to report the drugs they suspected of being inappropriately used along with the frequency, age and gender of the suspected customers. Pharmacists were also asked to mention the action taken to limit inappropriate use at their pharmacy.

Results

A total of 397 community pharmacists completed the questionnaire (86.9 % response rate). 86.4% of the pharmacists suspected some level of abuse or misuse to have occurred. After receiving the questionnaire, the pharmacists reported suspected inappropriate use as encountered during the past three months. Cumulative inappropriate use was reported 1069 times (prescription drugs - 530; non-prescription drugs - 539). The top three inappropriately used prescription-drug categories were gabapentinoids (22.5%), antipsychotics (17.5%) and topical corticosteroids (12.1%). Among non-prescription drugs, cough products (33.2%) ranked first, followed by cold and flu products (29.5%) and first-generation antihistamines (10.8%). The cross tabulations revealed that being in the age range of 26-50 years and being a male was significantly associated (p < 0.001) with abuse/misuse of antipsychotics, antidepressants, gabapentinoids, cough products and first-generation antihistamines. Eye products (Bimatoprost) and skin products abuse/misuse had significant association with female gender (p < 0.001).

Conclusion

The results of our study provide crucial information to the healthcare authorities regarding the medications that can be inappropriately used at the community pharmacies in Saudi Arabia which necessitates implementation of stringent dispensing regulations. Educational programs can be implemented to increase the awareness among public regarding the harmful effects of inappropriate use of drugs.

Community Pharmacies' Promotion of Smoking Cessation Support Services in Saudi Arabia: Examining Current Practice and Barriers

BACKGROUND

Community pharmacists' interventions have been found to be highly effective. However, to date, there has been little information about pharmacists' potential roles and perceived barriers to providing smoking cessation. This study aimed to assess the potential role of community pharmacists in supporting their patients to quit smoking by summarizing their self-reported level of current activities, confidence, and perceived barriers; Methods: A self-administered questionnaire was used for a cross-sectional study in Saudi Arabia. As part of the questionnaire, demographic characteristics were measured, as well as confidence, perceived berries, and level of smoking cessation activities (asking, advising, assessing, assisting, and arranging, including follow-up).; Results: 370 community pharmacists practicing responded to the survey. Pharmacists indicated high activity rates about advising and assessing patients in quitting smoking, with lower rates of assisting and arranging, including following up. The rate of recording smoking status was very low. There were significant differences between gender, source of education, years practicing as a licensed pharmacist, attended an education or training program on smoking cessation, and interest in providing smoking and perceived practice of smoking cessation. Pharmacists are confident about providing smoking cessation activities. Barriers to providing smoking cessation services include unable to follow up, lack of counseling space, lack of educational materials, and lack of time.; Conclusions: Saudi Arabian community pharmacists actively offer smoking cessation services, which may reduce smoking-related health issues. It appears that pharmacists need to be empowered by team-based, systematic, comprehensive approaches to overcome barriers and enhance their confidence.

A cross-sectional study on Saudi pharmacists working as medical representatives: What attracted them and what is keeping them in this sector—Misconceptions and reality

Background

The government in Saudi Arabia issued a labor reform initiative to renationalize the pharmacy profession in pharmaceutical companies to generate more employment for Saudi pharmacists. Considering the nationalization of the pharmacy workforce employed in this sector, as well as the pharmacists' preferences toward working in this setting, the current study was conducted determine the reasons to choose this career pathway, to clarify the common misconceptions about this sector and to assess job satisfaction, work commitment, and intentions to leave.

Methods

An online self-administered questionnaire was used to collect data from pharmacists working as medical representatives across Saudi Arabia. A total of 133 medical representatives participated in the study.

Results

The main factors that motivated study participants to join this sector included performing a socially important job, receiving a high salary, and further career development. The common misconceptions about the sector, such as lacking honor and value and considering commercial values to be accepted, were found to be incorrect by the medical representatives. A high job satisfaction level, high work commitment, and low intentions to leave the sector were reported by participants.

Conclusion

Working as a medical representative in a pharmaceutical company is an appealing career choice that fulfills pharmacists' career ambitions and may help in creating more jobs for the increasing numbers of pharmacy graduates.

Awareness of Cardiovascular Disease Risk Factors by Community Pharmacists in Saudi Arabia

BACKGROUND

Pharmacists in community settings are recognized as highly accessible healthcare practitioners and demonstrate a crucial role in the primary prevention of cardiovascular disease. Evidence indicates that community pharmacists can make a significant impact on controlling cardiovascular disease risk factors, particularly on hypertension.

OBJECTIVES

We aimed to assess the knowledge of community pharmacists in Saudi Arabia regarding cardiovascular disease risk factors.

METHODS

A cross-sectional study involving community pharmacists was conducted. The knowledge of cardiovascular disease risk factors was assessed with the Heart Disease Fact Questionnaire (HDFQ). A web link for an anonymous questionnaire was shared with the licensed community pharmacists in Saudi Arabia using the "Seha" platform of the Ministry of Health. Data analysis was performed with R version 4.0.5.

RESULTS

Three hundred seventy-four community pharmacists responded to the questionnaire. Many community pharmacists (94.4%) had satisfactory awareness of cardiovascular disease risk factors. The odds of having satisfactory HDFQ knowledge for community pharmacists seeing more than 20 individuals with diabetes per month were 20 times (AOR = 19.9, 95% CI: 1.73-260, and p = 0.019) more compared to those seeing fewer than 10 individuals with diabetes per month. The age of the community pharmacists and the average number of individuals with diabetes seen per month were found to be factors associated with satisfactory HDFQ knowledge.

CONCLUSION

The practicing pharmacists had a substantial understanding of cardiovascular disease risk factors. In line with counseling and education, the implementation of community pharmacy models for improving the knowledge of pharmacists, particularly the young pharmacists, is needed to effectively assist patients with cardiovascular disease.

Assessing the Presence of the Joint Commission International Accreditation Requirements in Western Saudi Arabia Hospital Pharmacies: A Cross-sectional Study

Objective

The Central Board of Accreditation for Healthcare Institutions (CBAHI) the national Saudi accreditation body accredited most hospitals in Saudi Arabia whereas, the Joint Commission International (JCI) a well-known international accreditation body accredited some hospitals. We assessed Western Saudi Arabia hospital pharmacists' knowledge, opinions, and observations about pharmacy-related JCI accreditation criteria needed for hospitals.

Methods

This was a cross-sectional survey-based study conducted among pharmacy personnel working in the Ministry of Health (MOH), Military, and private hospitals in the Makkah region in western Saudi Arabia. The present report represents the findings of descriptive and comparative analyses. Comparative analyses were tested by Student's t-test, analysis of variance, and Chi-square when applicable and a P ≤ 0.05 was considered statistically significant.

