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الملخص: أهداف البحث: شهد نظام الرعاية الصحية في المملكة العربية السعودية تحولات كبيرة كجزء من رؤية 2030. وكجزء من هذا التحول، تم تنفيذ نظام الوصفات الطبية الإلكتروني (وصفتي) لتمكين المرضى من تلقي الوصفات الطبية من صيدليات المجتمع. قامت هذه الدراسة بتقييم رضى المرضى عن خدمات صيدليات المجتمع ونظام وصفتي. طرق البحث: استخدمت دراسة رصدية مقطعية بيانات موجودة من برنامج تجربة المرضى التابع لوزارة الصحة السعودية. تم جمع البيانات من مرضى أعمارهم أكبر من 15 سنة، والذين زاروا مراكز الرعاية الأولية الحكومية خلال النصف الأول من عام 2022. وتم إجراء إحصاءات تلخيصية، وتحليلات الانحدار اللوجستي متعدد المتغيرات، لتقييم ومقارنة الرضى بين مجموعات المرضى. النتائج: شملت العينة 66,541 مريضاُ. وكان أكثر من 70% من المرضى راضين عن خدمات صيدليات المجتمع ونظام وصفتي. أظهر التقدم في السن والإناث ارتباطا إيجابيًا بالرضى عن العديد من الخدمات. في حين أظهر المرضى الذين زاروا العيادات الوقائية احتمالات أعلى للرضى عن توافر الأدوية ووقت الانتظار، بينما كان مرضى عيادات الأمراض المزمنة أقل رضى عن توافر الأدوية. كان لدى المرضى السعوديين احتمالات أقل للرضى عن الخدمات المتعددة. الاستنتاجات: قد تشير مستويات الرضى المرتفعة بشكل عام بين المرضى إلى نجاح نظام وصفتي في تلبية احتياجات المرضى وتوقعاتهم. ومع ذلك، لا تزال هناك مجالات للتحسين لزيادة رضى المرضى، مثل معالجة نقص الأدوية وضمان التواصل الواضح بين المريض والصيدلي. تسلط النتائج الضوء على أهمية المراقبة والتقييم المستمرة لدعم تجربة المريض مع خدمات الصيدلة التي قد تحسن تجربة∖رحلة المريض، والالتزام بالدواء، ونتائج الرعاية الصحية الشاملة. Abstract: Introduction: The healthcare system in KSA has been substantially transformed as part of Vision 2030, including implementation of an electronic prescribing system, called Wasfaty, to enable patients to receive their prescriptions from community pharmacies (CPs). This study assessed patient satisfaction with CPs and the Wasfaty system. Methods: This cross-sectional observational study used existing data from the Saudi Ministry of Health's patient experience program. Data were collected from patients (≥15 years of age) visiting governmental primary care clinics in 2022. Summary statistics were determined and multivariable logistic regression analyses were conducted. Results: The sample included 66,541 patients. More than 70% of patients were satisfied with the services of the CPs and the Wasfaty system. Being older and being female consistently showed a positive association with satisfaction across several services. Whereas patients in preventive clinics had higher odds of satisfaction with medication availability (OR: 1.19, 95% CI: 1.03–1.37) and waiting time (OR: 1.23; 95% CI: 1.03–1.47), patients in chronic disease clinics had lower satisfaction with medication availability (OR: 0.92, 95% CI: 0.85–0.99). Saudi patients had lower odds of being satisfied with multiple services. Conclusions: The overall high satisfaction among patients suggested the success of the Wasfaty system in meeting patient needs and expectations. However, areas for improvement exist to increase patient satisfaction, such as addressing medication shortages and ensuring clear patient–pharmacist communication. The results highlight the importance of continued monitoring and evaluation to support the patient experience with pharmacy services, and to improve patients' journeys, medication adherence, and overall healthcare outcomes.

