National and Regional Rates of Chronic Diseases and All-Cause Mortality in Saudi Arabia-Analysis of the 2018 Household Health Survey Data

Effects of the Stanford Chronic Conditions Model on Behavioral and Clinical Indicators in Saudi Arabia: A Prospective Quasi-Experimental Study

Purpose

This study aimed to evaluate the 6-month impact of the Chronic Disease Self-Management Program based on the Stanford chronic condition model on behavioral and clinical indicators in individuals with chronic illnesses.

Patients and Methods

This prospective, quasi-experimental study was conducted in primary healthcare centers located in Riyadh, Saudi Arabia. A total of 110 adults aged 18 years or older, living with at least one chronic disease, and receiving treatment at a primary healthcare center were included. We compared patients who received the Chronic Disease Self-Management Program with those who received the usual care from primary healthcare centers. Data analysis included analysis of descriptive and covariance statistics.

Results

The analysis of covariance indicated that individuals who received the Chronic Disease Self-Management Program had significantly lower systolic (F=5.60, p<0.05) and diastolic blood pressure (F=7.60, p<0.01). These patients were more likely to adopt healthy behaviors to manage their chronic illnesses (F=11.17, p<0.01). However, no significant differences were observed in the HbA1c values of the patients.

Conclusion

We recommend incorporating the Stanford Chronic Disease Self-Management Program into patient education to foster peer support for effective chronic disease management.

Public perceptions and attitudes of drive-through pharmacy services: Insights from a cross-sectional survey in Saudi Arabia

Disease-related fatalities in Saudi Arabia (SA) are on the rise, with 28% of all deaths attributed to cardiovascular diseases, followed by cancer, diabetes, and chronic respiratory disorders. In response to this issue, pharmacy dispensing practices have been significantly altered. One such innovative approach is the drive-through pharmacy service. This study aimed to assess the public perceptions and attitudes of drive-through pharmacy services living in Riyadh, SA. A cross-sectional, web-based study was conducted between October 2023 and December 2023 among adults living in Riyadh, SA to assess their perceptions and attitudes toward drive-through dispensing practice. A 19-item questionnaire, divided into 4 sections, was used to achieve the objectives. The first section focused on demographics and personal information. The second section included 3 questions about awareness, the population most benefited, and support. The final section assessed attitudes (5 items) of individuals toward drive-through pharmacy services. A response rate of 79.6% (n = 398) was achieved. A significantly high percentage of respondents, 86.2% (n = 343), reported being aware of drive-through pharmacy. Furthermore, 73.1% of them indicated that drive-through service benefits all populations, with 66.1% (n = 263) actually using the drive-through pharmacy service. In addition, 68.1% (n = 271) of individuals had positive perceptions. Positive perceptions were found to be higher among young adults aged 26 to 35 years compared with other age groups (P = .0001), among married individuals compared with unmarried individuals and others (P = .0001), as well as among housewives (P = .030). The results of the Student t test showed that males had a higher mean overall perception of drive-through pharmacy services (9.33) than females (9.26). Similarly, the analysis of variance analysis showed that individuals aged ≥46 years had a higher perception score (12.53) than other age groups. Furthermore, individuals with children had a lower perception (8.94) compared with those without children, indicating a statistically significant difference in mean perceptions of drive-through pharmacy based on gender (P = .002), age (P = .006), employment (P = .081), and presence of children (P = .001). Most respondents were aware of the drive-through pharmacy services and agreed that they would benefit the nation's entire population. The majority of individuals also supported the expansion of drive-through pharmacy services.

Healthcare Priorities, Barriers, and Preferences According to a Community Health Needs Assessment in Jazan, Saudi Arabia: A Cross-Sectional Study

Background: Community needs assessments can provide valuable insights concerning the health of communities. This study aims to measure health priorities according to community members in Jazan, Saudi Arabia, to assess healthcare service utilization, barriers to accessing these services, and preferences for utilizing government or private healthcare services. Method: Multistage sampling was utilized to reach a sample of adults in community settings. The assessment was performed via personal interviews utilizing a structured questionnaire to measure demographics, health priorities, service utilization, barriers, and preferences for healthcare settings. Chi-squared tests, Student's t-tests, and multivariate regression analysis were used to assess the differences between demographics and service utilization according to the preferred healthcare settings. Results: A total of 3411 participants were recruited for the assessment. The mean age of the participants was 34 years, and 51% were male. The participants viewed diabetes as the most important health condition. Emergency services and primary care were viewed as the most important healthcare services, and time constraints were the main barriers to healthcare accessibility. Thirty-six percent of the participants preferred to utilize healthcare services in the private sector, where age, gender, nationality, education, income, housing type, and family size were statistically associated with the preference for seeking healthcare in either the private or government sectors (p < 0.05). Conclusions: Future assessment is required to recruit healthcare providers and decision-makers to understand the process of strengthening multidisciplinary collaboration to tackle chronic diseases such as diabetes, strengthen the role of emergency and primary healthcare services, and address time constraints pertaining to healthcare accessibility.

