National Survey of the Pharmacokinetics Services at the Ministry of Health Hospitals in Saudi Arabia: Prescribing and Dispensing Medication

Abstract

Objectives: To explore the pharmacokinetics services at the Ministry of Health (MOH) hospitals in Saudi Arabia with an emphasis on prescribing and dispensing medication. Methods: This is a 2-month crosssectional national survey of pharmacokinetics services. The study consisted of two parts: the first part captures demographic information and the second part is a questionnaire with 43 questions divided into three domains. The questions are derived from the guidelines of the American Society of Health-System Pharmacists (ASHP) and from the literature. We used the 5-point Likert response scale system to obtain responses of the participants; there were close-ended questions. The electronic questionnaire was distributed to all the coordinators of the clinical pharmacy services or to the drug information centers at MOH hospitals, The data were collected through the Survey Monkey system. Results: A total of 43 hospital pharmacies responded to the survey; the response rate was found to be 86%. The pharmacists and nurses had privileges of prescribing medication as per pharmacokinetics services in nearly 18 (46.15%) and 16 (41.03%) hospitals respectively. At 14 (37.84%) hospitals, pharmacists have the privilege to request an estimation of patient's drug levels and at 12 (30.77%) hospitals, they have the privilege to change drug sampling time. At 15 (38.46%) hospitals, nurses have the privilege to request an estimation of patient's drug level and at 12 (31.58%) hospitals, they have the privilege to change drug sampling time. The commonly prescribed medications via pharmacokinetics consultation were gentamicin (23 (71.88%)), phenytoin (23 (71.88%)), carbamazepine (22 (70.97%)), sodium valproate (22 (70.97%)) and warfarin (22 (70.97%)). The pharmacokinetics altering system during an electronic prescription was found in 9 (26.5%) hospital pharmacies and the pharmacist was found to participate in pharmacokinetics research in 8 (23.5%) hospitals. Conclusion: Healthcare providers including the pharmacists and nurses have a significant role in providing pharmacokinetics services to the patients. Expanding these services with standard guidelines and the electronic prescription is required in order to prevent drug-Pharmacokinetics related problems, improve the clinical outcome of the patient and reduce the economic burden.

Pharmacist-Managed Therapeutic Drug Monitoring Programs within Australian Hospital and Health Services—A National Survey of Current Practice

“…In another survey, approximately 18% of community pharmacies reported to be performing clinical laboratory tests, including those for lithium and tricyclic anti-depressants TDM [ 31 , 32 ]. In Saudi Arabia, a recent survey demonstrated that, at 37.84% of hospitals, pharmacists have the ability to request an estimation of patients’ drug levels and, at 30.77% of hospitals, they have the ability to change drug sampling time [ 18 ].…”

“…In an Australian and New Zealand survey conducted in 2010 by Norris et al, the pharmacist was cited as being the most frequently accessed health professional to provide TDM in hospitals [ 21 ]. In a survey conducted in Saudi Arabia in 2018, pharmacists were able to request a drug level in 38% of hospitals [ 18 ].…”

“…The survey explored the presence of such a program, the scope of practice, medications included in the program, operational requirements, attitudes, and practices of pharmacists towards the service, as well as any perceived barriers and enablers associated with the establishment and delivery of these services. The instrument was developed from the literature [ 18 , 19 , 20 ]. This included literature on surveys conducted within the area of TDM from an international perspective and surveys on pharmacist confidence when working in an extended scope position [ 21 ].…”

Practice of Pharmacokinetics Services by Physicians in Saudi Arabia

“…Previous studies have not discussed about the aspects of pharmacokinetics practice [20,21]. Most physicians requested for the analysis of drug levels such as aminoglycoside and vancomycin [12,21]. In comparison, the peak drug level is not necessarily of vancomycin.…”

“…Previous studies have reported on the impact of involvement of pharmacists in the therapeutic drug monitoring and pharmacokinetics services [7][8][9][10][11]. Other studies have investigated the pharmacokinetics survey services at various healthcare organizations [12][13][14][15][16][17][18][19]. However, to the best of our knowledge, there are only a few local studies conducted to assess the practice of pharmacokinetics services by physicians across Middle Eastern countries [20,21].…”