Background: The global COVID-19 crisis has underscored the critical role of effective decision-making in healthcare systems. Saudi Arabia has shown resilience by implementing comprehensive testing, tracing, and vaccination measures. Given the unique cultural and religious characteristics of Makkah, specific challenges have prompted efforts to uncover local pandemic responses. This qualitative assessment aims to delineate the challenges faced by decision-makers during COVID-19 in Makkah and identify key interventions implemented by the Makkah healthcare cluster to manage and coordinate care. Method: Utilizing a purposive sampling approach, executive leaders within the Makkah Healthcare Cluster were invited for semi-structured interviews during the COVID-19 period. Thematic analysis was carried out in five steps, ensuring rigor and trustworthiness through multiple checks, and employing a critical and collaborative approach. Result: Throughout the COVID-19 outbreak in Makkah, participants revealed Several factors that have hindered healthcare organizations' ability to effectively manage the pandemic, including testing difficulties, resource shortages, vaccination misconceptions, continuity of care issues, infections among healthcare workers, and the need for consistent protocols. The participant leaders in Makkah's healthcare cluster specified implemented strategies that helped in overcoming the encountered challenges, such as adopting new technologies, enhancing communication, managing supply and demand, and improving workforce adaptability and development. Their experience in managing Hajj and Umrah provided valuable insights for handling the pandemic effectively. Conclusion: The study emphasizes the significance of technology adoption, effective communication, supply management, workforce development, and lessons from managing religious events. Its findings have implications for healthcare systems globally, emphasizing the importance of preparedness, response, and resilience in diverse cultural contexts.

الملخص: أهداف البحث: تشهد المملكة العربية السعودية تغييرات تحويلية في مجال الرعاية الصحية، مع إعطاء الأولوية لمراكز الرعاية الصحية الأولية لتحسين تجربة المرضى ونظام الرعاية الصحية الشامل. وتهدف هذه الدراسة إلى تقييم مدى الاستعداد للتغيير لدى مديري مراكز الرعاية الصحية الأولية في مكة المكرمة، المملكة العربية السعودية. طرق البحث: استخدمت دراسة مقطعية نموذج استبانة ''أدكار''، التي تتكون من 22 سؤالاً على مقياس ليكرت، لتقييم وعي المديرين ورغبتهم ومعرفتهم وقدراتهم وتعزيزهم واستعدادهم للتغيير بشكل عام. النتائج: وجدت الدراسة وجود ارتباط كبير بين مستويات التعليم العالي وزيادة الوعي، إلى جانب زيادة الرغبة، بين مديري الرعاية الصحية الأولية. بالإضافة إلى ذلك، تم العثور على ارتباط إيجابي بين العمر (أكبر من 41 سنة) والمعرفة بين مديري الرعاية الصحية الأولية. ومع ذلك، أظهر المديرون الذين لديهم 11 عامًا أو أكثر من الخبرة ارتباطا سلبيا بالاستعداد للتغيير. الاستنتاجات: يحدد نموذج ''أدكار'' خمسة أبعاد مفيدة لتحديد مدى استعداد المديرين واستعدادهم للخضوع للتغيير. تعتمد إدارة التغيير الناجحة على انفتاح الأفراد على التغيير، متأثرين بعوامل مثل العمر والتعليم والخبرة. Abstract: Background: KSA is currently undergoing significant changes in its healthcare system, with a particular emphasis on enhancing the role of primary healthcare centers (PHCs) to elevate patient experience and overall healthcare quality. At the forefront of this transformation are head managers in PHCs, who play a crucial role in implementing these changes effectively. The readiness of these managers is paramount to the successful execution of the envisioned transformation and the subsequent improvement of patient experience. Objective: This study aims to assess the readiness to change among head managers of primary healthcare centers in Makkah, KSA. Methodology: Cross-sectional study utilized the ADKAR model questionnaire, consisting of 22 Likert scale questions, to assess PHCs head managers' awareness, desire, knowledge, ability, reinforcement, and overall change readiness. Results: The study found a significant association between higher educational levels and increased awareness (β = 0.214, p = 0.030), along with greater desire (β = 0.207, p = 0.029) among primary healthcare (PHC) managers. Additionally, a positive association was found between age (≥41 years) and knowledge among PHC managers (β = 0.138, p = 0.030). However, managers with 11 or more years of experience showed a negative association with change readiness (β = −0.112, p = 0.001). Conclusion: The ADKAR model outlines five dimensions that are useful for identifying the readiness and willingness of head managers in PHCs in Makkah cluster to undergo change. Assessing change readiness is crucial for organizational transformation, with head managers playing a significant role. Factors such as age, education, and experience influence managers' readiness for change in primary healthcare centers (PHCs) in Makkah.

