@article {139, title = {Analysis of Antimicrobial Medication Consumption in Intensive Care Unit, North West (Tabuk) Region Hospitals, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {August 2019}, pages = {119-123}, type = {Research Article}, chapter = {119}, abstract = {

Objectives: This article describes antimicrobial medication use among different age groups and the cost associated with it in intensive care units at North West (Tabuk) hospitals, Saudi Arabia. The aim of this study to explore the antimicrobial medication use in intensive care units at North West Region Hospitals, Ministry of Health, Saudi Arabia. Methods: It is a 12-month antimicrobial drug use by intensive care units at North West region hospitals which included critical care for adults, pediatrics and neonates. The medications selected by Central Antibiotics committee at MOH as part of the National Antimicrobial Stewardship program. The consumption was driven from pharmacy database and calculated based on off standard unit of antimicrobials per hospital. The antimicrobials consisted of antibacterial drugs, antifungal and antiviral medications. The cost of antimicrobial consumption was calculated by using the Ministry of Health National Cost database. All cost used were as US currency. Results: The total number of antimicrobial standard units were (14,305) and average (2,861) per hospital. The highest drug consumption was Ceftriaxone 1 gm injection (2724) followed by Imipenem 500 mg injection (1251) and Vancomycin 500 injection (1165). The total cost of Antimicrobial consumption was (53,884.95 USD) and (10,777 USD) per each hospital. The highest cost medication consumption from Adults critical care 73.42\% (39,562.33 USD) followed by pediatrics critical care 18.15\% (9,779.93 USD) and Neonates critical care 8.43\% (4,542.68 USD). The highest medication cost was very broad-spectrum antibiotics like Meropenem, Imipenem and Ceftriaxone. It consumed more than 50\% of the cost burden. Conclusion: This study is the first in Saudi Arabia, Gulf and Middle East countries. Health system pharmacist leaders are targeting to implement the antimicrobial stewardship program and National Drug Utilization Evaluation system to control unnecessary medication expenditure and prevent misuse of medicines.

}, keywords = {Knowledge, Medications, Ministry of Health, Patient, Saudi Arabia}, doi = {10.5530/PTB.2019.5.22}, author = {Yousef Ahmed Alomi and Abeer Hussin Almasoudi and Ghormallah Abdullah Alghamdi and Samira Ali Asiri} } @article {141, title = {Analysis of Antimicrobial Medications Consumption in Inpatient Units at North West (Tabuk) Region Hospitals, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {August 2019}, pages = {130-134}, type = {Research Article}, chapter = {130}, abstract = {

Background: This article aims to explore antimicrobial medication consumption and related cost among different age groups in inpatient units at North West Region Hospitals, Ministry of Health, and Saudi Arabia. Objectives: To explore the selected antimicrobial medication consumption in inpatient units at North West Region Hospitals, Ministry of Health, Saudi Arabia. To increase the awareness of antimicrobial medication consumption side effect. Methods: It is a 9-month study about antimicrobial drug use by inpatients at North West region hospitals. It included inpatient department for adults, pediatrics and neonates. The medications were selected by Central Antibiotics committee at MOH as part of the National Antimicrobial Stewardship program. The consumption is driven from pharmacy database and calculated based on off-stranded unit of antimicrobial per hospital. The antimicrobials consisted of antibacterial drugs, antifungal and antiviral medications. The cost of antimicrobial consumption was calculated by using Ministry of Health National Cost database. All cost used as US currency. Results: The total number of Antimicrobial standard units was (25,845) and average (5,169) per hospital. The highest drug consumption was Ceftriaxone 1 gm injection (3,712) followed by Ceftazidime 1 gm injection (1807) and Gentamicin IV 80 mg (1,011) at adult{\textquoteright}s inpatient wards. The total cost of Antimicrobial consumption was (6,829,003.42 USD) and (1,365,800.68 USD) per hospital. The highest cost medication consumption from Adults inpatient departments was 99.62\% (6,803,229.92 USD) followed by pediatrics inpatient 0.24\% (16,087.6 USD) and Neonatal inpatient departments 0.14\% (9,685.9 USD). The highest medication cost was for very broad-spectrum antibiotics like Meropenem, Imipenem and Ceftriaxone. It consumed more than 50\% of the cost burden. Conclusion: There was very high consumption of antimicrobial drugs inpatient department with huge cost burden. Urgent application of antimicrobial stewardship program especially adults{\textquoteright} inpatients departments is a mandate and urgent.