Prevalence and Predictors of Premature Graying of Hair Before the Age of 30: A Cross-Sectional Study in Saudi Arabia

BACKGROUND

Graying is an inherent and unavoidable consequence of the aging process, impacting individuals of all genders. There are limited studies in Saudi Arabia that have examined the prevalence and predictors of premature graying of hair (PGH).

OBJECTIVES

This study aims to explore the prevalence and predictors of PGH before the age of 30 among the population of Saudi Arabia.

METHODS

This is a cross-sectional online survey that was conducted between July 2023 and February 2024 in Saudi Arabia. Binary logistic regression analysis was used to identify risk factors of having gray hair before the age of 30.

RESULTS

A total of 1193 participants were involved in this study. A significant portion of respondents reported having gray hair before the age of 30 (55.9%). The younger population (younger than 44 years), smokers, and those who have comorbidities, have anxiety, have depression, have a family history of gray hair before the age of 30 years, have a dry scalp, suffer from vitamin or mineral deficiencies, have hair loss due to immune diseases (such as alopecia), and use minoxidil or rosemary for hair loss were more likely to have gray hair before the age of 30 years (p < 0.05).

CONCLUSION

This study highlighted the high prevalence rate and associated predictors of PGH in Saudi Arabia. Identified predictors include genetic, health, and lifestyle factors. Healthcare professionals and decision makers are advised to promote the awareness of the general public on its risk factors to enhance the prevention of PGH. Public health initiatives include campaigns on smoking cessation, healthy nutrition, and mental health.

Showcasing the Saudi e-referral system experience: the epidemiology and pattern of referrals utilising nationwide secondary data

Introduction

Referrals are an integral part of any healthcare system. In the Kingdom of Saudi Arabia (KSA) an electronic referral (e-referral) system known as the Saudi Medical Appointments and Referrals Centre (SMARC) began formally functioning in 2019. This study aims to showcase the Saudi experience of the e-referral system and explore the epidemiology of referrals nationally.

Methods

This retrospective descriptive study utilised secondary collected data between 2020 and 2021 from the SMARC system. Cross tabulations with significance testing and colour-coded maps were used to highlight the patterns across all regions.

Results

The study analysed over 600,000 referral requests. The mean age of patients was 40.70 ± 24.66 years. Males had a higher number of referrals (55.43%). Referrals in 2021 were higher than those in 2020 (56.21%). Both the Autumn and Winter seasons had the highest number of referrals (27.09% and 27.43%, respectively). The Surgical specialty followed by Medicine had the highest referrals (26.07% and 22.27%, respectively). Life-saving referrals in the Central region were more than double those in other regions (14.56%). Emergency referrals were also highest in the Southern regions (44.06%). The Central and Eastern regions had higher referrals due to unavailable sub-speciality (68.86% and 67.93%, respectively). The Southern regions had higher referrals due to both unavailable machine and unavailable beds (18.44% and 6.24%, respectively).

Conclusion

This study shows a unique system in which referrals are between secondary, tertiary, and specialised care. It also highlights areas of improvement for equitable resource allocation and specialised care in slightly problematic areas as well as the use of population density in future planning.

External Vs Internal e-Referrals: Results from a Nationwide Epidemiological Study Utilizing Secondary Collected Data

Background

E-referral systems, streamlining patient access to specialists, have gained global recognition yet lacked a comparative study between internal and external referrals in Saudi Arabia (KSA).

Methods

This retrospective study utilized secondary data from the Saudi Medical Appointments and Referrals Centre system. The data covers 2020 and 2021, including socio-demographic data, referral characteristics, and specialties. Logistic regression analysis was used to assess factors associated with external referrals.

Results

Out of 645,425 e-referrals from more than 300 hospitals, 19.87% were external. The northern region led with 48.65%. Males were 55%, and those aged 25-64 were 56.68% of referrals. Outpatient clinic referrals comprised 47%, while 61% of referrals were due to a lack of specialty services. Several significant determinants are associated with higher rates of external referral with (p-value <0.001) and a 95% Confidence interval. Younger individuals under 25 exhibit higher referral rates than those aged 25-64. Geographically, compared to the central region, in descending order, there were increasing trends of external referral in the northern, western, and southern regions, respectively (OR = 19.26, OR = 4.48, OR 3.63). External referrals for outpatient departments (OPD) and dialysis services were higher than for routine admissions (OR = 1.38, OR = 1.26). The rate of external referrals due to the lack of available equipment was more predominant than other causes. Furthermore, in descending order, external referrals for organ transplantation and oncology are more frequent than for medical specialties, respectively (OR = 9.39, OR = 4.50).

