BackgroundPatients’ non-adherence to diabetes medication is associated with poor glycemic control and suboptimal benefits from their prescribed medication, which can lead to worsening of medical condition, development of comorbidities, reduced quality of life, elevated health care costs, and increased mortality.ObjectiveThis study aimed to assess medication adherence among patients with diabetes and associated factors in Bisha primary health care centers (PHCCs) in Saudi Arabia.Patients and methodsA cross-sectional study was conducted with a sample of 375 type 1 and 2 Saudi diabetic patients attending PHCCs under the Health Affairs of the Bisha governorate. The participants were aged 18 years and above, and had been taking diabetes medications for at least 3 months. Pregnant women, patients with mental illnesses, and those who were not willing to participate were excluded. Adherence to diabetes medications was measured using the four-item Morisky Green Levine Medication Adherence Scale (MGLS). All participants completed a self-report questionnaire including sociodemographic and clinical variables. Univariate and multivariate analyses were carried out using SPSS version 22.ResultsOf all the respondents, 134 (35.7%), 161 (42.9%), and 80 (21.4%), patients had high (MGLS score 0), intermediate (MGLS score 1 or 2), and low adherence (MGLS score ≥3), respectively. Factors associated with the level of adherence in univariate analysis were occupational status (P=0.037), current medication (P<0.001), glycated hemoglobin (A1c) (P<0.001), and number of associated comorbidities (P<0.001). In multivariable analyses, A1c <7 (P<0.001) and no associated comorbidities (P<0.003) variables remained significantly associated with adherence.ConclusionThe level of adherence to medication in diabetes mellitus patients in the Bisha PHCCs was found to be suboptimal. The findings point toward the need for better management of primary health care providers’ approaches to individual patients, by taking into account their medication adherence levels. Better identification of patients’ level of adherence remains essential for successful diabetes treatment.

The first incidence of acquired immunodeficiency syndrome (AIDS) from the Kingdom of Saudi Arabia (KSA) was reported back in 1984, and by the end of 2013, around 1509 patients were diagnosed with HIV infection. Recently in 2018, the Saudi ministry of health released that the incidence of HIV in Saudi Arabia is 3 cases of HIV for every 10,000 of the population. Having said that, the surveillance of HIV will face a range of challenges in KSA despite proper medical care, counseling, family planning, diagnostic, evaluation, and the use of effective anti-retroviral therapy. Patients who underwent anti-retroviral therapy showed significant reduction in morbidity as well as mortality. On the other hand, further targeted treatment and preventive strategies are warranted to control HIV co-infections in the KSA. In addition, progress towards meeting the WHO 90-90-90 goals for HIV not only at KSA but at the MENA region too, which is that of the population, 90% are diagnosed, 90% undergoing treatment, and 90% under viral control, is not being systematically monitored. In this review, we discuss the common co-infections with HIV infections that are reported in KSA, which when compared to international trends, it is similar for both viral hepatitis and tuberculosis. Although those co-infections exist, they are presented in different ratios and percentages when compared to the international reported data. These differences mandates defining and introducing new resilient methods of treatment and preventive measures. In this review, we offer an insight into healthcare policymakers to be compliant with UNAIDS 2020 vision program. We also discuss some of the gaps and recommendations to achieve the WHO 90-90-90 goal.

BackgroundSince the early 90’s antiretroviral drugs have been available at King Faisal Specialist Hospital and Research Centre (KFSH&RC), a referral hospital in Riyadh, Saudi Arabia, for the treatment of both adults and children infected with HIV-1. However, up to date, there are no genetic profiling data for the resistance-causing mutations in HIV-1 virus in patients on antiretroviral drugs therapy. This paper presents an initial report and a profiling survey of drug resistance-associated mutations of 103 HIV-1 patients seen at KFSH&RC.MethodsThis is a retrospective study on Patients treated at KFSH&RC since 2003 up to 2016. The analysis was done on the drug resistance mutations profiles of 103 patients who were undergoing highly active antiretroviral therapy protocols.ResultsOur analysis shows that the drug resistance mutations reported in our treatment cohort of HIV-infected adults patients is similar what is internationally reported to some extent. Additionally, we have identified novel drug resistance causing mutations. Furthermore, different profile of drug resistance causing mutations was also observed.ConclusionPatients showed both similar and new drug resistant causing mutations, early identification of these mutations is crucial to guide and avoid failure future therapy.

Background Many organizations have suggested a minimum standard of counseling for patients, which includes information about the name of the drug, description, indication, how to use it, the method of treatment, precautions, adverse reactions, and any contraindications. Correspondingly, the World Health Organization (WHO) has recommended spending at least 3 minutes with each patient to undertake counseling. The present study aimed to evaluate the practice of counseling by community pharmacists for both over-the-counter (OTC) and prescription-only medicines in Bisha Health Directorate, Saudi Arabia. Method This was a cross-sectional study designed to be a simulation patient visit to community pharmacies at Bisha area. The simulated patient visit were include 73 pharmacies. Two scenarios were used in the simulated patient visit. The first scenario was for a prescription-only medicine and the second scenario was for an OTC medicine. The time recorded for every visit to evaluate counsling period. Results A total of 105 visits were conducted to the community pharmacies as follows: scenario 1 = 73 and scenario 2 = 32. The average time for the simulation was 110 seconds in scenario 1 and 73.4 seconds in scenario 2. There was a statistically significant negative correlation between the period it took for the simulation scenario and the time of visit during the day (rho = −0.396, p = 0.001) in the patient simulation. Conclusion It that the service in community pharmacies is selling medicines and patient needs to be given a greaterin these community pharmacies.

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