}, keywords = {Antimicrobial, Consumption, Hospitals, Inpatient, Medications, Ministry of Health, North West (Tabuk), Saudi Arabia}, doi = {10.5530/PTB.2019.5.24}, author = {Abeer Hussin Almasoudi and Yousef Ahmed Alomi and Ghormallah Abdullah Alghamdi and Rasha Saad Alshahrani} } @article {146, title = {Cost Analysis of Delivery Adult Medication Therapy Services at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S1-S3}, type = {Research Article}, chapter = {S1}, abstract = {

Objectives: The aim of this study is to explore the cost analysis of drug delivery therapy services for adults{\textquoteright} population at Ministry of Health in Saudi Arabia by using American Model with local cost. Methods: It is a cross-sectional 6-months analysis of drug distribution services for adult patients conducted in 2016. It was at 300-bed maternity and pediatrics hospital in Riyadh, Saudi Arabia. The cost calculated adults drug therapy management services delivered to 144 beds. The physician prescribed the medications. The pharmacist reviewed and prepared drugs and distributed through the unit dose system, floor stock distribution and discharge medication services. The fast-moving oral and topical medications were included in the study. The cost model was calculated based on variable expenses including personal cost, material and supply cost. The fixed cost was including direct cost, non-salary cost and overhead cost. All cost was used of US dollar currency and local prices. Results: The estimated cost of drug delivery therapy services for all total number adults{\textquoteright} beds per day was (1,191.965 USD). It contained three types; the unit dose system (761.35 USD), drug floor stock distribution system (334.99 USD) and discharge medication system (95.62 USD). The cost of delivery of medicines to single bed per day was (13.99 USD) with the highest estimated cost of delivery from discharge medication (6.37 USD), followed by unit dose services (5.29 USD) and floor stock therapy (2.33 USD). The total estimated annual expenditures of drug distribution services were (435,067.15 USD). Conclusion: In this adults medication therapy services cost-estimation the first study was conducted at MOH in Saudi Arabia. It is an essential necessary element of the Pharmacoeconomic program and implements Saudi{\textquoteright}s future vision 2030 for drug therapy health care services.

}, keywords = {Adult, Cost, Delivery, Distrubution, Medication, Ministry of Health, Saudi Arabia, Services, Therapy}, doi = {10.5530/PTB.2019.5.28}, author = {Yousef Ahmed Alomi and Malika Alhadab and Tahani Alotaibi} } @article {149, title = {Cost Analysis of Neonatal Drug Distribution Services at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S17-S19}, type = {Research Article}, chapter = {S17}, abstract = {

Objectives: The cost estimation of delivery of drug therapy management (unit dose, floor stock and discharge) for neonatal inpatient is a part of the pharmacoeconomic program and changing the system to the Saudi vision 2030 at MOH in Saudi Arabia. The study explored the cost calculations of delivery of drug therapy services for neonate{\textquoteright}s population by using American Model with local cost. Methods: It is cross-sectional 6-months analysis of drug distribution services for neonate patients conducted in 2016. It was at 300-Bed Maternity and Pediatrics Hospital in Riyadh, Saudi Arabia. The cost analysis consisted of three domains. Domain one; the cost of delivery of Adults drug therapy management with 144 beds. Domain two; the cost of delivery of pediatrics drug treatment services with 55 beds. Domain three; cost of delivery for neonate{\textquoteright}s therapy services with 82 beds. For each domain, the physician prescribed the medications. The pharmacist reviewed and prepared drugs and distributed through unit dose system, floor stock distribution and discharge medications. The nurse administered drugs and followed up with doctors. The drugs were prepared through ASHP standards and facilities. The oral and topical ready to deliver drugs were included in the study while sterile product and compounding formulations were excluded from the study. The cost was derived from Ministry of Health information database. The cost model was calculated based on variable expenses including personal cost, material and supply cost. Fixed costs including direct cost, non-salary cost and overhead cost. All cost was used US dollar currency and local prices. This study analyses the three domains. Results: The estimated daily cost of neonatal unit dose drug distribution system for all total pediatrics 82 beds was (1,303.31 US). It contained three types; the unit dose system (794.83 USD), drug floor stock distribution system (371.37 USD) and discharge medication system (137.11 USD). The cost of delivery of medicines to single bed per day was (41.64 USD) with highest estimated cost of delivery from discharge medication (27.42 USD), followed by unit dose services (9.69 USD) and floor stock therapy (4.53 USD). The majority of cost came from overhead cost in floor stock services and discharge medication delivery; while the personal cost in unit dose services delivery. The total estimated annual expenditures of drug distribution services were (475,708.15 USD). Conclusion: The estimated cost of delivery of neonatal medication therapy is a part of the pharmacoeconomic program at pharmacy services and future vision 2030 in Saudi Arabia.

