@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 {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 {119, title = {National Survey of Medication Safety Practice: Environmental Culture and Staff Competency at Primary Healthcare Centers/ Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {20-27}, type = {Research Article}, chapter = {20}, abstract = {

Objective: To explore the national survey of medication safety practices with an emphasis on environmental factors and staff competencies at primary healthcare centers (PHCs) and community pharmacies (CPs) in Saudi Arabia, Riyadh city. Method: This is a 4-month cross-sectional medication safety practice survey conducted at pharmacies of PHCs of Ministry of Health and CPs in Riyadh city. The survey consisted of the modified version of the Medication Safety Self-Assessment{\textregistered} for Community/ Ambulatory Pharmacy from the Institute of Safe Medication Practices (ISMP). The survey consisted of a demographic section and 10 domains with questions on environmental factors, staff competency and education. The authors distributed the questionnaire and followed-up on a daily basis by physically visiting or via telephonic call. The survey was prepared in an electronic format and it was analyzed through the Survey Monkey system and Microsoft Excel version 10. Result: 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\%) (95\% confidence interval (95\% CI) = 2.55{\textendash}2.95; P\<0.05; range = 2.04{\textendash}3.38). The average score of all ISMP-self assessment of medication safety items at CPs was 3.14 {\textpm} 0.42 (62.86\%) (95\% CI = 2.90{\textendash}4.38; P\<0.05; range = 2.40{\textendash}3.88). The average score of environmental factors, workflow and staffing domain at PHCs was 2.7 {\textpm} 0.45 (54\%) (95\% CI = 2.53{\textendash}2.87; P\<0.05; range = 1.55{\textendash}3.68), whereas in CPs, the average score was 3.58 {\textpm} 0.43 (71.6\%) (95\% CI = 3.44{\textendash}3.717; P\<0.05; range = 2.63{\textendash}4.37). The average score of staff competency and education at PHCs was 3.02 {\textpm} 0.298 (60.4\%) (95\% CI = 2.9{\textendash}3.2; P\<0.05; range = 2.64{\textendash}3.55), whereas in the CPs, the average score was 4.15 {\textpm} 0.20 (83\%) (95\% CI = 4.03{\textendash}4.27; P\<0.05; range = 3.78{\textendash}4.53). Conclusion: The PHCs implemented only half of the environmental factors, workflow and staff competency domains preventive measures for medication safety and lower than CPs. Targeting of improving environmental culture and staff competency for medication safety at PHCs is highly recommended in KSA.

}, keywords = {Community Pharmacy, Environmental culture, Medication, Primary Healthcare Centers, Riyadh, Safety, Saudi Arabia, Staff competency}, doi = {10.5530/PTB.2019.5.5}, author = {Yousef Ahmed Alomi and Zainab Abdulmunem Almuallem and Manar Mohammed Alslim and Rana Mohammed Alslim and Khulud Abdulrahman Alamoudi and Adel Mehmas Hamdi Alragas} } @article {120, title = {National Survey of Medication Safety Practice: Medication Administration at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {28-35}, type = {Research Article}, chapter = {28}, abstract = {

Objective: To explore the national medication safety practice with emphasis on medication administration at primary healthcare centers (PHCs) and community pharmacies (CPs) in Riyadh city, Kingdom of Saudi Arabia. Methods: This is a four-month cross-sectional medication safety practice survey conducted at PHC pharmacies and CPs in Riyadh city. The survey consisted of the modified version of the Medication Safety Self-Assessment{\textregistered} for Community/Ambulatory Pharmacy from the Institute of Safe Medication Practice (ISMP). The survey consisted of a demographic section and 10 domains with 198 questions. The domains included questions on patient information; drug information; communication of drug orders and other drug information; drug labeling and packaging and nomenclature; use of devices; environmental factors; staff competency and education; patient education; quality processes; and risk management domain. In this study, we emphasized on medication administration; it is a finding from medication safety self-assessment for community/ambulatory pharmacy in Riyadh city. Results: The survey was distributed to 13 PHC pharmacies and 23 CPs. The average score of all ISMP-self assessment items of medication safety at PHCs was 2.75{\textpm}0.36 (54.94\%) (95\% CI=2.55{\textendash} 2.95; P\<0.05; range=2.04{\textendash}3.38). The average score of all ISMP-self assessment items of medication safety at CPs was 3.14{\textpm}0.42 (62.86\%) (95\% CI=2.90{\textendash}4.38; P\<0.05; range=2.40{\textendash}3.88). The average score of drug standardization, storage and distribution domain at PHCs was 2.35{\textpm}0.41 (47\%) (95\% CI=2.17{\textendash}2.53; P\<0.05; range=1.33{\textendash}3.09) and in CPs, it was 3.4{\textpm}0.54 (68\%) (95\% CI =3.16{\textendash}3.54; P\<0.05; range=2.22{\textendash}4.25). The average score of medication devices acquisition, use and monitoring domain at PHCs was 3.62{\textpm}0.14 (72.4\%) (95\% CI=3.26{\textendash}3.978; P\<0.05; range=3.45{\textendash}3.70) and in CPs, it was 2.78{\textpm}0.23 (55.6\%) (95\% CI=2.21{\textendash}3.349; P\<0.05; range=2.63-3.05). Conclusion: The medication administration safety was inadequate at PHCs while acceptable at CPs. Targeting to drug standardization, storage and distribution with emphasis on medication devices use and monitoring are highly recommended at PHCs in the Kingdom of Saudi Arabia.