Findings

One hundred and one pharmacists completed the survey; most of them were from Taif (53.5%) and Jeddah (37.6%) and fewer from Makkah (8.9%). The highest proportions were from MOH (55.4%), private (29.7%), and some from military (14.9%) hospitals. They worked mostly in hospitals accredited with CBAHI (93.1%) than JCI (58.4%) and only (41.6%) worked with quality units. Correct answers on knowledge items ranged from 14.9% to 65.3%. On five-point Likert Scale, they showed supportive ratings on how they perceived the importance of JCI statement provided (overall average score: 3.78) and on how statement criteria are implemented in their hospitals (overall average score: 3.76). Higher proportions of those working in quality units compared to their counterparts were aware that accreditation cycles for JCI and CBAHI are identical (66.7% vs. 55.9%, P = 0.009) and that JCI criteria are more concise than CBAHI (59.5% vs. 52.5%, P = 0.007). Higher proportions of those working in JCI-accredited hospitals compared to their counterparts were aware that JCI criteria are clearer than CBAHI (55.9% vs. 33.3%, P = 0.021) and that JCI criteria are more concise than CBAHI (61% vs. 47.6%, P = 0.012).

Conclusion

To a high extent, pharmacists were supportive of JCI criteria and considered the criteria to be implemented in their hospitals. There is a room for improvement to enhance awareness and support of JCI quality criteria among pharmacists.

Infectious diseases pharmacy practice, education, and research in Saudi Arabia: A review and future perspectives by the Infectious Diseases Pharmacy Specialty Network at the Saudi Society of Clinical Pharmacy

Background

Infectious diseases (ID) pharmacy is one of the rapidly evolving clinical pharmacy specialties in the Kingdom of Saudi Arabia (KSA). There are gaps in the literature on ID pharmacy status in KSA. This review aimed to provide an update on the current status of several areas related to ID pharmacy in KSA, including practice, education, and research, and make pertinent recommendations for future development to achieve the KSA Vision, 2030, KSA Vision, 2030.

Methods

This review was developed by a group of ID pharmacists working in different sectors under the umbrella of the ID Pharmacy Specialty Network (PSN) of the Saudi Society of Clinical Pharmacy (SSCP). The authors evaluated domains related to ID pharmacy in KSA and searched the literature for relevant articles. Based on the experts' assessment of the current gaps and challenges, recommendations were made for future improvement.

Results

Several aspects of ID pharmacy in KSA were evaluated, including history and development, antimicrobial resistance (AMR), antimicrobial stewardship programs (ASP), roles of ID pharmacists, ID pharmacy education, and research. The biggest challenges include AMR, the varying levels of ASP implementation, and the low number of ID-trained pharmacists, especially in non-major cities. Several recommendations for improvement were discussed.

Conclusion

Infectious diseases pharmacy has sustained remarkable progress in KSA in several areas. However, more efforts are needed to increase ASP implementation, increase the number of ID-trained pharmacists, and encourage ID pharmacists in publishing and participating in practice guidelines, which will eventually help achieve the KSA Vision, 2030, KSA Vision, 2030.

Home Drug Delivery Service from the Perspective of Community Pharmacy Staff in Saudi Arabia

Background: In response to COVID-19, many big pharmacy chains in Saudi Arabia have started to provide home drug delivery services. This study aims to understand home drug delivery service from the perspective of community pharmacists in Saudi Arabia. Also, the study investigates the obstacles that may limit the use of home drug delivery service. Methods: A cross-sectional self-reported survey was distributed from February 2021 to May 2021. Descriptive analysis of sociodemographic characteristics was conducted and presented. Frequencies and percentages were calculated for all variables. Results: A total of 965 community pharmacists were surveyed. Most of the pharmacists, (73.5%) were young, aged 23 to 34 years old. The vast majority of the participants, (93.6%), said that the service will improve drug adherence. The lack of required knowledge and skills among pharmacists could be the main obstacle to implement home drug delivery service (34%). A shortage in the number of community pharmacists was the second main obstacle (24%). Conclusion: Home delivery services in the future may largely replace the tradition of going in person to the pharmacy. There are obstacles that may limit the full use of the service like shortage in number of pharmacists and the lack of required training.

Career Readiness Among Saudi Pharmacy Students: Exploring the Need for and the Impact of Career Counseling Services

PURPOSE

Employers place emphasis on graduates' work experience and interpersonal skills while academia mainly focuses on developing students' learning ability. One proposed strategy is through career guidance by universities; however, supportive evidence is lacking. This study explored the career readiness of pharmacy students for the Saudi job market. It also examined the availability of career guidance services for pharmacy students and alumni in Saudi Arabia and the impact of such services on recipients' career path choices and development of competencies.

SUBJECTS AND METHODS

This cross-sectional study utilized an online-based survey. Pharmacy students in the last three years of their program and recent graduates participated in the survey. The study used descriptive statistics to describe participants' demographic data. Respondents were asked to rate aspects related to career readiness on a 5-point Likert scale, and their responses were reported as frequencies with percentages or means as appropriate. Comparisons between groups were made using t-test or one- way ANOVA as required.

RESULTS

A total of 576 responses were collected. About 25% of participants acknowledged the career guidance services provided at their pharmacy college, whereas the majority indicated that they have never reached out to a career counselor at their university (89.6%). The highest level of disagreement was noticed in impact of career guidance services on participants' establishment of their CV/portfolio (50.7%). Using the work readiness scale, the lowest mean was seen in the social intelligence domain (3.64 ± 0.94).

CONCLUSION

Although substantial proportion of students reported the presence of career guidance services in their university or college, very few stated that they had utilized such services. This could have impacted the students' career readiness for the rapidly changing Saudi job market. Therefore, proper measures to advertise the availability of career guidance services in Saudi pharmacy schools have to be implemented.

Developing pharmacists' competencies in Saudi Arabia: A proposed national competency framework to support initial education and professional development

INTRODUCTION

With the currently accelerating changes in pharmacists' roles in Saudi Arabia, evidence-based developmental tools are required to guide initial pharmacy education and define competencies for early career (foundation level) pharmacists' progression. This study aimed to develop a profession-wide competency framework for foundation level pharmacists in Saudi Arabia using the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) as the source framework.

METHODS

An online nominal group technique was used to develop consensus on a profession-wide national competency framework in Saudi Arabia. Purposive sampling was used to recruit experts from local various pharmacy sectors. A combination of self-administered surveys and online meetings was used to measure and develop consensus. The survey items were adopted from the FIP GbCF version 2.

RESULTS

Nine pharmacy experts participated in five iterative rounds of consensus measurement and development between July and November 2021. Consensus was achieved on appropriateness to Saudi pharmacy practice for all the behaviours in the "Pharmaceutical Public Health," "Pharmaceutical Care," and "Professional/Personal" clusters. The "Organisation and Management" cluster caused most differences of opinion. The final consensus generated a list of 125 behavioural statements for inclusion in the national competency framework.

CONCLUSION

This study proposes the first competency framework for foundation level pharmacists in Saudi Arabia. The developed framework represents a consensus on competencies for foundation level pharmacists working across all pharmacy sectors and is eligible for supporting further improvement of initial pharmacy education and support excellence in pharmacists' performance to address the country's needs from pharmaceutical services.