}, keywords = {Analysis, Cost, Distribution, Drug, Ministry of Health, Neonatal, Saudi Arabia, Services}, doi = {10.5530/PTB.2019.5.32}, author = {Yousef Ahmed Alomi and Malika Alhadab and Tahani Alotaibi and Awatif Faraj Alshammari and Nouf Alhaze} } @article {150, title = {Cost of Pediatrics Drug Therapy Services at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S9-S11}, type = {Research Article}, chapter = {S9}, abstract = {

Objectives: The aim of this study is to explore the estimation cost of delivery drug therapy services for pediatrics by using American Model with local cost in the Kingdom of Saudi Arabia. Methods: It is a cross-sectional 6-months analysis of drug distribution services for pediatric conducted in 2016. It was at 300-bed maternity and pediatrics Hospital in Riyadh, Saudi Arabia. The cost was calculated pediatrics drug therapy management services delivered to 55 beds. The physician prescribed the medications. The pharmacist reviewed and prepared drugs and distributed through unit dose system, floor stock distribution and discharge medications services. The medications were prepared through ASHP standards and facilities. The fast moving oral and topical medications were included in the study. The cost model was calculated based on variable expenses including personal cost, material and supply cost. Fixed cost was including direct cost, non-salary cost and overhead cost. All cost was used of US dollar currency and local prices. Results: The estimated cost of delivery of drug therapy services for all total number pediatrics beds per day was (1,214.68 USD). It consisted of three types; the unit dose system (771.89 USD), drug floor stock distribution system (350.32 USD) and discharge medication services (92.47 USD). The majority of cost came from overhead cost in floor stock services and discharge medication delivery; compared to the personal cost in unit dose services delivery. The total estimated annual expenditures of Drug distribution services were (443,358.20 USD). The highest budget expenditures from unit dose services 63.55\% (281,739.85 USD), followed by floor stock medication delivery 28.84\% (127,866.80 USD) and discharge drug therapy 7.61\% (33,751.55 USD). Conclusion: The estimation cost of delivery pediatrics drug therapy is the first study in the Middle East, Gulf countries and Saudi Arabia. It is basic element of cost calculation of pediatrics-related health care services.

}, keywords = {Cost, Drug, Ministry of Health, Pediatrics, Saudi Arabia, Services, Therapy}, doi = {10.5530/PTB.2019.5.30}, author = {Yousef Ahmed Alomi and Malika Alhadab and Tahani Alotaibi and Awatif Faraj Alshammari and Nouf Alhaze} } @article {148, title = {Cost-effectiveness Analysis of Medication Safety Program at Pediatrics, Obstetrics and Gynecology Hospital, East Province, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S12-S16}, type = {Research Article}, chapter = {S12}, abstract = {

Objectives: Medication safety program initiated at East Province of Ministry of Health in 2013. The pharmacist prevents all drug related problems. To improve continuity of care at hospital admission, discharge and to diminution medication errors medication safety programs are established. The objective of this study was to evaluate the cost-effectiveness of the Medication Safety program at the hospital in East province, Saudi Arabia by using International Study Model. Methods: This cross-sectional study with a 12-month recruitment period was conducted in a 500-bed Pediatrics, Obstetrics and Gynecology Hospital through preventing and documentation of medication errors in adults and pediatrics at Ministry of Health hospitals in 2015. The hospital had medication safety officer with medication safety committee. The program led by trained pharmacist and delivered basic patient safety in medical education to all healthcare professionals. The expected cost calculated using International Study Model, expressed in United State Dollars (USD), the cost measured were the expected results of medication errors outcome if not stopped; starting from ambulatory care visit or community pharmacy, additional laboratory test, hospital or critical care admission or even death complications. Results: The total number of prevented medication errors were 2071 at 827 prescribed to 827 patients with an estimated cost avoidance of avoiding medication was (116,228.41 USD) annually. The most estimated cost avoidance was prescriber related and general errors was 99.12\% (115.201.9 USD). The pharmacist avoided medication errors with estimated cost avoidance of drug related problem (140.54 USD) per each prescription and (56.12 USD) per error. The most common categories of medications cost avoidance were Musculoskeletal and joint disease (8,397.2 USD) followed by Infections (5,731.17 USD) and Nutrition class (4,717.99 USD). The highest drug of cost avoidance were Insulin injection (39,964.32 USD), iron tablet (11,526.9 USD) folic acid tablet (11,526.9 USD) and calcium tablet (11,526.9 USD) and Enoxaparin injection (9,637.02 USD). There were three high-risk medication founded with Insulin, Enoxaparin and Heparin errors with (42.9\%) of annual total cost avoidance. Conclusion: Medication safety program is a cost-efficiency replication at Pediatrics, Obstetrics and Gynecology Hospital in Saudi Arabia, prevents medication misadventures, improve patient safety and education. Growing drug safety program related with preventing drug-related problems and cost avoidance replication for Healthcare improvement, better care and better patient consequences.

