Implementation of a specialty pharmacy in an ambulatory care setting in Saudi Arabia: Patient experience and operational outcomes.

Background: Specialty pharmacy practice requires unique patient-centric care, emphasizing high-cost medications, complex treatment regimens, and medications requiring special handling.

Objective: We conducted this study to assess the effect of specialty pharmacy practice on patient and healthcare provider (HCP) satisfaction and pharmacy practice-related outcomes.

Methods: This prospective, concurrent, and historically controlled cohort study was performed in an ambulatory care setting for over 6 months and included 6 specialties: neurology, pediatrics, dermatology, gastroenterology, pediatric liver transplantation, and medical genetics.

Cardiovascular adverse events of antineoplastic monoclonal antibodies among cancer patients: real-world evidence from a tertiary healthcare system.

Background: Antineoplastic monoclonal antibodies (mAbs), such as trastuzumab, bevacizumab, and pertuzumab have been the mainstay of therapy in cancer patients. Despite proven efficacy of the monoclonal antibodies, cardiovascular-induced adverse events such as heart failure, hypertension, ischemic heart disease, arrhythmias, thromboembolic events, and hemorrhage remain a major complication. The European society of cardiology address that concern with antineoplastic monoclonal antibodies issuing a guideline to manage and monitor chemotherapy-induced cardiotoxicity.

The clinical and Practice Dilemma of Frequent Switching Among Generic Medications: Magnitude and Patient Safety Prospective.

To assess the magnitude of generic-generic and brand-generic medication switching and its impact on patients' understanding and the potential risk of medication errors. The study composed of 2 parts. The first part is a retrospective study to measure the frequency of medications switching in King Faisal Specialist Hospital and Research Centre (KFSH&RC), from 1 of January 2015 to the 31 of December, 2020.

Performance Assessment of Anti-Xa Assay-Based Heparin Dosing Protocol in Pediatric Patients on Extracorporeal Membrane Oxygenation.

Background: The use of extracorporeal membrane oxygenation (ECMO) in the postoperative cardiac critical care setting is evolving. Anticoagulation monitoring is among the most challenging aspects of pediatrics. However, there is no consensus on the optimal dosing and monitoring of unfractionated heparin in this setting.

Does Secondary Antibiotic Prophylaxis Improve Clinical Outcomes in Adult Rheumatic Heart Disease Patients Post-Valve Replacement?

Background: Secondary prevention of recurrent rheumatic fever in individuals with rheumatic heart disease (RHD) requires continuous antibiotic prophylaxis. However, the impact of antibiotic prophylaxis on the outcome of patients with severe RHD who underwent heart valve replacement is unknown. The objective of the study was to assess the relationship between the use of antibiotics as secondary prophylaxis in RHD patients who underwent valve replacement and clinical outcomes including mortality, reoperation, and valve-related hospitalization.

Clinical pharmacy definition, required education, training and practice in Saudi Arabia: A position statement by the Saudi society of clinical pharmacy.

The Saudi Society of Clinical Pharmacy (SSCP) is a scientific and professional society in the field of clinical pharmacy that operates under the Saudi Commission for Health Specialties governance. The SSCP believes that there is a need to define and describe many aspects related to the clinical pharmacy profession in Saudi Arabia. Moreover, there is an increasing demand for promoting the concept of clinical pharmacy and developing a consensus regarding the scope of practice and clinical pharmacist's required postgraduate education and training in Saudi Arabia.

Quantifying Clinical Pharmacist Activities in a Tertiary Care Hospital Using Key Performance Indicators.

Key performance indicators (KPIs) are a set of measures used to help an organization in assessing and achieving goals critical to success. The aim of this study was to quantify the clinical pharmacists' contribution to patient care in a tertiary care hospital using predefined clinical pharmacy KPIs. This study was a prospective, observational study conducted by the Pharmaceutical Care Division of a tertiary care hospital.

Pharmacy service accreditation: Raising the bar of practice standards.

Purpose: To summarize the journey of a tertiary and quaternary care hospital outside the United States in receiving American Society of Health-System Pharmacists (ASHP) accreditation for its pharmacy services.