Community Pharmacists’ Perceptions of Their Role in Provision of Anemia Management in Jazan Region, Saudi Arabia, and the Associated Barriers

Background: As a result of the lack of research exploring community pharmacists’ perspectives on anemia care, this study examined the perceived practices and barriers to anemia management services in Saudi Arabia. Methods: A questionnaire was administered to community pharmacists to validate pharmacist perceptions of their role in anemia care. Using an 11-item role test, pharmacists were asked about their perceptions of anemia management. Pharmacy anemia management barriers were explored using 20 items, and their perceptions of inter-professional contact were examined by two items. Data analyses were performed using SPSS version 22. Results: This research involved 324 community pharmacists, 62.3% of whom were males. There were significant differences between the location of pharmacy education and the perceived practice of anemia management. The most common barriers to anemia counseling were patients’ lack of knowledge about anemia, health beliefs, patients’ perceptions that their doctor takes care of them, and time constraints. The majority of respondents said they would like to have more contact with other healthcare professionals regarding the care of anemia patients. Conclusions: A positive perception of pharmacists’ role in anemia management is prevalent among Saudi pharmacists in the Jazan region. Anemia management is challenging due to time limitations and patient-related problems.

Effect of Occupational Stress on Pharmacists’ Job Satisfaction in Saudi Arabia

Work stress occurs when employees have to deal with pressures that do not align with their skills, knowledge, or expectations. This study aimed to assess the impact of work stress on job satisfaction among pharmacists in Saudi Arabia. Therefore, a cross-sectional, self-administered, paper-based survey was conducted between August 2019 and October 2020 using three scales. Descriptive and analytical statistical analyses were performed. A linear regression analysis was used to determine the relationship between occupational stress and job satisfaction among Saudi pharmacists. A total of 284 questionnaires were completed. Multiple linear regression analyses showed a significant negative relationship between occupational stress and job satisfaction (β = −0.456, 95% CI, −0.561 to −0.350), a positive relationship between confirmation and satisfaction (β = 0.147, 95% CI, 0.005 to –0.290), and a negative relationship between working in hospitals and job satisfaction (β= −3.009; 95% CI, −5.424 to −0.593) when other variables were kept constant. The results of this study indicated that occupational stress and satisfaction negatively influenced pharmacists, whereas confirmation was associated with better satisfaction. Moreover, hospital pharmacists had lower job satisfaction. The job satisfaction of pharmacists may help improve medication safety and ensure an adequate pharmacist workforce.

Current state of career placement and employment opportunities for Doctor of Pharmacy graduates: A cross-sectional analysis from a college of pharmacy, Saudi Arabia

Background

Traditionally, graduates from colleges of pharmacy in Saudi Arabia work mainly in hospital settings, and only a few graduates work in other practice settings. However, several initiatives and national plans have recently been introduced to facilitate employment in community pharmacies and the pharmaceutical industry/companies. Consequently, the objectives of this study were to explore the current state of career placement, type of employment sectors, and practice settings that Doctor of Pharmacy (PharmD) graduates join based on recent developments in the profession.

Methods

This study is a cross-sectional, descriptive study. The target population was PharmD graduates from Unaizah College of Pharmacy, Qassim University, Saudi Arabia. Consequently, all 162 graduates from three recent cohorts (2018–2020) were contacted to participate in this survey.

Results

A total of 157 graduates participated in this study, yielding a response rate of 96.91 %. Of the participants, 92 (58.6 %) were female graduates. The overall rate of employment was 84.7 %. Moreover, a higher proportion of male graduates than female graduates (97.1 % versus 73.7 %, P = 0.006) were employed. In this study, the three main sectors that the graduates joined were the pharmaceutical industry and companies (41.2 %), community pharmacies (29.4 %), and medical cities, hospitals and clinics (23.5 %). In addition, almost the same proportions of male and female graduates joined the pharmaceutical industry and companies (40.3 % versus 42.1 %). However, a higher proportion of male graduates than female graduates joined community pharmacies (32.3 % versus 26.3 %). Conversely, a higher proportion of female graduates joined medical cities, hospitals and clinics compared to male graduates (28.1 % versus 19.4 %).

Conclusion

The current employment of PharmD graduates in the job market is generally high, but further improvement could be made, especially for female graduates. Moreover, the study findings showed that jobs are shifting toward community pharmacies and the pharmaceutical industry. Therefore, we believe that decision-makers in pharmacy education and curriculum developers must consider these trends and ensure that there is adequate preparation for careers in community pharmacy practice and other sectors of the profession in the curriculum.

Hospital pharmacists' awareness and perspective toward the management of COVID-19 pandemic in the Kingdom of Saudi Arabia

Objectives

This study investigates the hospital pharmacists' awareness of important facts about the COVID-19 disease and their source of information, as well as their perception.

Methods

This cross-sectional study using a self-administered questionnaire was conducted from November 2020 to March 2021 in the Kingdom of Saudi Arabia (KSA). The questionnaire was developed via electronic platform and invitations were sent to pharmacists working in private and government hospitals. A multivariate logistic regression was used to identify factors associated with awareness of COVID-19.

Results

A total of 272 pharmacists submitted their responses via weblink. Many pharmacists (n=228, 84%) followed the latest COVID-19 updates on treatment and updated their information mainly through World Health Organization documents (n=151, 56%). Pharmacists working in secondary and tertiary hospitals were relatively five-times times (AOR = 4.59; 95% CI: 1.69-12.8; p-value = 0.003) and three-times (AOR = 2.93; 95% CI: 1.35-6.72; p-value = 0.008) more aware of COVID-19 than those working in primary hospitals. Pharmacists with prior adequate knowledge regarding epidemics and pandemics were two-times more likely to have a good awareness of COVID-19 compared to those who had received none (AOR = 2.15; 95% CI: 1.09-4.35; p-value = 0.030).

Conclusions

Half of the pharmacists believed that they received required education in the past about epidemics and pandemics, and many follow the recent COVID-19 updates on medicines predominantly from the WHO followed by the government awareness campaigns. Many pharmacists believed they have a key role in the management of epidemics/pandemics via their hospital pharmacy. However, this study identified certain awareness gaps regarding COVID-19, highlighting areas of improvement.

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

Background

Methods

Results

Conclusion

A National Survey of Community Pharmacists’ Viewpoints About Pharmacovigilance and Adverse Drug Reaction Reporting in Saudi Arabia

This study assessed the knowledge, attitudes, and practices of community pharmacists regarding pharmacovigilance and adverse drug reaction (ADR) reporting system in Saudi Arabia. A cross-sectional survey of community pharmacists from different regions in Saudi Arabia was performed through convenience sampling between November 2020 and January 2021. The responses were received from 1,172 community pharmacists. Most respondents (86.7%) were familiar with the National Pharmacovigilance and Drug Safety Center, and 830 (70.8%) knew about the ADR reporting form. The majority (94%) of the respondents agreed with the importance of reporting ADRs for patient care and national health. Although 92.2% of the participants asked their patients about ADRs, 90.2% agreed that more training programs are required to be organized by the Saudi Food and Drug Authority for healthcare professionals on the ADR detection and reporting system. Analgesic agents were the most common drug category for which ADRs were reported (67.4%). The majority (92.1%) of ADRs reportedly occurred in patients with chronic diseases. The study concluded that most community pharmacists in Saudi Arabia are knowledgeable and have good attitudes and practices regarding pharmacovigilance and ADR reporting.

