Availability of Antidotes in Kuwait: A National Audit

Al‐Taweel, Dalal; Al‐Haqan, Asmaa; Qabazard, Bedoor; Abuzainah, Dana; Koshy, Samuel; Alqenae, Fatema; Ali, Seham Ahmed; Abahussain, Eman

doi:10.1016/j.jemermed.2019.11.016

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. It has been reported that public and private hospitals in Kuwait have suboptimal stocks of essential antidotes [ 8 ]. In order to assist hospitals to reduce costs and improve patient care, this study aimed to develop an essential antidote list for Kuwait through expert consensus using the e-Delphi method.…”

Section: Discussionmentioning

confidence: 99%

“…Our study’s preliminary antidote list (that contained 47 antidotes) was based on the results of a national audit of antidotes in Kuwait that looked at the availability of antidotes in public and private hospitals that provide emergency care in 2020 [ 8 ]. In this study, Round 1 resulted in 41 antidotes out of 47 antidotes to be included in the final list of essential antidotes for Kuwait, while Round 2 and 3 provided consensus on two of the newly suggested antidotes by the expert panel, giving a final list of 43 antidotes.…”

Section: Discussionmentioning

confidence: 99%

“…A questionnaire was developed using the commercial survey software Qualtrics® (Provo, USA) with a preliminary list of 47 antidotes. This initial list was composed of antidotes retrieved from a national audit conducted in Kuwait in 2020 [ 8 ], that was based on evidence-based international guidelines [ 1 , 20 ]. The research group (which included an academic toxicologist) reviewed in-depth the initial list and made necessary additions and deletions, as needed.…”

Section: Methodsmentioning

confidence: 99%

“…A globally recognized consensus guideline recommended a “list” of antidotes to be stocked for timely delivery of essential antidotes to the emergency department [ 1 ]. It is advocated that this list must be modified and adopted by each healthcare institute based on a hazard vulnerability assessment (HVA) to meet local antidote needs [ 1 , 8 ]. It is also highly recommended that the list should be determined by the concerned stakeholders consisting of physicians, pharmacists, and other healthcare professionals associated with emergency care [ 1 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…A 2020 national audit of antidote stocking in Kuwait concluded that there is inadequate stocking of some antidotes in both the public and private hospital sector. The same study recommended the development of national guidelines for antidote stocking in Kuwait and the customization of guidelines to suit the local poisoning cases [ 8 ]. To assist hospitals to reduce costs and improve patient care, there is an urgent need to develop expert consensus guidelines, including a locally relevant list of essential antidotes, through a systematic, explicit, and transparent decision-making process [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Expert consensus for a national essential antidote list: E-Delphi method

et al. 2022

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Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. In order to assist hospitals to reduce costs and improve patient care, an essential antidote list can be used as an initial foundation for securing sufficient antidote availability at healthcare institutions. The aim of our study is to generate a nationally relevant essential antidote list for emergency care hospitals in Kuwait using the e-Delphi method by establishing consensus through a multidisciplinary expert group of healthcare providers. An electronic survey with 47 essential antidotes was developed. The e-Delphi method was used, with three rounds of voting, to determine expert consensus on an essential antidote list for hospitals in Kuwait. A purposive sample of healthcare professionals from governmental and private hospitals were selected for this study (n = 30). Consensus was gained if ≥75% of the expert panel agreed on the inclusion of the antidote, without any strong disagreements. Round 1 of the e-Delphi resulted in 41 antidotes reaching consensus and seven new antidotes suggested by the expert panel. Round 2 had two antidotes (out of seven newly suggested ones) reaching consensus. Round 3 was a confirmatory round, where the expert group agreed on their previous rounds’ opinions. This resulted in the development of an essential antidote list with 43 antidotes. The optimal approach for ensuring adequate availability of antidotes is continuous monitoring of local poisoning incidence and antidote requirements through collaborations between academic researchers and emergency care clinicians. The development of an essential antidote list, with expert consensus, is one of the initial steps in securing a foundation for appropriate provision of antidotes at all healthcare institutions. This is the first study that the authors are aware of that demonstrates that the e-Delphi technique can consolidate recommendations of experts in emergency medicine to provide a list of essential antidotes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Expert consensus for a national essential antidote list: E-Delphi method

et al. 2022

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Optimization of antidote stocking, availability, and administration practices for a large multihospital organization

Antoniello

Pauls

Awad

et al. 2022

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Inadequate hospital antidote inventory is a widely documented international issue due to high medication costs, lack of emphasis on antidote importance, variable international standards, hospital size, and drug availability. A large health system underwent process and policy implementation for antidote stocking, availability tracking, and administration strategies to ensure appropriate inventory and improve patient safety. Summary Process and policy implementation occurred over a 12-month period across the health system’s 11 acute care hospitals with emergency department services. Opportunities for optimization were identified following data capture surrounding institution-specific antidote inventory and usage across the health system. Specifically, minimum par levels at each institution were determined from 2018 expert recommendations for both the central pharmacy and automated dispensing machines within the emergency department. These quantities ensured the availability of an antidote within a specific timeframe contingent on the acquisition acuity for at least one 100-kg patient. Entries for order sets, order statements, and smart pump drug libraries were modified or formulated to facilitate standardized practices and minimize safety errors before a system-wide electronic health record transition. Conclusion It is prudent for all institutions, independent or within a health system, to identify areas of improvement for antidote inventory and management. Implementation of a similar process for antidote stocking, sharing, and delivery at other institutions is feasible and necessary to mitigate issues with drug acquisition and timely administration.

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