Summary: Tertiary and quaternary care hospitals have gained their reputation owing to the high quality and advanced services that they provide. Our organization, King Faisal Hospital & Research Center (KFSH&RC), Riyadh, Saudi Arabia, is a 1300-bed capacity hospital that serves as a center of excellence in solid organ transplant, genetic and metabolic diseases, hematology and oncology, and cardiology, in addition to a diversity of medical services.

Clinical Validity Assessment of Integrated Dose Range Checking Tool in a Tertiary Care Hospital Using an Electronic Health Information System.

The electronic clinical decision support system (CDSS) is mainly used to assist health care providers in their decision-making process. CDSS includes the dose range checking (DRC) tool. This study aims to evaluate the clinical validity of the DRC tool and compare it to the institutional Formulary and Drug Therapy Guide powered by Lexi-Comp.

The usefulness of an ambulatory care pharmacy performance dashboard during the COVID-19 pandemic in a complex tertiary care system.

Purpose: To describe the usefulness of an innovative "semi-real-time" pharmacy dashboard in managing workload during the unpredictable coronavirus disease 2019 (COVID-19) pandemic.

Summary: We created a pharmacy dashboard to monitor workload and key performance indicators during the dynamic COVID-19 crisis. The dashboard accessed the prescribing workload from our clinical information system and filled prescriptions from robotic prescription dispensing systems.

Possible Azithromycin-Induced Life-Threatening Arrhythmia Requiring Extracorporeal Membrane Oxygenation Support: A Case Report.

BACKGROUND Azithromycin is a commonly prescribed antibiotic due to several advantages, including the broad range of indications, spectrum of activity, favorable drug interaction profile, and convenience of dosing. Although azithromycin carries a black-box warning for QTc prolongation and ventricular arrhythmias, these are considered rare adverse effects. CASE REPORT We present the case of a 37-year-old woman who received azithromycin (500 mg) for follicular tonsillitis and was admitted for worsening of symptoms.

Performance Assessment of a Multifaceted Unfractionated Heparin Dosing Protocol in Adult Patients on Extracorporeal Membrane Oxygenator.

Background: The use of extracorporeal membrane oxygenator (ECMO) support devices are associated with complications, including bleeding and thrombosis. Unfractionated heparin (UFH) is the gold standard anticoagulant in ECMO patients. Clinically, UFH is monitored through activated clotting time (ACT), activated partial thromboplastin time (aPTT), and anti-factor Xa assay.

Twelve-Month Review of Infusion Pump Near-Miss Medication and Dose Selection Errors and User-Initiated "Good Save" Corrections: Retrospective Study.

Background: There is a paucity of quantitative evidence in the current literature on the incidence of wrong medication and wrong dose administration of intravenous medications by clinicians. The difficulties of obtaining reliable data are related to the fact that at this stage of the medication administration chain, detection of errors is extremely difficult. Smart pump medication library logs and their reporting software record medication and dose selections made by users, as well as cancellations of selections and the time between these actions.

Saudi Heart Association (SHA) guidelines for the management of heart failure.

Heart failure (HF) is the leading cause of morbidity and mortality worldwide and negatively impacts quality of life, healthcare costs, and longevity. Although data on HF in the Arab population are scarce, recently developed regional registries are a step forward to evaluating the quality of current patient care and providing an overview of the clinical picture. Despite the burden of HF in Saudi Arabia, there are currently no standardized protocols or guidelines for the management of patients with acute or chronic heart failure.

Assessment of Late Thromboembolic Complications Post-Fontan Procedure in Relation to Different Antithrombotic Regimens: 30-Years' Follow-up Experience.

The current CHEST guidelines recommend the use of antithrombotic therapy, either aspirin or warfarin, as a primary thromboembolic complications (TECs) prophylaxis in patients who undergo Fontan procedure, without specification on drug selection or duration of therapy. To investigate the incidence rate of late TECs, occurring after 1-year post-Fontan procedure and to assess the difference in rate of late TECs between warfarin and aspirin. A retrospective cohort study included patients who had Fontan procedures between 1985-2010 at our institution.