Publics’ Perceptions of Community Pharmacists and Satisfaction with Pharmacy Services in Al-Madinah City, Saudi Arabia: A Cross Sectional Study

Background and Objectives: Pharmacists play a major role in serving patients and delivering pharmaceutical services to the community. It is unclear whether the public fully appreciates what pharmacists can do as key health care providers. This study aims to examine public perceptions of community pharmacists and levels of satisfaction with pharmacy services. Materials and Methods: A cross-sectional study was conducted on a randomly selected sample population (n = 1000) in Saudi Arabia over a period of six months from January through June 2019. A 40-item, structured, self-administered questionnaire was used, comprised of questions on the demographics characteristics of the respondents and their satisfaction with pharmacy services. Descriptive statistics were used to analyze the data. Results: The response rate of the survey was 76.92%. Public opinions were influenced by pharmacists’ availability and knowledge, service promptness, and counseling services. Overall, 80.5% of respondents agreed that community pharmacists treat them with respect. Doctors were identified as the preferred source of drug therapy consultation by 58.7% and pharmacists by 41.29%. About 72.8% of respondents agreed that pharmacists provided them with clear instructions about medication use, and 70.2% trusted pharmacists’ opinions about medications. About 62.5% of respondents expressed satisfaction with pharmacists, and 64.8% with pharmacy services. Conclusions: Customers’ opinions were influenced by pharmacists’ availability and knowledge, pharmacy service promptness, pharmacy location, waiting area, medication knowledge, and counseling. However, the public was greatly satisfied with community pharmacists’ professionalism and pharmaceutical services. This positive perception provides an opportunity for pharmacists to extend their roles as healthcare professionals.

Dispensing Practices for Weight Management Products in Eastern Saudi Arabia: A Survey of Community Pharmacists

Due to changing lifestyles and socioeconomic status, obesity prevalence has been rising in Saudi Arabia, and community pharmacists often counsel patients about its management. The study aimed to evaluate practices of community pharmacists involved in dispensing products for weight control in four cities located in the eastern province of Saudi Arabia. A cross-sectional study was conducted involving community pharmacists in Dammam, Dhahran, Khobar, and Al-Ahsa, using a Likert format questionnaire. Only those who consented to participate were handed the questionnaire. A total of 100 complete responses were analyzed. The median value for packs sold per month for tea containing products Al-Diafa Slimming Tea, Jamue Tea, and Green Tea was ≥6 while the same for orlistat and apple cider vinegar were ≤4. Moreover, >50% of pharmacists mentioned that orlistat and apple cider vinegar were effective while ≥35% mentioned that metformin and Jamue tea were effective. Furthermore, ≥25% mentioned that green tea and Al-Diafa slimming tea were effective. Excluding orlistat, >50% of pharmacists did not know about adverse effects for other products. The rate of dispensing of several weight loss products was significant for participants’ background characteristics, such as time duration of consultation, gender, and age of patients, and pharmacist work experience (p < 0.05). The tea products and orlistat were the most frequently sold products, and community pharmacists appeared most knowledgeable about the effectiveness and adverse effect of orlistat. The pharmacists seemed to be aware about the effectiveness of other weight loss products; however, their knowledge about their potential adverse effects was unsatisfactory.

Gene Therapy Knowledge and Attitude Among Healthcare Professionals: A Cross-Sectional Study

This study aimed to assess healthcare professionals' knowledge, attitudes, and concerns toward gene therapy in Saudi Arabia. We conducted an online cross-sectional survey via convenience sampling during the period from December 2018 to March 2019. A total of 419 (358 pharmacists and 61 physicians) responded to our questionnaire. Three hundred and nine (73.7%) were male, and the mean (±SD) age of 32.0 ± 7.7 years. The mean knowledge scores of all participants, pharmacists, and physicians were 3.8 ± 1.9, 3.8 ± 1.9, and 3.7 ± 1.9, respectively (P = 0.73). Higher knowledge score was associated with younger age (Coefficient: -0.03; P = 0.02), male (Coefficient: 0.57; P = 0.01), master's degree (Coefficient: 0.93; P = 0.003) and Ph.D. holders (Coefficient: 1.10; P = 0.01), and participants graduated from Canada (Coefficient: 2.10; P = 0.01).Moreover, about half of the respondents (55%) were concerned about gene therapy, and genetics training at college was considered the best gene therapy education method by 69.4%. Attitude score was not significantly associated with the profession (P = 0.88) but positively correlated with the knowledge score (rho= 0.4; P < 0.001). In conclusion, pharmacists and physicians showed limited knowledge with a positive attitude toward gene therapy. Therefore, educational programs on gene therapy need to be considered, focusing primarily on the safety, and social acceptance of such new therapeutic management.

Involvement of community pharmacists in public health services in Asir Region, Saudi Arabia: A cross-sectional study

BACKGROUND

Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of the health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers for the provision of these services in Saudi Arabia.

MATERIALS AND METHODS

This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers for practising public health roles.

RESULTS

The total number of respondents was 193. The proportion of respondents who reported that they were "very involved" or "involved" in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counselling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunisation. Most of the barriers in the current research were rated as having low relevance to the provision of public health services.

CONCLUSION

Findings in the current research suggest that community pharmacists in Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Community Pharmacists' Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists’ soft skills, clear policies and authorization for offering this type of service are also needed.

Work readiness scale for pharmacy interns and graduates: A cross-sectional study

Introduction

As the number of unemployment among pharmacy graduates increases, the Saudi Ministry of Labor implemented extra measures to facilitate their training and hiring by the private sectors. Nevertheless, there is a paucity of data regarding pharmacy graduates’ work readiness (WR). Hence, we aim to assess their WR and identify predicting factors associated with WR among pharmacy graduates’ in Saudi Arabia.

Methods

A 46-item self-reported pre-validated anonymous work readiness scale (WRS) survey with a 5-point Likert scale was administered to pharmacy senior students and graduates using Qualtrics XM® survey tool over the month of May 2020. The main outcome was to assess WRS for pharmacy interns and graduates and identify factors associated with work readiness.

Results

A total of 617 participants have participated in this survey, out of which 46.5% were freshly graduated pharmacists and 19.6% were pharmacy interns. Most participants (82.3%) were PharmD candidates or graduates. Around two-third of participants (63%) have successfully completed all survey items. The maximum points scored was 223 out of 230, and the median overall score was found to be 175. There was no significant association with gender, age, or type of university regarding overall scores. However, a statistically significant odds ratio was observed with PharmD program type and previous pharmaceutical marketing training (OR = 1.778, 95% CI = 1.143–2.765: OR = 0.618, 95% CI = 0.432–0.884, respectively).