}, keywords = {Cost, Efficiency, Medication, Ministry of Health, Obstetrics and Gynecology, Pediatrics, Safety, Saudi Arabia}, doi = {10.5530/PTB.2019.5.31}, author = {Yousef Ahmed Alomi and Amal Ahmad Alanazi and Mohammed Mohsen Almaznai and Fatimah Ali Albusalih} } @article {151, title = {Cost-efficiency of Clinical Pharmacy Services at Ministry of Health Hospital, Riyadh City, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S20-S22}, type = {Research Article}, chapter = {S20}, abstract = {

Objectives: The primary aim of this study was to estimate cost-efficiency of clinical pharmacy services in Saudi Arabia by using American model. Methods: This is a simulation study which includes data of all 5 months of providing clinical pharmacy services for adults organized by local drug information center at biggest public hospital in Riyadh city. Ten clinical pharmacists and expert trained pharmacists provided clinical pharmacy services at the hospital including drug information services, poisoning control services, therapeutic drug monitoring services, orthopedic services, oncology services, Pharmacoeconomical services and pain management services. All pharmacists should document the clinical pharmacy activities on a monthly basis. The estimated cost avoidance was calculated by using two International Studies Models, expressed in US dollars (USDs). The cost considered were the expected results of drug-related inquiries, poisoning information calls if not resolved and pharmacist intervention for all other clinical pharmacy services. Results: The total average estimated monthly cost avoidance from all clinical services (17,554,931.46 USD) with cumulative cost avoidance was 65,830,992.97 USD during the study period. The estimated total cost avoidance annually was 210,659,177.52 USD. The highest cost avoidance came from poisoning services, whose estimated cost avoidance was 61.8\% (9,110,026.40 USD) followed by drug information services, whose estimated cost avoidance was 26.8\% (4,711,273.50 USD) and other clinical pharmacy services, whose estimated cost avoidance was 11.4\% (2,006,444.63 USD). Each USD invested in the clinical pharmacist estimated cost avoidance was an average of 28.76 USD. Each USD invested in the clinical pharmacist provides poisoning control services estimated cost avoidance was an average of 17.77 USD and each USD invested in the clinical pharmacist provide drug information services estimated cost avoidance was an average of 7.7 USD. Conclusion: The clinical pharmacy services had a very high economic impact on the healthcare system in the local public hospital. In the future, we are targeting to expand the clinical pharmacy services to prevent drug-related cost in the Kingdom of Saudi Arabia.

}, keywords = {Clinical pharmacy, Cost-efficiency, Ministry of Health, Riyadh, Saudi Arabia}, doi = {10.5530/PTB.2019.5.33}, author = {Yousef Ahmed Alomi and Sultan Mohammed Al-Jarallah and Faiz A. Bahadig} } @article {147, title = {Cost-Efficiency of Medication Safety Program at Public Hospital, Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S4-S8}, type = {Research Article}, chapter = {S4}, abstract = {

Objectives: Medication safety program started at Riyadh city of Ministry of Health in 2014. Identifying, resolving and preventing drug therapy problems are the unique contributions of the pharmaceutical care practitioner. The research aimed to estimate cost-efficiency of Medication Safety program at the hospital in East province, Saudi Arabia by using American model of pharmacist intervention cost avoidance. Methods: This cross-sectional study with a 9-month recruitment period was conducted in a 300-bed public hospital through preventing and documentation of medication errors in adults and pediatrics at Ministry of Health hospitals in 2015. The program led by trained pharmacist and delivered basic patient safety in medical education to all healthcare professionals. The predictable cost calculated using International Study Model, expressed in USD, the cost measured were the expected results of medication errors outcome if not stopped; starting from physician visit, additional laboratory test, further treatment, hospital admission and critical care admission to death stage. Results: The total number of prevented medication errors were 3,378 at 805 prescribed to 805 patients with an estimated cost avoidance of avoiding medication errors was (98,195.97 USD) for the study period and (10,910 USD) per month. The pharmacist avoided medication errors with estimated cost avoidance of drugrelated problem (29 USD) per each mistake and (122 USD) per prescription and patient. The most type inquiries estimated cost avoidance was prescribing stage 86,939.05 USD (99.86\%), followed by drugrelated errors 7,061.26 USD (7.2\%) and dosage form-related errors 6,084.98 USD (6.2\%). The highest drug of cost avoidance were Musculoskeletal and joint disease (8,397.2 USD) followed by Infections (5,731.17 USD) and Nutrition (4,717.99 USD), while the largest drug of cost avoidance was Paracetamol Injection (5,812.17 USD), followed by oral Ferrous Sulfate (3,562.79 USD) and Ceftriaxone 1g (2,861.70 USD). Conclusion: Medication safety program is a cost-efficiency simulation at the public hospital in Saudi Arabia, prevents medication disasters, improve patient safety. Increasing drug safety program associated with preventing drug-related problems and cost avoidance simulation for Healthcare development and better care and better patient consequences.