Comparison of closed system transfer devices for turnaround time and ease of use.

Objective/purpose: The primary purpose of this study was to compare three closed-system transfer devices with differing mechanical interfaces for their suitability for adoption into our daily practice. The secondary purpose was to use the results of this study to support the selection of one of the closed-system transfer devices, which would suit both the pharmacy and nursing staff at our institution, furthermore promoting the enculturation of international recommendations into our clinical practice.

Study Design/methods: The hazardous drug preparation process was observed and timed continuously from the moment the technician started compounding until the finished product was handed to the designated checker by raising hands.

Impact of a medication reconciliation program on cardiac surgery patients.

Background Cardiac surgery patients are at high risk of medication errors. Resumption of home medications reduces the significance and number of medication errors. This could be achieved by implementing a medication reconciliation program.

A P&T Committee's Transition to a Complete Electronic Meeting System-A Multisite Institution Experience.

Purpose: In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage.

Assessment of evidence-based practice among hospital pharmacists in Saudi Arabia: attitude, awareness, and practice.

Background Many studies have previously looked at the perceptions, attitude, and use of Evidence-based Practice (EBP) among healthcare providers. However, limited data is available on the implementation of EBP among pharmacists in general, and Saudi Arabia in particular. Objective To evaluate the awareness, attitude, and practice of EBP among hospital practicing pharmacists in Saudi Arabia.

Guidelines for the secondary prevention of rheumatic heart disease: Endorsed by Saudi Pediatric Infectious Diseases Society (SPIDS).

Rheumatic fever is a rare yet serious condition develop as a consequence of throat infection caused by It is the leading cause for rheumatic heart disease. Rheumatic heart disease is a worldwide public health concern. It is a chronic condition that results in carditis, irreversible valve damage and heart failure in children and young adults living in low-income countries.

A three-year study of a first-generation chemotherapy-compounding robot.

Purpose: Results of a performance evaluation of an automated system for compounding antineoplastic preparations are reported.

Methods: Three years after the pharmacy department of a hospital in Saudi Arabia installed an i.v.

Antimicrobial stewardship program implementation in a medical intensive care unit at a tertiary care hospital in Saudi Arabia.

Background And Objectives: Antimicrobial stewardship programs (ASPs) have shown to prevent the emergence of antimicrobial resistance associated with an inappropriate antimicrobial use. The primary objective of this study was to compare the prescribing appropriateness rate of the empirical antibiotic therapy before and after the ASP implementation in a tertiary care hospital. Secondary objectives include the rate of Clostridium difficile-associated diarrhea (CDAD), physicians' acceptance rate, patient's intensive care unit (ICU) course, total utilization using defined daily dose, and total direct cost of antibiotics.

The first international residency program accredited by the American Society of Health-System Pharmacists.

The processes by which the pharmacy residency program at King Faisal Specialist Hospital and Research Centre-Riyadh, Saudi Arabia became the first American Society of Health-System Pharmacists (ASHP) accredited program outside the United States is described. This article provides key points for a successful program for other pharmacy residency programs around the world. Additionally, it points out the need for establishing international standards for pharmacy residency programs.

Assessment of the standard pediatric unfractionated heparin dosing protocol.

Current dosing guidelines for unfractionated heparin therapy in pediatric patients are based on recommendations of only one study that evaluated a weight-based dosing nomogram. To test the hypothesis that adhering to a strict weight-based nomogram yields better therapeutic results in pediatric patients, we prospectively monitored 25 consecutive pediatric patients who received unfractionated heparin based on the nomogram, and compared them to control patients whose treatment did not follow the standard nomogram. The mean time needed to achieve the target activated partial thromboplastin time was significantly shorter in the study group than the control group (18.

Pharmacoeconomic analysis in Saudi Arabia: an overdue agenda item for action.

Pharmacoeconomics is a branch of health economics related to the most economical and efficient use of pharmaceuticals. Pharmacoeconomic research identifies, measures and compares the costs and outcomes (clinical, economic and humanistic) of pharmaceutical products and services. Pharmacoeconomic evaluation can play a significant role in the efficient allocation of resources in healthcare systems with constrained budgets.