Conclusion

The overall median score shows a good work readiness level among pharmacy students/graduates in Saudi Arabia; however, PharmD program graduates exposed to advance pharmacy training, including the pharmaceutical marketing experience, have higher work readiness odds than Bpharm graduates. Further studies involving other related perspectives, such as stakeholders, employers, and preceptors, would give a clear image of pharmacy graduates’ job readiness levels.

Medical Devices-Related Counseling Practices Among Community Pharmacists: A Nationwide Cross-Sectional Study from Saudi Arabia

Objective

The current study was conducted to assess medical devices-related counseling practices among community pharmacists in Saudi Arabia.

Methodology

This was a cross-sectional study conducted among community pharmacists from Saudi Arabia using a convenience sampling technique. An online questionnaire based on Google forms was used to collect data. Descriptive and inferential analyses were conducted using SPSS statistics 22. Student t-test, one way ANOVA, and Pearson correlation statistics were used where applicable. Results with a p-value of <0.05 were considered statistically significant.

Results

One thousand and six community pharmacists responded to the survey. Males’ rating of their ability to operate medical devices was significantly higher than females (overall average score of 3.8 versus 3.5, p=0.033). As years of experience increased there were slight but significant increases in the overall scores on ability to operate medical devices (p=0.002) and confidence to counsel patients about the devices (p=0.032). Those who got a board certification used devices for self-treatment significantly more than their counterparts (on average 6.9 devices versus 5.2, p=0.003). Those who received clinical training reported higher rates of ability to use/operate devices (p=0.011), confidence to counsel patients on devices (p=0.001), and counseling practice (p=0.044) than those who did not receive clinical training.

Conclusion

The present study revealed good to very good self-reported medical devices-related counseling practices. There is a need for more future rigorous research to evaluate pharmacists' actual practice in this area. Pharmacy educators and CPD programs should pay attention to updating pharmacists’ knowledge and skills and improve their contribution to medical devices supportive services.

Community pharmacists' preparedness and responses to COVID-19 pandemic: A multinational study

BACKGROUND

Community pharmacists play a pivotal role in healthcare worldwide. Their role became more critical during the COVID-19 pandemic. This study aims to investigate the community pharmacists' preparedness and responses to the COVID-19 pandemic and how efficiently they were prepared to contain and prevent the spread of infection.

METHODS

An online questionnaire was distributed to community pharmacists in Saudi Arabia, Lebanon, and Jordan through social media platforms. A scoring system was developed to measure their level of adherence to the preventive measures of the global infection.

RESULTS

The total included responses were 800. Around 44% of the pharmacists reported spending less than 15 min/d reading about COVID-19 updates. Although more than half of them were reviewing official sites, 73% of them were also retrieving information through non-official channels. Additionally, almost 35% of them were directly contacting customers without physical barriers, 81% reported encountering infected customers, and 12% wore the same facial masks for more than a day. Moreover, 58% of the pharmacies reported the absence of door signs requesting infected customers to declare the infection, 43% of the pharmacies were not limiting the number of simultaneous customers, and 70% were not measuring customers' temperatures prior to entry. Collectively, the mean total score of applied protective measures was 10.12 ± 2.77 (out of 17).

CONCLUSION

The level of preparedness of the community pharmacies in these three Middle Eastern countries was not adequate for facing the COVID-19 pandemic. Health authorities in these countries should closely monitor their adherence to the protective guidelines.

Medication reconciliation process: Assessing value, adoption, and the potential of information technology from pharmacists' perspective

The Medication Reconciliation (MedRec) process aims to improve patient safety through safe prescription and medication administration. A validated survey was carried out to address aspects related to MedRec process, its obstacles, the role of information technology, and the required functionalities for optimizing the MedRec process. A total of 81% of the survey's respondents acknowledged the roles of EHR (62% of respondents), PHR (41%), and electronic medication registration list (33%) as necessary technology tools for MedRec. Most respondents emphasized the need to compile multiple medications' entries of information technology systems into one application (96.4%), allowing the entries from community pharmacies (90.6%). Further, incorporating information technology into the MedRec process presents a challenge in terms of legal responsibility (92 %) and the ability to integrate medications with other hospitals and community medications (78.6%). Findings affirm the need for a well-designed MedRec process aided with information technology solutions. The external data and user preferences should be considered when redesigning the MedRec process. The study also suggests initiating a policy that mandates sharing data necessary for creating a compiled medication list for each patient. MedRec is an indispensable tool for building a fruitful medication management system in a healthcare organization.

Using a Global Systematic Framework Tool to Identify Pharmacy Workforce Development Needs: A National Case Study on Saudi Arabia

Background

Healthcare is one of the key focuses of the Saudi Vision 2030. Identifying and acknowledging the strengths and weakness of the healthcare manpower, including pharmacy, are crucial for workforce development and for achievement of the vision.

Methods

This paper used a global systematic framework tool, the International Pharmaceutical Federation the International 21 Development Goals (FIP DGs), as a roadmap to identify pharmacy workforce development needs.

Results

An increase in the number of qualified Saudi pharmacy employees was successfully achieved by increasing the number of pharmacy education institutions. Several postgraduate pharmacy programs (Master’s and Ph.D.) were also established. Some pharmacy colleges around the country obtained national and international accreditation/certification from reputable quality assurance organizations, such as the NAAA, ACPE and CCAPP. Clinical pharmacy residency programs were expanded to cover various specialties. No comprehensive competency framework exists for pharmacists in Saudi Arabia. A wide range of CDP programs, including electronic courses, have been offered for healthcare practitioners and accredited by SCFHS. While a certain number of CME hours are required for re-registration as a pharmacist, these CME hours are currently not linked to a needs-based health initiative. Several initiatives and strategies have been developed and implemented to address pharmaceutical workforce gender and diversity balances. The pharmacy profession is regulated by the MOH, the SCFHS, and the HRSD.

Discussion and Conclusion

Among the three clusters of the DGs – Academia, Professional Development, and Systems – Cluster 2, Professional Development, was identified as a priority area for improvement. Within this cluster, these particular DGs were selected as top priority: competency development (DG 5), leadership development (DG 6), and working with others (DG 8). Two DGs in Cluster 3, Systems, were also highlighted as priorities: continuing professional development strategies (DG 9) and impact and outcome (DG 11).

Community Pharmacists' Practice, Awareness, and Beliefs about Drug Disposal in Saudi Arabia

The awareness among Saudi people regarding the good and safe practice of drug disposal is fairly low. Community pharmacists’ potential toward drugs disposal directions and practice are not emphasized enough. Therefore, a cross sectional study was conducted in Riyadh, Saudi Arabia, to evaluate the practice, awareness and beliefs of community pharmacists about disposal of unused drugs. Out of 360 subjects who participated in the study, more than 70% returned the unused drugs to the pharmaceutical distributors. Around 80% of the participants confirmed the risk of environmental damage due to the inappropriate disposal of drugs, and 87.5% of them held themselves responsible for preventing such risk. Approximately 85% of surveyed pharmacists believed community pharmacies to be an appropriate location for the collection of unused drugs. There was no significant association between the community pharmacists’ age group and years of practice as community pharmacists with either the awareness of unused medication disposal on environmental hazards, or the beliefs about the appropriate location for collecting unused drugs (p > 0.05). The awareness and proactive accountable responsibility, along with community pharmacists’ belief of appointing pharmacies to collect unused drugs, strongly support the institution of drug take-back programs.

