The Saudi Society of Clinical Pharmacy (SSCP) is striving to enhance the concept of clinical pharmacy within Saudi Arabia (SA) at all levels. Given the differences that exist between clinical pharmacy education, training, and practice settings in SA and other countries, the SSCP believes that it can play a proactive role in highlighting and streamlining various aspects of clinical pharmacy in SA. By gaining new knowledge, skills, and values through entering clinical practice, clinical pharmacists should be equipped with certain competencies to meet the expectations of the SSCP clinical pharmacy definition. In 2019, the SSCP established an expert writing task force of clinical pharmacy specialists representing different private and governmental sectors to lead and write a series of position statements relating to clinical pharmacy within SA. This position statement seek to identify the core competencies of clinical pharmacists in SA. The SSCP is calling on all educational institutions, postgraduate training programs, and professional organizations to collaborate to guarantee that these competencies are adopted to ensure the professional growth of clinical pharmacists and that optimal individual and population health outcomes are achieved.

The need for healthcare reform in Saudi Arabia (SA) is mostly related to inadequate primary care services, the inconsistent quality of services, and the high demand for workforce capacity and capabilities. Therefore, the proposed healthcare transformation plan is part of the country’s overall transformation plan of Saudi Vision 2030, which aims to prevent morbidity and mortality associated with non-communicable diseases (NCD), communicable diseases, and avoidable injuries. Clinical pharmacists in internal medicine (IM) play an integral role in managing and preventing NCDs and communicable diseases. Most of the leading causes of mortality in SA can be prevented or managed with medications, and highly skilled pharmacist in medication therapy management. To improve the quality of health and well-being of the Saudi population, there is a need for a much larger number of well-trained IM clinical pharmacists in the public and private sectors. This opinion paper by the IM Pharmacy Specialty Network (PSN) of the Saudi Society of Clinical Pharmacy (SCCP) presents the current status of the IM pharmacy workforce in SA and provide initial phase recommendations to help develop the IM pharmacy workforce to serve the needs of the Saudi people. However, to meet the goals of Saudi Vision 2030, all healthcare systems need to work collaboratively with other stakeholders such as MOH, Ministry of Human Resources and Social Development, and SCFHS to prepare a highly skilled and effective Saudi healthcare workforce to meet the high demands of reforming the healthcare system.

Adverse drug effects such as electrolyte abnormalities and acid-base disturbances are commonly associated with intravenous (IV) fluids administered in the intensive care units (ICUs). Although several studies have addressed the risk associated with resuscitative fluids in ICU patients, limited data evaluating the safety of IV medications diluents and their association with clinical outcomes in critical care settings. We conducted a systematic review and meta-analysis to compare the safety of 0.9% sodium chloride (0.9% NaCl) and dextrose 5% in water (D5W) as drug diluents in ICU settings. We searched PubMed, MEDLINE, Cochrane Library bibliographic databases, and conference abstracts for studies comparing medication diluents in adult critically ill patients. Our primary outcome was the risk of hypernatremia. The secondary outcomes included hyperchloremia, acute kidney injury (AKI) rate, ICU length of stay (LOS), ICU mortality, and hospital mortality. Three observational studies were included (1549 patients), all received 0.9% NaCl as standard diluents and D5W was the comparison. Our results shows that hypernatremia and hyperchloremia were significantly higher in 0.9% NaCl group (risk ratio [RR], 1.84; 95% confidence interval [CI], 1.38–2.47; P ≤ 0.001; I = 0%), (RR, 1.78; 95% CI, 1.38–2.31; P < 0.001, I 2 = 0%), respectively. There was no significant difference in AKI risk, hyperglycemia, and hospital mortality between the groups. However, the 0.9% NaCl group has a longer ICU LOS (mean difference 0·407, 0·062–0·752; P = 0.021). The utilization of D5W as medication diluent in critical care settings was associated with a lower incidence of hypernatremia and hyperchloremia, In addition, may be associated with shorter ICU LOS.