}, keywords = {Cost-efficiency, Hospital, Medication, Ministry of Health, Public, Riyadh, Safety, Saudi Arabia}, doi = {10.5530/PTB.2019.5.29}, author = {Yousef Ahmed Alomi and Mona Awad Alanazi and Radi Abdullah Alattyh and Fatimah Ali Albusalih} } @article {123, title = {Drug Evaluation Steps of Ministry of Health Drug Formulary in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {8-15}, type = {Review Article}, chapter = {8}, abstract = {

Objective: To illustrate the Drug Evaluation Steps of Ministry of Health Drug Formulary at Health care institutions in the Kingdom of Saudi Arabia. Method: It is description analysis of Drug Evaluation Steps of drug information service at the Ministry of Health of Health institutions. The modified pharmacy business model system and Project Management Procedure used in the report. Results: The Drug Evaluation Steps established with a defined vision, mission and goals. The system human or economic and other resources described in the review. The risk management was discussed to assure the continuation of the system. Besides, the monitoring and controlling of the system as illustrated. The closing stage with convention to operation project demonstrated in the analysis. Conclusion: The drug evaluation steps system implemented and it is considered as part of the health care system and drug information centers regulations. The drug evaluation Steps needs the continuous updating accordingly at all Ministry of Health strategic planning in the Kingdom of Saudi Arabia.

}, keywords = {Drug Evaluation, Drug Formulary, Ministry of Health, Saudi Arabia, Steps}, doi = {10.5530/PTB.2019.5.3}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {154, title = {The Economic Outcomes of Pharmacist Interventions in Total Parenteral Nutrition Services in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S40-S49}, type = {Research Article}, chapter = {S40}, abstract = {

Objectives: There are several problems and complications related to the Total Parenteral Nutrition (TPN) services. The pharmacist plays a crucial role in preventing these problems. Therefore, in this study, we aimed to assess the economic outcomes of pharmacist intervention in cost avoidance related to TPN services at a public hospital in Riyadh city, Saudi Arabia. Methods: Cohort prospective analysis of data collected regarding pharmacist intervention in TPN services provided to neonates, pediatrics and adult patients was performed. TPN services were provided 8 hr in a day and 7 days in a week. The study site was a 300-bed public hospital at the Ministry of Health (MOH) in Riyadh city, Saudi Arabia. The pharmacist reviews and prepares TPN and he pharmacist documents any or all TPN-related problems before the preparation of TPN or after dispensing it. The pharmacist uses an International Study Model to measure level of activity and provides rational of clinical intervention, recommendation, patient outcome, impact of pharmacoeconomics and related cost analysis. Results: The pharmacist identified a total of 402 TPN-related problems. The total number of TPN services provided was 394 prescribed to 82 patients. Of these, 209 (51.99\%) and 193 (48.01\%) interventions were provided to males and females, respectively. The total cost avoidance from pharmacist intervention in 1 year was 578,926.89 USD. The highest cost avoidance of TPN interventions was recorded for potentially significant (54.90\%; 100,040.91 USD) and potentially serious problems (33.33\%; 244,696.83 USD). The maximum cost avoidance in the case of rational clinical activities was recorded for TPN consultations (325,695.76 USD) followed by incompatibility (275,802.66) and inappropriate route (189,912.34 USD). The maximum cost avoidance related to patient outcome was recorded for patient condition improved (489,830.93 USD) and laboratory value improved (89,095.96). The maximum pharmacoeconomic cost avoidance impact was the patient duration of hospital stay decreased (226; 332,220.70 USD) and reduction in the drug therapy monitoring (246,227.15 USD). Conclusion: The clinical pharmacist responsible for TPN services plays an essential role in preventing TPN-related problems and avoid the unnecessary economic burden on the healthcare system. Expanding the role TPN clinical pharmacist is highly recommended for all TPN services to reduce the economic burden on healthcare system in Saudi Arabia.

}, keywords = {Economic outcome, Ministry of Health, Pharmacist Intervention, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/PTB.2019.5.36}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Faiz A. Bahadig and Amjad Ahmad AL Qahtani} } @article {153, title = {Economic Outcomes of Pharmacist Prescribing Total Parenteral Nutrition at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S35-S39}, type = {Research Article}, chapter = {S35}, abstract = {

Objectives: In 2013, The General Administration of Pharmaceutical Care started the National Total Parenteral Nutrition (TPN) Program in Saudi Arabia. The pharmacist can provide neonates{\textquoteright} TPN services. In this study, we aimed to estimate the economic outcomes and cost avoidance in relation to pharmacist prescribing TPN. Methods: A total of 20 hospitals provide TPN services for neonates, pediatrics and adult patients. Cost avoidance stimulation in relation to the pharmacist prescribing and running neonates, pediatrics TPN services and replacement physician of a pharmacist as prescriber with adults TPN services. All costs were calculated by using US dollar currency. One-way sensitivity analysis was conducted for a list of discount prices and variety of wage cost with 10{\textendash}20\%. Results: The total annual estimated cost avoidance of pharmacist by providing TPN services for 20 hospitals for all types of patients was (1,569,865.40 USD) and with a discount of 10-20\%, it was (1,412,878.86-1,255,892.32 USD). Of those, the total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for neonates was (562,027.40 USD) and with discount of 10-20\%, it was (505,824.66- 449,621.92 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for adults was (523,337.00 USD) and with discount of 10-20\%, it was (471,003.30- 418,669.60 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for pediatrics was (484,501.00 USD) and with a discount of 10-20\%, it was (436,050.90- 387,600.80 USD). Conclusion: The pharmacist prescribing TPN prevents high economic burden on the healthcare system at Ministry of Health. Expanding the role of a pharmacist in the nutrition support services with an emphasis on prescribing TPN services is highly recommended at healthcare institutions in the Kingdom of Saudi Arabia.