Cardiovascular disease risk prevention services by pharmacists in Saudi Arabia: what do policymakers and opinion leaders think?

Background

Cardiovascular disease (CVD) is an emerging contributor to national morbidity and mortality in Saudi Arabia. CVD risk prevention services are limited, particularly with an over-utilised public health sector and an under-utilised and under-resourced primary care sector. Globally, there is evidence that community pharmacists can play a key role in CVD prevention within primary care. However, the perspectives of policymakers and opinion leaders are critical to successful translation of evidence into practice. Thus, the aim was to engage policymakers and professional leaders in discussions about implementing high-quality CVD risk prevention services in community pharmacy.

Methods

Qualitative semi-structured interviews were conducted, audio-recorded and transcribed verbatim. All transcripts were thematically analysed.

Results

A total of 23 participants (87% male) from government and non-government sectors were interviewed. Of these, almost 65% had pharmacy qualifications. Limited provision of CVD risks preventative services in primary care was acknowledged by most participants and building community pharmacists’ capacity to assist in preventive health services was viewed favourably as one way of improving the status quo. The data yielded four key themes: (1) future pharmacy CVD health service models; (2) demonstrable outcomes; (3) professional engagement and advocacy; and (4) implementability. CVD health services roles (health screening, primary and secondary prevention services), pragmatic factors and tiered models of care (minimal, medium, and comprehensive pharmacist involvement) were discussed. The need for humanistic, clinical, and cost effectiveness outcomes to be demonstrated and active involvement of professional bodies were deemed important for such services to be sustainable. Professional pharmacy governance to develop pharmacy careers and workforce, pharmacy curricular reform and ongoing education were posed as key success factors for novel pharmacy roles. Practice policies, standards, and guidelines were seen as required to adhere to stringent quality control for future pharmacy services provision. Participant’s implementation vision for such services included scalability, affordability, access, adoption and health system reform. Most discussions focused on the need for structural improvement with limited input regarding processes or outcomes required to establish such models.

Conclusions

Most participants favoured pharmacy-based CVD risk prevention services, despite the variability in proposed service models. However, prior to developing such services, support structures at the health system and health professional level are needed as well as building public support and acceptability for pharmacy services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40545-021-00319-6.

A Cross-Sectional Study on Pharmacy Students' Career Choices in the Light of Saudi Vision 2030: Will Community Pharmacy Continue to Be the Most Promising, but Least Preferred, Sector?

INTRODUCTION

The Saudi Arabian healthcare divisions that recruit and hire pharmacists include hospital pharmacy, community pharmacies, universities, and research centres. Local studies showed that hospital pharmacy is the most preferred sector, while community pharmacy is the least preferred. However, jobs in hospital pharmacy are limited compared to community pharmacy. Hence, to accommodate the increasing numbers of pharmacy graduates and to facilitate the implementation of Saudi Vision 2030, which promotes primary healthcare and the participation of both private and non-governmental organisations in healthcare delivery, community pharmacy ought to be Saudised. This study was conducted to assess the career choices made by Saudi pharmacy students and the enablers that influence their career choice, especially in community pharmacy.

METHODS

A prospective cross-sectional approach was used. A total of 437 final year pharmacy students were recruited from 15 pharmacy schools around the country.

RESULTS

Salary and advancement opportunities as well as geographical location, benefits, and work environment were found to be "very important" enablers when making career decisions. Hospital pharmacy was selected as the most preferred sector by 242 (55.4%) of the participants, while community pharmacy was the least favoured pharmacy sector (17% or 6.2%). The enablers that might influence the consideration of a job in community pharmacy included career aspiration and social accountability. On the other hand, the barriers were personal beliefs about the sector and the nature of the work.

CONCLUSIONS

The community pharmacy sector was found to be the least preferred sector to work in. The study revealed a list of enablers that the participants found to be relevant or of high relevance when choosing community pharmacy as a career pathway. Some of the enablers contribute to the role of the pharmacist towards the local community, social accountability, and towards the country's Vision, such as interaction with the general public and educating them. Other enablers are related to the pharmacists' career aspirations, such as owning a business. Some of the barriers that were found relevant include high workload, inflexible working hours, and limited opportunities for professional development. Localisation of community pharmacies would help to create more jobs for national pharmacists, increase the participation of female pharmacists in the workforce and support the achievement of Vision 2030. The barriers should be tackled on several levels: undergraduate curriculum, regulatory, and actual practice. Undergraduate education needs to include primary pharmaceutical care services in its curriculum. Regulatory changes include enforcing the renationalisation of the community pharmacy sector and permitting females to work in community pharmacies without location restrictions.

Perceived barriers and facilitators to uptake of non-traditional roles by pharmacists in Saudi Arabia and implications for COVID-19 pandemic and beyond: a qualitative study using Theoretical Domain Framework

Background

The COVID-19 pandemic has further strengthened the need for pharmacists to uptake non-traditional roles. Pharmacy practice in Saudi Arabia is emerging in recent years with greater policy emphasis on pharmacists taking new clinical roles. This study aimed to explore the experiences, perceptions and barriers of Saudi pharmacists about their uptake of non-traditional roles using Theoretical Domains Framework (TDF).

Methods

A qualitative semi-structured study using face-to-face or telephone interviews were conducted. Eligible participants included qualified pharmacists from Saudi Arabia. Interviews focused on pharmacist’s perceptions, current opportunities and key challenges towards the uptake of non-traditional roles. Interviews were audiotaped and transcribed verbatim. Results were analysed through the framework analysis method and were later mapped with respective domains of TDF.

Results

A total of 14 pharmacists completed the interview (9 females and 5 males). Participants showed an overall positive attitude towards the uptake of non-traditional roles. Participants felt that there was wider support available for pharmacists at the policy level to uptake non-traditional roles. However, a need for greater recognition of roles by other healthcare professionals and patients were identified. Participants alluded to reluctance of some physicians to take on board the suggestions from a pharmacist. Key barriers to uptake of non-traditional roles were related to environmental context and resources domain of TDF. For example, participants discussed the need for even further practical experiences during their undergraduate degree to become ready to adopt non-traditional roles in clinical practice.

Conclusions

Participants of this theoretically informed qualitative study showed an overall positive attitude towards the way pharmacy practice is progressing in Saudi Arabia and their uptake of non-traditional roles. However, there is a need to improve interdisciplinary working, patient awareness of pharmacist competencies and their educational preparedness in furthering their uptake of non-traditional roles. Addressing such barriers and promoting uptake of novel roles by pharmacists is imperative in the context of emerging COVID-19 and future pandemics.

Readiness of Community Pharmacists to Play a Supportive and Advocacy Role in the Fight Against Corona Virus Disease

BACKGROUND

As the coronavirus disease pandemic continues to severely strain healthcare systems across the globe, there is need to determine whether every facet of the healthcare system is ready to respond.