}, keywords = {Administration, Community Pharmacy, Medication, Primary care centers, Riyadh, Safety, Saudi Arabia}, doi = {10.5530/PTB.2019.5.6}, author = {Yousef Ahmed Alomi and Adel Mehmas Hamdi Alragas and Manar Mohammed Alslim and Khulud Abdulrahman Alamoudi and Zainab Abdulmunem Almuallem and Rana Mohammed Alslim} } @article {121, title = {National Survey of Medication Safety Practice: Patient Education, Quality Process and Risk Management at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {January 2019}, pages = {36-43}, type = {Research Article}, chapter = {36}, abstract = {

Objective: To explore the national medication safety practice such as patient education, quality process and risk management at primary healthcare centers (PHCs) and community pharmacies (CPs) in Riyadh city, Kingdom of Saudi Arabia. Methods: This is a four-month cross-sectional medication safety practice survey conducted at PHC pharmacies and CPs in Riyadh city. The survey consisted of the modified version of the Medication Safety Self-Assessment{\textregistered} for Community/Ambulatory Pharmacy from the Institute of Safe Medication Practice (ISMP). The survey consisted of a demographic section and 10 domains with 198 questions. The domains included questions on patient information; drug information; communication of drug orders and other drug information; drug labeling and packaging and nomenclature; use of devices; environmental factors; staff competency and education; patient education; quality processes; and risk management domain. In this study, we emphasized on patient education, quality process and risk management; it is a finding from medication safety self-assessment for community/ ambulatory pharmacy in Riyadh city. Results: The survey was distributed to 13 PHC pharmacies and 23 CPs. The average score of all ISMP-self assessment of medication safety items at PHCs was 2.75{\textpm}0.36 (54.94\%) (95\% confidence interval (95\% CI)=2.55{\textendash}2.95; P\<0.05; range=2.04{\textendash}3.38). The average score of all ISMP-self assessment of medication safety items at CPs was 3.14{\textpm}0.42 (62.86\%) (95\% CI=2.90{\textendash}4.38; P\<0.05; range=2.40{\textendash}3.88). The average score of patient education at PHCs was 3.04{\textpm}0.365 (60.8\%) (95\% CI=2.89{\textendash}3.19; P\<0.05; range=2.00{\textendash}3.73) and at CPs, it was 3.73{\textpm}0.29 (74.6\%) (95\% CI=3.61{\textendash}3.85; P\<0.05; range=3.11{\textendash}4.22). The average score of quality processes and risk management at PHCs was 2.76{\textpm}0.35 (55.2 \%) (95\% CI=2.64{\textendash}2.88; P\<0.05; range=2.09{\textendash}3.50) and at CPs, it was 3.20 {\textpm}0.38 (64\%) (95\% CI=3.07{\textendash}3.33; P\<0.05; range=2.47{\textendash}3.89). Conclusion: The implementation of patient education and quality processes and risk management at PHCs and CPs were inadequate. Targeting to improve all meditations safety assessment tools at PHCs and CPs is highly recommended in the Kingdom of Saudi Arabia.

}, keywords = {Community Pharmacies, Education, Medication, Primary Healthcare Centers, Quality, Risk Management, Riyadh, Safety, Saudi Arabia}, doi = {10.5530/PTB.2019.5.7}, author = {Yousef Ahmed Alomi and Zainab Abdulmunem Almuallem and Manar Mohammed Alslim and Khulud Abdulrahman Alamoudi and Adel Mehmas H. Alragas and Rana Mohammed Alslim} } @article {109, title = {National Survey of Medication Safety Practice: Drug Information at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {37-42}, type = {Research Article}, chapter = {37}, abstract = {

