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Alghamdi SM, Alzahrani A, Alshahrani YM, Al Ruwaithi AA, Aldhahir AM, Alsulayyim AS, Siraj RA, Almansour AH, Alasmari AM, Alqahtani JS, Alanazi AM, Jaishi ST, Allehyani BA, Hopkinson NS. Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia. BMJ Open 2023; 13:e074849. [PMID: 37709318 PMCID: PMC10503362 DOI: 10.1136/bmjopen-2023-074849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known. DESIGN A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients. SETTING Saudi Arabia. PARTICIPANTS 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists. PRIMARY OUTCOME MEASURES Healthcare providers' level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia. RESULTS 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them. CONCLUSION Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients. TRIAL REGISTRATION NUMBER ISRCTN44651852.
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Affiliation(s)
- Saeed Mardy Alghamdi
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz Alzahrani
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yousef M Alshahrani
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulhadi A Al Ruwaithi
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | - Rayan A Siraj
- Department of Respiratory Therapy, King Faisal University, Al-Hasa, Saudi Arabia
| | - Abdulelah H Almansour
- Department of Family Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali M Alasmari
- Department of Respiratory Therapy, College of Medical Rehabilitation Services, Taibah University, Madinah, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah M Alanazi
- Department of Respiratory Care, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Siraj T Jaishi
- Al-Noor Specialist Hospital, Saudi Arabia Ministry of Health, Makkah, Saudi Arabia
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ALHarbi ER, Wazqar DY, Sofar SM. A quasi-experimental study of the effect of a comprehensive blended health educational program on self-management practices among patients with chronic obstructive pulmonary disease. Heart Lung 2022; 56:133-141. [PMID: 35901603 DOI: 10.1016/j.hrtlng.2022.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The prevalence and illness burden of chronic obstructive pulmonary disease (COPD) are both high. Currently, limited guidance is available to support the establishment of effective health programs to increase self-management practices in patients with COPD. OBJECTIVES To explore the effect of a comprehensive blended health education program on self-management practices in patients with mild-to-moderate COPD in Jeddah City, Saudi Arabia. METHODS A quasi-experimental research study was carried out with a convenience sample of 60 discharged or stable patients with COPD following treatment. Participants were divided into an intervention group (n = 30) that received usual hospital care and blended health education program, and a control group (n = 30) that obtained the usual hospital care without involvement in the health education program from May 2021- to August 2021. Data were collected before and three months after the intervention using the COPD Self-Management Scale and patient socio-demographic and clinical information surveys. RESULTS Statistically significant differences were found between the control and intervention groups after three months of the intervention based on total COPD Self-Management Scale scores. There were no statistically significant relationships between the participants' mean COPD Self-Management Scale scores in both groups with their socio-demographic and clinical characteristics before and after the intervention. CONCLUSIONS A nurse-led, comprehensive blended health education program was found to be an effective method for improving COPD patients' self-management practices. COPD nurses and nurse researchers must collaborate to identify the most common interventions with the best cost/benefit ratios and greater positive effects on early COPD patients' self-management practices and general well-being.
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Affiliation(s)
- Eman Rashed ALHarbi
- Graduate Student, Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, P. O. Box 24828, Jeddah 21551, Saudi Arabia
| | - Dhuha Youssef Wazqar
- Consultant, Associate Professor of Oncology Nursing and Palliative Care, Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Samah Mahmoud Sofar
- Assistant Professor of Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt.
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Aldhahir AM, Alghamdi SM, Alqahtani JS, Alqahtani KA, Al Rajah AM, Alkhathlan BS, Singh SJ, Mandal S, Hurst JR. Pulmonary rehabilitation for COPD: A narrative review and call for further implementation in Saudi Arabia. Ann Thorac Med 2021; 16:299-305. [PMID: 34820017 PMCID: PMC8588944 DOI: 10.4103/atm.atm_639_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable condition, in which outcomes can be improved with careful management. Pulmonary rehabilitation (PR) comprises exercise and education, delivered by multidisciplinary teams. PR is a cost-effective management strategy in COPD patients which improves exercise performance, reduces dyspnea, reduces the risk of exacerbation, and improves health-related quality of life. All COPD patients appear to benefit irrespective of their baseline function, and PR has also been shown to be a clinically and cost-effective management approach following an acute exacerbation. COPD patients with greater disability and those recovering postexacerbation should be specifically targeted for PR. Due to limited current capacity, the latter group may not currently be able to benefit from PR. Therefore, there is a need for the wider implementation of PR services in Saudi Arabia, requiring us to address challenges including capacity and workforce competency.