}, keywords = {Cost avoidance, Economic, Ministry of Health, Outcomes, Pharmacist, Prescribing, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/PTB.2019.5.35}, author = {Yousef Ahmed Alomi and Mona Awad Alanazi and Faiz A. Bahadig} } @article {117, title = {History and Strategies of Drug Information Services at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {1-3}, type = {Review Article}, chapter = {1}, abstract = {

Over more thirty years back the first drug information services founded at Ministry of Health institutions in the Kingdom of Saudi Arabia. The drug information services stated with very simple and essential to the comprehensive with high quality and quantity specialized pharmacy practice. The services transferred over several periods from established time to advance stage and public stage. The drug information strategic plan founded for five years and included the updated Pharmacy strategic plan with Saudi vision 2030. The new drug information services started for the public with hotline at the Ministry of Health in the Kingdom of Saudi Arabia.

}, keywords = {Drug Information, History, Ministry of Health, Saudi Arabia, Services, Strategies}, doi = {10.5530/PTB.2019.5.1}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {122, title = {Inpatient Medication Errors and Pharmacist Intervention at Ministry of Health Public Hospital, Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {44-48}, type = {Research Article}, chapter = {44}, abstract = {

Objectives: To explore the inpatient medication errors and pharmacist intervention at Ministry of Health Hospital, Riyadh, Saudi Arabia. Methods: This is a 9-month cross-sectional study conducted at a 300-bed public hospital to evaluate pharmacist response and prevention of inpatient medication errors in adult and pediatric patients. There is a medication safety officer in the hospital along with a medication safety committee. The following information on medication errors were documented in the form available at the hospital: patient{\textquoteright}s demographic information, sources of medication errors, time of errors, type of errors, description of errors, causes of errors, recommendation to prevent such errors and the outcome of errors. The form was developed by using the National Coordinating Council (NCC) for Medication Error Reporting and Prevention (MERP) system. Results: According to the results, the pharmacist prevented a total of 3089 medication errors within 805 patients. About 3.8 errors per prescription were prevented. Most of the prevention occurred during prescribing stage (705 (99.2\%)). Patient-related errors (1564 (50.63\%)) and prescriber-related errors (1435 (46.46\%)) were the most type of prevented errors. Allergy was the most prevented subtype of errors (560 (91.4\%)) followed by patient{\textquoteright}s body weight (543 (88.6\%)) and prescriber data missing/unclear (347 (56.6\%)). Most of the errors that were prevented were near miss (93.3\%) followed by 6.3\% of the errors that reached the patient but did not cause any harm. The highest percentage with respect to the causes of medication errors was missing clinical information (649 (83.7\%)) and miscommunication of drug order (627 (80.9\%)). The top 20 medications involved in medication errors were oral and intravenous injections (Paracetamol and enoxaparin injection, respectively). Conclusion: The pharmacist plays a very crucial role in preventing medication errors. In order to prevent medication errors and improve patient outcome, the pharmacist provides education to the healthcare professional about medication safety and establishes the intravenous medication guidelines.

}, keywords = {Inpatient, Intervention, Medication errors, Ministry of Health, Pharmacist, Riyadh, Saudi Arabia}, doi = {10.5530/PTB.2019.5.8}, author = {Yousef Ahmed Alomi and Nesreen Alshabaar and Nadia Lubad and Fatimah Ali Albusalih} } @article {124, title = {Ramadan Pharmaceutical Care System at the Ministry of Health Institutions, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {July 2019}, pages = {49-55}, type = {Review Article}, chapter = {49}, abstract = {

Objectives: To demonstrate the Ramadan Pharmaceutical Care System as part of the national pharmacy practice program at the Ministry of Health institutions in the Kingdom of Saudi Arabia. Methods: This is a description analysis of Ramadan Pharmaceutical Care System at the Ministry of Health institutions. It was analyzed within the national pharmacy practice program. We used the modified pharmacy business model system and the project management procedure in the report. Results: The Ramadan Pharmaceutical Care program was established with a defined vision, mission and goals. In this project, human, economic and other resources have been described. The risk management was discussed to assure the continuation of the program. Furthermore, we illustrate the monitoring and controlling of the system. The closing stage with conversion to operation project was demonstrated in the Analysis. Conclusion: The Ramadan Pharmaceutical Care system has been implemented and is considered as part of the healthcare system and pharmacy strategic plan. This program has been created to improve pharmacy services provided to the patient and to increase patient satisfaction in the Ministry of Health institutions, Kingdom of Saudi Arabia.