PURPOSE OF THE STUDY

The study investigated whether community pharmacists in the Kingdom of Saudi Arabia are ready to play a supportive role in the fight against COVID-19.

METHODS

The study employed a descriptive cross-sectional survey. A descriptive analysis to capture the demographic characteristics of the sampled population, frequency tables and graphs were generated to capture community pharmacists' practice, readiness, attitudes and awareness. The means of the subset of knowledge on COVID-19 etiology, prognosis and management, and the practice, attitudes were compared in a one way analysis of variance to determine whether the difference was significant to predict preparedness towards playing a supportive role in the fight against COVID-19.

RESULTS

The practice of community pharmacist as reflected adherence to recommended guidelines by the ministry of health on COVID-19 management and control. About 74% always disinfected contact surfaces, 69% conducted basic temperature checks on staff members and customers. Community pharmacists in Saudi Arabia displayed positive attitudes towards fight against COVID-19 [m = 4.08 and a relatively narrow difference in percentage distribution between those who were not sure and those who claimed to be very satisfied 20%]. Community pharmacists in KSA displayed extensive knowledge on the subject of COVID-19 as all respondents were aware of the primary symptoms of COVID-19 (100%), 62% were aware of COVID-19 management strategies, 81% believed information supplied through the ministry was sufficient. A p value of 0.00 indicated that the results were significant to support the assumption that community pharmacists in KSA were prepared to play a supportive role in the fight against COVID-19.

CONCLUSION

The result demonstrated readiness among Saudi Arabian community pharmacists to be integrated into COVID-19 pandemic planning and response.

Pharmacy students' attitudes toward patient safety in Saudi Arabia: a cross-sectional study

BACKGROUND

There is a growing recognition of the importance of teaching patient safety to medical students to improve healthcare and minimize patients' harm; however, few studies evaluated the attitudes of pharmacy students toward patient safety. The purpose of this study was to explore the attitudes toward patient safety among pharmacy students in Saudi Arabia.

METHODS

A cross-sectional study was conducted among pharmacy students from four different universities using a self-administered questionnaire. The Attitudes to Patient Safety Questionnaire III (APSQ-III) was used to measure the attitude toward patient safety. The data were presented using descriptive statistics, such as percentages and means, and compared across gender using Student's t-test.

RESULTS

All of the students who agreed to participate and signed the consent form have completed the questionnaire. Of the 347 pharmacy students who participated in the study; 63% were enrolled in the Doctor of Pharmacy Program and 37% were enrolled in the Bachelor of Pharmaceutical Sciences program. Only 46% of the participants received courses for patient safety mainly in the fourth year of their pharmacy program, and around 93% were interested to learn more about patient safety. A more positive attitude toward patient safety was reported in the domain of 'confidence to report errors', 'working hours as error cause', 'patient involvement in reducing error', and 'team functioning'. However, most negative attitudes were reported in the domains of 'Error inevitability' and 'Disclosure responsibility'. Gender differences were noticed in the attitude toward patient safety; female students had more positive attitudes in most domains of patient safety.

CONCLUSIONS

Around one-half of the surveyed pharmacy students did not receive any courses on patient safety. Our findings emphasize the need for including patient safety courses in the curricula of the different pharmacy programs given the patient safety training importance in improving the quality of patient care.

Evaluation of the community pharmacists' performance in the screening of non-steroidal anti-inflmmatory drugs risks in Saudi Arabia

OBJECTIVES

To assess community pharmacists' knowledge and practices regarding screening risk factors and providing safety information about the use of non- steroidal anti-in ammatory drugs (NSAIDs) to patients.

METHODS

Cross-sectional and a self-administered questionnaire-based study was conducted over a 4-month period (May-August 2019) with selected community pharmacies in Jeddah, Saudi Arabia. The questionnaire composed of demographic data and the pharmacist's role in supplying NSAIDs.

RESULTS

The majority of participating community pharmacists dispense NSAIDs. However, many did not apply relevantly good communication skills such as seeking information about concomitant drugs (42.5%) or providing advice on managing any adverse side effects of taking NSAIDs (39.1%). Most of the community pharmacists also did not provide relevantly good communication about risk factors. The most common screening risk factors mentioned were a history of pregnancy and breastfeeding (84.2%) followed by being at an older age (74.5%) or a history of a gastrointestinal ulcer (71.5%).

CONCLUSION

Community pharmacists in Saudi Arabia need to appropriately screen their patients for adverse drug reactions and the ectively communicate the risks of using NSAIDs. The Saudi Regulatory Authority could endorse several approaches to apply a good strategy for improving the dispensing practices in community pharmacies, communication and awareness of risk factors especially in high-risk patients who are taking NSAIDs.

Health consumer engagement in developing novel preventive health community pharmacy roles in cardiovascular disease in Saudi Arabia: A qualitative analysis

Introduction

Cardiovascular diseases (CVD) are one of key leading causes of mortality worldwide. Both modifiable and non-modifiable risk factors contribute to the development of CVD. Modifiable risk factors such as smoking, unhealthy diets and lack of exercise are increasing in prevalence in Saudi Arabia but may be mitigated using pharmacological and non-pharmacological approaches. Thus, identifying, assessing and managing these modifiable risks at an early stage is essential. Pharmacists are highly accessible primary health professionals and can play a crucial role in screening and managing these risk factors in collaboration with primary care physicians. There is currently no research in Saudi Arabia exploring the views of health consumers with CVD risk factors regarding their preferences for or willingness to engage with community pharmacy CVD preventive health services.

Objectives

To explore the perceptions of health consumers about current and feasible future services by pharmacists with a specific focus on CVD risk screening and management in Saudi Arabia.

Methods

Semi-structured interviews were conducted with consumers with at least one modifiable CVD risk factor. The interviews were audio-recorded, transcribed verbatim, translated into English and then thematically analysed.

Results

A total of 25 individuals, most of whom were Saudi (88%) and women (65%), participated in face to face interviews. Five main themes emerged from the analysis of consumers’ responses. 1. Perception of pharmacists’ role, the pharmacists’ main role was perceived as medication supply. 2. Trust and satisfaction with current service, most participants appeared to have low trust in pharmacists. 3. Preferences for future pharmacy services, most participants were willing to engage in future pharmacy delivered CVD preventive health services, provided there was stringent regulation and oversight of the quality of such services. 4. Viability of new pharmacy services was raised with promotion of such services to the public, collaboration with other health professionals, financial incentivization and motivational rewards thought of as essential ingredient to ensure service feasibility. 5. Health beliefs and help seeking behaviours of consumers were diverse and low health literacy was evident; it was thought that pharmacists can help in these matters by educating and advocating for such consumers. Overall, the data suggested that clinical, communication and professional skills need to be enhanced among Saudi pharmacists to enable them to provide optimal patient cantered services.

Conclusion

Health consumers participants were willing to participate and utilise CVD risk screening and management pharmacy-based services, when offered, provided their concerns are addressed. Therefore, in light of the burden of CVD disease in the country, development, implementation and evaluation of pharmacist provided CVD risk screening and management should be undertaken.