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Affiliation(s)
- Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.,UCL Respiratory, Royal Free Campus, University College London, London, UK
| | - Saeed M Alghamdi
- Respiratory Care Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jaber S Alqahtani
- UCL Respiratory, Royal Free Campus, University College London, London, UK.,Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Khaled A Alqahtani
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.,Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Ahmed M Al Rajah
- Respiratory Care Department, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia
| | - Bedor S Alkhathlan
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.,Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.,Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre- Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Swapna Mandal
- UCL Respiratory, Royal Free Campus, University College London, London, UK.,Royal Free London NHS Foundation Trust, London, UK
| | - John R Hurst
- UCL Respiratory, Royal Free Campus, University College London, London, UK.,Royal Free London NHS Foundation Trust, London, UK
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Ahmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J 2017; 29:203-211. [PMID: 28955434 PMCID: PMC5610297 DOI: 10.4314/mmj.v29i2.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are a major and increasing global health issue. The World Health Organization (WHO) estimates that NCDs represent 63% of all global deaths of which 3.9 million are due to chronic respiratory diseases (CRDs) and Chronic Obstructive Pulmonary Disease (COPD) in particular. COPD is now the third most common cause of death globally; 90% of these deaths occur in Low and Middle Income Countries (LMICs). COPD affects 329 million people, almost 5% of the world's population. In addition, asthma affects 334 million people, again representing almost 5% of the world's population. There is limited literature published on the epidemiology of COPD and Asthma from Sub-Saharan Africa (SSA) and Middle East and North Africa (MENA). Both diseases are under-diagnosed and underestimated in both SSA and MENA regions. The burden of COPD in sub-Saharan Africa is disputed and reports offer variable prevalence estimates, ranging from 4.1% to almost 22.2%. SSA and MENA countries report similar mortality rates from COPD of 18 per 100,000 population (2001 data). Asthma is a less common cause of death than COPD but is a major cause of morbidity; WHO estimates that there are 250,000 deaths per year from asthma, mainly in LMICs and it remains in the top twenty causes of disability in children globally. Risk factors for CRD are genetic and environmental; the latter dominated by air pollution exposures including tobacco smoke, household air pollution, outdoor air pollution and occupational exposures.
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Affiliation(s)
- Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ryan Robinson
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Alsubaiei ME, Cafarella PA, Frith PA, McEvoy RD, Effing TW. Barriers for setting up a pulmonary rehabilitation program in the Eastern Province of Saudi Arabia. Ann Thorac Med 2016; 11:121-7. [PMID: 27168860 PMCID: PMC4854058 DOI: 10.4103/1817-1737.180028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/06/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) programs proven to be one of the most effective treatment options for respiratory diseases; yet, they are not well-established in hospitals in Saudi Arabia. AIM To determine the main barriers for setting up PR programs in Saudi Arabia. METHODS A cross-sectional study was conducted in the Eastern Province of Saudi Arabia. Health care providers involved in treatment of chronic obstructive pulmonary disease (COPD) patients were recruited from 22 general government hospitals. Data were collected using questionnaires: Full version if they had heard about PR before the study, and a short version if they had not heard about PR before. RESULTS A total of 123 health care providers were recruited (physicians [n = 44], nurses [n = 49], and respiratory therapists/technicians [n = 30]). Only 3.2% of the recruited health care providers had heard about PR programs before. According to the health care providers, the main barriers for setting up PR programs were a lack of (1) hospital capacity (75.6%), (2) trained health care providers (72.4%), and (3) funds (48.0%). There were significant differences in barriers reported by the health care providers. Compared to physicians, nurses were more likely to nominate the PR costs as a barrier (18.0% vs. 38.8%; P < 0.05). CONCLUSION There is a worrisome lack of knowledge regarding content and benefits of PR programs among Saudi health care providers treating COPD patients. These findings imply that improving awareness and increasing education of the health care providers regarding PR will be required before PR can be more widely implemented as an integral treatment modality for patients with COPD in Saudi Arabia.
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Affiliation(s)
- Mohammed E. Alsubaiei
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Flinders University, Adelaide, Australia
- Department of Respiratory Medicine, School of Medicine, Flinders University, Adelaide, Australia
| | - Paul A. Cafarella
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Flinders University, Adelaide, Australia
- Department of Respiratory Medicine, School of Medicine, Flinders University, Adelaide, Australia
| | - Peter A. Frith
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Flinders University, Adelaide, Australia
- Department of Respiratory Medicine, School of Medicine, Flinders University, Adelaide, Australia
| | - R. Doug McEvoy
- Department of Respiratory Medicine, School of Medicine, Flinders University, Adelaide, Australia
- Department of Sleep and Respiratory Medicine, Adelaide Institute for Sleep Health, Southern Adelaide Local Health Network, Daw Park, SA, Australia
| | - Tanja W. Effing
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Flinders University, Adelaide, Australia
- Department of Respiratory Medicine, School of Medicine, Flinders University, Adelaide, Australia
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