Objective: To explore regarding drug information at Primary Healthcare Centers (PHCs) and Community Pharmacies (CPs) in Riyadh city, Kingdom of Saudi Arabia. Methods: This is a 4-month crosssectional survey conducted at PHCs and CPs in Riyadh city. In this study, the survey was adapted and modified from the Institution of Safe Medication Practice (ISMP) medication safety self-assessment for community/ambulatory pharmacy. It consists of a demographic section and 10 domains with 198 questions. The domains captured the following information: patient information; drug information; communication of drug orders and other drug information; drug labeling and packaging and nomenclature; use of medication delivery devices; environmental factors; staff competency and education; patient education; quality processes; and risk management domain. The survey was conducted at PHCs of Ministry of Health and at CPs located in Riyadh city. This study is focused on the second domain, that is, drug information at PHCs and CPs in Riyadh city. Results: The survey was distributed to 13 PHCs and 23 CPs. The average {\textpm} Standard Deviation (SD) of all ISMP-self assessment items of medication safety practice at PHCs was 2.75{\textpm}0.36 (54.94\%) (95\% Confidence Interval (CI) = 2.55{\textendash}2.95; P\<0.05; range = 2.04{\textendash}3.38). The average score of all ISMP-self assessment items of medication safety practice at CPs was 3.14{\textpm}0.42 (62.86\%) (95\% CI = 2.90{\textendash}4.38; P\<0.05; range = 2.40{\textendash}3.88). The average score of drug information domain at PHCs was 2.04{\textpm}0.34 (40.8\%) (95\% CI = 1.89{\textendash}2.19; P\<0.05; range = 1.50{\textendash}2.73), whereas that at the CPs was 2.35{\textpm}0.5 (47\%) (95\% CI = 2.13{\textendash}2.57; P\<0.05; range = 1.61{\textendash}3.43). Conclusion: The PHCs and CPs need to improve the key aspects of drug information related to the safety documentation and reporting system for medications. We recommend that the PHCs and CPs in the Kingdom of Saudi Arabia (KSA) should regularly conduct awareness programs on medication safety. We also recommend conducting an annual follow-up assessment of all the critical elements of drug information related to the medication safety system at PHCs and CPs.

}, keywords = {Community Pharmacies, Drug Information, Medication, Primary Healthcare Centers, Riyadh, Safety, Saudi Arabia}, doi = {10.5530/PTB.2018.4.13}, author = {Yousef Ahmed Alomi and Manar Mohammed Alslim and Rana Mohammed Alslim and Khulud Abdulrahman Alamoudi and Zainab Abdulmunem Almuallem and Adel Mehmas H. Alragas} } @article {110, title = {National Survey of Medication Safety Practice: Patient Information at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {4}, year = {2018}, month = {September 2018}, pages = {43-48}, type = {Research Article}, chapter = {43}, abstract = {

Objective: To explore patient{\textquoteright}s information regarding national medication safety Practice At Primary Healthcare Centers (PHCs) and Community Pharmacies (CPs) in Riyadh city, Kingdom of Saudi Arabia. Methods: This is a 4-month cross-sectional survey conducted on medication safety practice at PHCs and CPs in Riyadh city. In this study, the survey was adapted and modified from the Institution of Safe Medication Practice (ISMP) medication safety self-assessment for community/ambulatory pharmacy. It consists of a demographic section and 10 domains with 198 questions. The domains captured the following information: 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 domain. The survey was conducted at the PHCs of the Ministry of Health and at CPs located in Riyadh city. This study is focused on the first domain, that is, patient information in PHCs and CPs in Riyadh city. Results: The survey was distributed to 13 PHCs and 23 CPs. The average {\textpm} Standard Deviation (SD) of all ISMP-self assessment items of medication safety practice at PHCs was 2.75{\textpm}0.36 (54.94 \%) (95\% confidence interval (95\% CI) = 2.55{\textendash}2.95; P\<0.05; range = 2.04{\textendash}3.38). The average {\textpm} SD score of all ISMP-self assessment items of medication safety practice at CPs was 3.14{\textpm}0.42 (62.86\%) (95\% CI = 2.90{\textendash}4.38; P\<0.05; range = 2.40{\textendash}.88). The average {\textpm} SD score of patient information at PHCs was 2.80{\textpm}0.467 (56 \%) (95\% CI = 2.54{\textendash}3.58; P\<0.05; range = 2.08{\textendash}3.45), whereas that of the CPs was 2.60{\textpm}0.667 (52 \%) (95\% CI = 2.23{\textendash}2.97; P\<0.05; range = 1.36{\textendash}3.96). Conclusion: The PHCs and PCs implemented almost half the of ISMP medication safety critical elements including the patient information related issue. Targeting to improve medication safety system at PHCs and CPs is highly recommended in the Kingdom of Saudi Arabia

}, keywords = {Community Pharmacy, Information, Medication, Patient, Primary Healthcare Center, Riyadh, Safety, Saudi Arabia.}, doi = {10.5530/PTB.2018.4.14}, author = {Yousef Ahmed Alomi and Rana Mohammed Alslim and Manar Mohammed Alslim and Khulud Abdulrahman Alamoudi and Zainab Abdulmunem Almuallem and Adel Mehmas H. Alragas} }