}, keywords = {Ministry of Health, Pharmaceutical Care, Ramadan, Saudi Arabia}, doi = {10.5530/PTB.2019.5.9}, author = {Yousef Ahmed Alomi and Aljohara Abdullah Adouh and Meshael Ibrahim Alghuraibi} } @article {104, title = {National Adverse Drug Reaction Reporting System at the Ministry of Health, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {21-23}, type = {Review Article}, chapter = {21}, abstract = {

Objective: To illustrate the adverse drug reaction during the pharmacy strategic plan at the Ministry of Health of Health institutions in the Kingdom of Saudi Arabia. Method: It is description analysis of adverse drug reaction system at the Ministry of Health of Health institutions. It was analysis within the Pharmacy strategic plan 2012-2020. The modified pharmacy business model system and Project Management Procedure used in the report. Results: The adverse drug reaction established with a defined vision, mission and goals. The system human or economic and other resources described in the review. The risk management was discussed to assure the continuation of the system. Besides, the monitoring and controlling of the system as illustrated. The closing stage with convention to operation project demonstrated in the Analysis. Conclusion: The Adverse drug reaction system implemented and it is considered as part of the healthcare system and pharmacy regulations. The documentation of ADR is updating improving accordingly at all Ministry of Health institutions in the Kingdom of Saudi Arabia

}, keywords = {Adverse drug reaction, Ministry of Health, Pharmaceutical Care, Saudi Arabia, System}, doi = {10.5530/PTB.2018.4.8}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {105, title = {National Corporate Pharmacy and Therapeutic Committee at the Ministry of Health, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {24-27}, type = {Review Article}, chapter = {24}, abstract = {

Objective: To review the Ministry of Health Corporate MOH Pharmacy and Therapeutic committee system at the Ministry of Health foundations in the Kingdom of Saudi Arabia. Method: It is a retrospective analysis of Ministry of Health Corporate MOH Pharmacy and Therapeutic committee system at Ministry of hospitals institutions. Its analysis illustrated within the Pharmacy strategic plan 2012-2020. The analysis process used. The modified pharmacy business model system and Project Management Procedure. Results: Ministry of Heath drug Corporate MOH Pharmacy and Therapeutic committee established with clear vision, mission and goals. The committee had human or economic and other resources described in the review. To assure the continuity of the system; the risk management was used and described. Besides, the monitoring and controlling of the system were demonstrated. The closing stage with convention to operation project shown in the Analysis. Conclusion: The Ministry of Health Corporate MOH Pharmacy and Therapeutic committee system founded though Pharmacy strategies and regulations. The Ministry of Health Corporate MOH Pharmacy and Therapeutic committee has regular development accordingly at all Ministry of Health hospitals and primary healthcare centers in the Kingdom of Saudi Arabia.

}, keywords = {Ministry of Health, Pharmacy and Therapeutic Committee, Saudi Arabia}, doi = {10.5530/PTB.2018.4.9}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {106, title = {National Drug Formulary of the Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {28-30}, type = {Review Article}, chapter = {28}, abstract = {

Objective: To explore the Ministry of Health drug formulary system at the Ministry of Health foundations in the Kingdom of Saudi Arabia. Method: It is description analysis of Ministry of Health drug formulary system at Ministry of hospitals and primary healthcare centers. It analysis illustrated within the Pharmacy strategic plan 2012-2020. The analysis process used. The modified pharmacy business model system and Project Management Procedure. Results: Ministry of Heath drug formulary system established with clear vision, mission and goals. The project had human or economic and other resources described in the review. To assure the continuity of the system; the risk management was used and described. Besides, the monitoring and controlling of the system as illustrated. The closing stage with convention to operation project demonstrated in the Analysis. Conclusion: The Ministry of Heath drug formulary system founded and it is considered as part of Pharmacy strategic planning and regulations. The Ministry of Heath drug formulary has normal development accordingly at all Ministry of Health institutions in the Kingdom of Saudi Arabia.

}, keywords = {Drug, Formulary, Ministry of Health, Saudi Arabia}, doi = {10.5530/PTB.2018.4.10}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {107, title = {National Pharmacist Intervention Documentation System at the Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {31-33}, type = {Review Article}, chapter = {31}, abstract = {

Objective: To review the pharmacist interventions documentation system at the Ministry of Health of Health hospitals and primary care centers in the Kingdom of Saudi Arabia. Method: It is description analysis of pharmacist interventions documentation system at the Ministry of Health of Health institutions. The system analyzed within the Pharmacy strategic plan 2012-2020. The modified pharmacy business model system and Project Management Procedure used in the analysis. Results: Pharmacist intervention documentation system founded with a clear vision, mission and goals. The project had human or economic and other resources clarified in the review. The risk management was described to assure the continuation of the system. Besides, the monitoring and controlling of the system as illustrated. The closing project stage with convention to operation project demonstrated in the Analysis. Conclusion: The Pharmacist interventions documentation system founded and it is considered as part of Pharmacy administration regulations. The documentation of pharmacist interventions has normal development accordingly at all Ministry of Health institutions in the Kingdom of Saudi Arabia.