Patient Satisfaction and Their Willingness to Pay for a Pharmacist Counseling Session in Hospital and Community Pharmacies in Saudi Healthcare Settings

Objective

Patient satisfaction is an indicator for quality of healthcare service and is sometimes linked to patients’ willingness to pay. Willingness to pay is an economic method for estimating patient’s inclination for a service in monetary terms. This study assessed satisfaction of patients from pharmacist counseling service and estimated their willing to pay for the same.

Methods

A month-long survey was conducted in community and hospital pharmacies located in Khobar, Dammam, and Qatif cities of Saudi Arabia, using Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction with counseling as well as willingness-to-pay. Convenient sampling method was used, and sample size was calculated based on power analysis. Data was analyzed through SPSS version 23. Chi-square (χ²) test and logistic regression analyses were conducted to report associations between variables and, determinants of satisfaction as well as willingness to pay respectively. The study was approved by concerned ethical committee (IRB-2019-05-020).

Results

Patients (n = 531) with previous counseling experience were more likely to be satisfied [adjusted odds ratio (AOR) 5.2, p < 0.05]. Patients were more willing to pay if, they had an income above SAR 10,000 i.e., USD 2666.5 (AOR 1.78, p < 0.05), were satisfied with counseling time duration (AOR 4.5) and, were able to get counseling without difficulty (AOR 2.1, p < 0.05). Patients were more likely to be satisfied and were willing to pay if, they received required knowledge/information completely (AOR 2.5, 3.7, and p < 0.05) and found pharmacist helpful (AOR 1, 4.5, and p < 0.05). Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10.

Conclusion

Patients considered counseling as an important service and were satisfied from it. Less than a third of patients were willing to pay for the service. Knowledge and helpfulness of pharmacist were identified as two major determinants that could not only satisfy and but also promote willingness to pay for the service. A pharmacist with skills in pharmaceutical care and counseling could be useful in promoting the service and making it profitable for pharmacy business.

Perceptions and Attitudes Towards Clinical Pharmacy Services and Their Impact on The Management of Cancer in Taif, Saudi Arabia

Aim:

To assess the perception and attitude of HCPs and health-related science colleges’ students regarding the clinical pharmacists’ roles and responsibilities in providing better pharmaceutical care to patients in Taif, Saudi Arabia and to detect its impact on management of cancer.

Methods:

This study was conducted in four randomly selected hospitals in Taif and three health-related science colleges in Taif University. A questionnaire was distributed to HCPs and another questionnaire to students of health-related science colleges.

Results:

Three quarters of students perceived that the clinical pharmacist is an important part of the healthcare team. Two-thirds of HCPs expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although two-thirds of HCPs reported that they did not have clinical pharmacists in their institutions, there was substantial willingness among HCPs to cooperate with the clinical pharmacists. Most HCPs expressed the view that the clinical pharmacist is an important integral part of the healthcare team and has a positive impact on cancer management.

Conclusion:

HCPs and students of health-related science colleges valued the role of clinical pharmacists in healthcare delivery and management of cancer. However, new developments in clinical pharmacy services in Taif hospitals are recommended to improve perception and attitudes towards the clinical pharmacy services. Also, well-organized programs should be conducted to students of health-related science colleges to improve their perceptions and attitudes towards the clinical pharmacy services which may have a positive impact on cancer management.

Exploring the value of a Doctor of Philosophy program in Pharmaceutical Outcomes and Policy Research in Saudi Arabia

Background

The need for graduate education in Pharmaceutical Outcomes and Policy Research (POPR) is becoming increasingly apparent worldwide. However, the number of professionals in this field is inadequate in the Middle East. Therefore, this study aimed at gaining insight into the perceived value of a potential Doctor of Philosophy (Ph.D.) program in POPR among different stakeholders in Saudi Arabia.

Methods

Following the development of a Ph.D. program structure in POPR, a questionnaire was created to explore the perception of its value among decision-makers in different healthcare and governmental institutions. An email with detailed information on the proposed program was sent to 131 identified individuals along with an online link to the questionnaire.

Results

Responses were provided by 107 (81.67%) individuals. The majority of respondents (53.3%) represented large organizations with more than 500 workers; hospitals and academia were the most represented types of institutions. More than 85% of the participants strongly agreed that the program will meet the needs of the healthcare market in Saudi Arabia and that there will be a demand for graduates of the program over the next 5–10 years. However, only 28.04% of the participants declared that they would definitely recommend the program to their colleagues and employees, and 49.53% would consider employing its graduates.

Conclusions

The obtained results indicate a significant interest among different stakeholders in introducing a Ph.D. program in POPR in Saudi Arabia.

Cardiovascular disease risk screening by pharmacists: a behavior change wheel guided qualitative analysis

BACKGROUND

In common with many developed countries, Saudi Arabia is currently experiencing an increasing cardiovascular disease (CVD) burden. However, systematic screening programs for early identification and minimization of CVD risk within community or general clinical settings are limited. Globally, research suggests that pharmacists can play an effective role in identifying, assessing, managing and referring people at risk of CVD in the community as well as in the hospital setting. This role is not yet developed in Saudi Arabia.

OBJECTIVES

This study aimed to explore the perspectives of hospital and community pharmacists in Saudi Arabia about potential roles in CVD risk screening. The purpose of the study was to propose potential interventions to facilitate the development of pharmacist delivered models for CVD risk prevention and management services in Saudi Arabia.

METHODS

A qualitative study was conducted using semi-structured in-depth interviews and focus group discussions with a purposive convenience sample of hospital and community pharmacists in Saudi Arabia. Data collection continued until saturation was achieved. All interviews were audio recorded, transcribed verbatim and thematically analyzed.

RESULTS

A total of 50 pharmacists (26 hospital and 24 community pharmacists) participated in this study. Twenty hospital and eight community pharmacists were interviewed individually, while the remaining participants contributed to three focus groups discussions. Currently, it appears that CVD risk prevention services are rarely provided, and when offered involved provision of discrete elements only such as blood pressure measurement, rather than a consolidated evidence based approach to risk assessment. Participating pharmacists did not appear to have a clear understanding of how to assess CVD risk. Four key themes were identified: pharmacists' perception about their current roles in CVD, proposed future clinical and service roles, impeding factors and enabling factors. Subthemes were mainly related to determinants likely to influence future CVD services. These subthemes included public perception of pharmacists' roles, pharmacist-physician collaboration, legislative restrictions, systemic issues, sociocultural barriers, organizational pharmacy issues, lack of professional motivation, government and organizational support and professional pharmacy support frameworks. These influencing factors need to be addressed at micro, meso and macro systems level in order to facilitate development of new pharmacist delivered cognitive services in Saudi Arabia.

CONCLUSIONS

Pharmacists in Saudi Arabia are willing to expand their role and offer pharmacy-based services, but influencing determinants have to be addressed at the individual, professional and health system levels. Further work is needed to clarify and develop practical and appropriate protocols for pharmacist CVD prevention and management services within the Saudi public and health care system. Such work should be guided by implementation science frameworks rather than embarking on conventional research trial pipelines where public benefit of generated evidence is delayed or limited.