Conclusion

The study reveals trends in e-referrals within the KSA, noting regional differences, demographic factors, and types of specialties regarding external referrals, benefiting the New Model of Care for the 2030 Vision. Findings suggest expanding virtual consultations to reduce external referrals. Strengthening primary care and preventive medicine could also decrease future referrals. Future studies should assess resource distribution, including infrastructure and workforce, to further inform healthcare strategy.

Social determinants of anxiety and mood disorders in a nationally-representative sample - Results from the Saudi National Mental Health Survey (SNMHS)

INTRODUCTION

Social determinants of health (SDH) influence and modify the risk for mental health disorders. To our knowledge, no study has explored SDH in the context of mental health in Saudi Arabia (SA) using population-based data. This study investigated the association between several SDH and anxiety and mood disorders in SA.

METHODS

We utilized data from the nationally-representative Saudi National Mental Health Survey (SNMHS) conducted in 2014 to 2016. This study examined associations between personal-level, socioeconomic, physical health, and family environment characteristics and anxiety and mood disorders. Participants were classified as having anxiety-only disorders, mood-only disorders, or comorbidity of both disorders. Multinomial logistic regression models were employed to examine the associations between SDH and anxiety and/or mood disorders, comparing them to participants who had not experienced these disorders.

RESULTS

A total of 4,004 participants were included in this analysis; the lifetime prevalence of disorders was: anxiety only (18%), mood only (3.8%), and comorbidity of both (5.3%). Regression models indicated that females, young adults (26-35 years), individuals with a higher level of education, and those who were separated or widowed had higher odds of experiencing anxiety and/or mood disorders. Furthermore, there was a significant and direct association between having physical chronic conditions and all three categories of anxiety and mood disorders. Experiencing Adverse Childhood Events (ACEs) was also associated with a significant risk of developing anxiety and/or mood disorders, with the highest risk associated with physical or sexual abuse, followed by violence and neglect.

CONCLUSION

This study underscores the correlation between several personal-level, socioeconomic, and environmental SDH and anxiety and mood disorders in SA. These findings provide a foundation for future analyses examining the intricate interplay between upstream and downstream SDH in SA. Such research can enhance local scientific knowledge, aid in planning for social services, and inform policy decisions and treatment strategies.

Molecular role of non-exonic variants in CALPAIN 10 gene in polycystic ovarian syndrome in Saudi women

Introduction

Non-diabetic women with polycystic ovarian syndrome (PCOS) often have abnormal insulin regulation. Calpain 10 (CALP10) is a biomarker of type 2 diabetes mellitus, with some of its single-nucleotide polymorphisms (SNPs) influencing PCOS development.

Methods

In this case-control study on 90 women each with and without PCOS, we explored the molecular role of five CALP10 SNPs using biochemical parameters and Sanger sequencing analyses.

Results

Different genetic models, genotypes, and allele frequencies were significantly associated with UCSNP-19 (rs3842570; p=0.01), UCSNP-44 (rs2975760; p=0.009), UCSNP-56 (rs2975762; p<0.0001), and UCSNP-63 (rs5030952; p=0.0003) in women with PCOS. The multiple logistic regression model showed a strong association of CALP10 SNPs with fasting blood glucose (p<0.001). ANOVA showed significant associations with various biochemical parameters such as FSH (p=0.0001) in UCSNP-19 (rs3842570), FI (p=0.002), TG (p=0.01) in UCSNP-56 (rs2975762) and FBG (p=0.001), FI (p=0.004), FSH (p=0.02) & LDLc (p=0.04) in UCSNP-63 (rs5030952) SNPs. Haplotype analysis also revealed significant associations between different combinations of alleles in the studied 5 SNPs in women with PCOS (p<0.05). Generalized multifactor dimensionality reduction analysis showed the best gene-gene interactions among the five SNPs in CALP10I (p<0.05). However, dendrogram and graphical depletion models found no strong association in women with PCOS.

Conclusion

In conclusion, this study confirms rs3842570, rs2975760, rs2975767, and rs5030952 SNPs in CALP10 gene is associated in diagnosed PCOS women in the Saudi Arabia.

Use of social media for the improvement of safety knowledge and awareness among Saudi Arabian phlebotomists

Purpose

The purpose of this study is to investigate the use of social media for the improvement of safety knowledge and awareness among phlebotomists.

Methods

As this study was intended to arrive at specific conclusions using empirical evidence, a deductive quantitative cross-sectional online survey design was adopted. A total of 521 phlebotomists participated in the survey, and 86 incomplete responders were removed, resulting in a final sample of 435 considered in this study. T-tests and ANOVA were used to analyze the data.

Results

A total of 41.6% stated that social media was very effective, and 31.5% stated that it was somewhat effective in improving safety knowledge and awareness. in addition, this study revealed no major differences between male and female participants (p > 0.05) with respect to the effectiveness of social media. However, statistically significant differences (p < 0.05) among the age groups were identified in relation to the effectiveness of social media and the intention to use it in the future.

Conclusion

Social media applications are effective for knowledge dissemination among healthcare professionals.