}, keywords = {Ministry of Health, Pharmaceutical Care, Pharmacist Intervention, Saudi Arabia}, doi = {10.5530/PTB.2018.4.11}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} } @article {111, title = {National Survey of Medication Safety Practice: Preparation of Medication and Dispensing at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {49-57}, type = {Research Article}, chapter = {49}, abstract = {

Objective: To explore the national medication safety practice in terms of medication preparation and dispensing at Primary Healthcare Centers (PHCs) and Community Pharmacies (CPs) in Riyadh, Kingdom of Saudi Arabia. Methods: This is a 4-month cross-sectional medication safety practice survey conducted at PHCs and CPs in Riyadh. The survey consisted of the modified version of the Medication Safety Self-Assessment{\textregistered} for Community/Ambulatory Pharmacy from the Institute for Safe Medication Practices (ISMP). The survey consisted of a demographic section and 10 domains with 198 questions. The 10 domains included patient information; drug information; communication of drug orders and other drug information; drug labeling, packaging and nomenclature; use of medical devices; environmental factors; staff competency and education; patient education; quality processes; and risk management. This study emphasizes on the medication preparation and dispensing as per the Medication Safety Self-Assessment for Community/Ambulatory Pharmacy, Riyadh. Results: The survey was distributed to 13 PHCs and 23 CPs. The average score of all the ISMP self-assessment of medication safety items at PHCs was 2.75{\textpm}0.36 (54.94 \%) with 95\% confidence interval (95\% CI) = 2.55{\textendash}2.95 (P\<0.05; range = 2.04{\textendash}3.38). The average score of all the ISMP self-assessment of medication safety items at CPs was 3.14{\textpm}0.42 (62.86\%) with 95\% CI = 2.90{\textendash}4.38 (P\<0.05; range = 2.40{\textendash}3.88). The average score of the communication of drug orders and other drug information domain at all hospitals were 2.57{\textpm}0.38 (51.4 \%) with 95\% CI = 2.36{\textendash}2.78 (P\<0.05; range = 1.92{\textendash}3.25) at PHCs and in the CPs, it was 2.44{\textpm}0.35 (48.8 \%) with 95\% CI = 2.245{\textendash}2.635 (P\<0.05; range = 2.00{\textendash}3.09). The average score of drug labeling, packaging and nomenclature domain at all hospitals was 2.57{\textpm} 0.41 (51.4 \%) with 95\% CI = 2.35{\textendash}2.79 (P\<0.05; range = 1.83{\textendash}3.08) at PHCs and in CPs, it was 3.2{\textpm}0.59 (64\%) with 95\% CI = 2.89{\textendash}3.51, (P\<0.05; range = 2.20{\textendash}4.05). Conclusion: Fifty percent of medication safety critical elements of ISMP standards was implemented during the preparation and dispensing of medication in the PHCs and CPs. Targeting to improve medication safety key at PHCs and CPs to prevent drug-related problems is required in the Kingdom of Saudi Arabia.

}, keywords = {Adverse drug reaction, Ministry of Health, Pharmaceutical Care, Saudi Arabia, System}, doi = {10.5530/PTB.2018.4.15}, author = {Yousef Ahmed Alomi and Adel Mehmas H. Alragas and Manar Mohammed Alslim and Rana Mohammed Alslim and Khulud Abdulrahman Alamoudi and Zainab Abdulmunem Almuallem} } @article {108, title = {On-the-Job Training of Pharmacy Technicians at the Ministry of Health Hospitals in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {34-36}, type = {Review Article}, chapter = {34}, abstract = {

Objective: To demonstrate the pharmacy technicians on the job training at the Ministry of Health of Health hospitals in the Kingdom of Saudi Arabia. Method: It is a retrospective analysis of pharmacy technicians on job training project at the Ministry of Health of Health hospitals. It was within The Pharmacy strategic plan 2012-2020. The study used the modified pharmacy business model system and Project Management Procedure. Results: The pharmacy technicians on job training system established with a defined vision, mission and goals. The system had several resources including human or economic and other described in the review. The continuation of the system assured by risk management model description. Also, the monitoring and controlling of the system as illustrated. The convention to operation project though closing project stage demonstrated in the Analysis. Conclusion: The pharmacy technicians on job training system established within the healthcare system and pharmacy regulations. The pharmacy technicians on the job training system are regularly improving accordingly at all Ministry of Health hospitals in the Kingdom of Saudi Arabia.

}, keywords = {Job, Ministry of Health, Pharmacy Technicians, Saudi Arabia, Training}, doi = {10.5530/PTB.2018.4.12}, author = {Yousef Ahmed Alomi and Saeed Jamaan Alghamdi and Radi Abdullah Alattyh} }