Introduction: Saudi Arabia has begun reforming its government-run health care system to increase efficiency and reduce costs. One effort is the adoption of an electronic prescribing system (Wasfaty) and outsourcing pharmaceutical services from government-run clinics to community pharmacies (CP). This study aims to compare satisfaction with pharmaceutical services offered in the two systems. Materials and methods: This cross-sectional observational study used existing survey data collected from patients (≥15 years of age) visiting government primary health care centers from January 2022 to June 2022. Satisfaction with three pharmaceutical services (availability of medications, pharmacist’s explanation of the prescription, and waiting time to get medications) were the main outcomes. Results: The study comprised 91,317 participants, 74.06 % of them were CP/Wasfaty users. CP/Wasfaty patients had lower odds of satisfaction with the three pharmaceutical services: availability of medications (OR = 0.49, 95 % CI = 0.47–0.51), pharmacists’ explanation of prescription (OR = 0.55, 95 % CI = 0.53–0.58), and waiting time to get medications (OR = 0.81, 95 % CI = 0.75–0.88). Additional findings showed variations in satisfaction levels based on demographic factors and clinic types. Conclusions: The significant differences observed in satisfaction levels based on demographic characteristics and type of clinics visited emphasize the importance of tailoring pharmaceutical services to meet the specific needs and expectations of different patient populations.

Aim: To explore nurses’ readiness to prescribe medications under supervision and identify associations between prescribing practices under supervision and demographic characteristics in Saudi Arabia. Design: A cross-sectional study. Methods: Using convenience sampling, this study used a 32-item survey to collect data on nurses prescribing medications under supervision between December 2022 and March 2023. Results: A total of 379 nurses were recruited from different regions in Saudi Arabia. Approximately 7% (n = 30) of the participants were prescribing medications independently, and 70% (n = 267) expressed their likelihood of becoming prescribers. The highest motivating factors to become prescribers were improvement of patient care (52.2%) and contribution to the multidisciplinary team (52.0%). Most participants (60%–81%) agreed that prescribing medications under supervision would improve potential outcomes at the system, nurse, and patient levels. Availability of appropriate mentors or supervisors (72.9%) was the highest rated facilitating factor, followed by support of nursing colleagues (72%). Based on demographic characteristics, findings revealed significant differences in the: a) likelihood and motivators of becoming prescribers; b) required minimum qualification, years of experience, and continuing professional education hours to become prescribers; and c) type of organizations delivering educational programs for nurse prescribing. Conclusion: Majority of nurses in Saudi Arabia favored becoming prescribers, and motivating factors were mostly relevant to optimizing patient care outcomes. Having the proper supervision was rated as the most facilitating factor for nurse prescribing. Nurses’ views on potential outcomes, facilitating factors, and possible motivators varied based on nurses’ demographical characteristics. Implications for the professional and/or patient care: Nurses favored prescribing under supervision to improve patient care outcomes, which is an opportunity to expand the benefits of health services, including easy access to healthcare. Impact: Results revealed that nurses support the implementation of prescribing practice under supervision. Thus, the findings may inform practice change in Saudi Arabia to allow prescribing under supervision, which was perceived to have a positive impact on patient care outcomes. Reporting Method: This study adhered to STROBE guidelines.

Abstract Background Tobacco use remains a leading cause of premature death. To combat tobacco use, the Ministry of Health (MOH) improved access to smoking cessation clinics (SCCs) by developing fixed SCCs and mobile SCCs, which move based on demand across locations. The goal of this study was to investigate awareness and utilization of SCCs among tobacco users in Saudi Arabia and the factors that influence their awareness and utilization. Method This cross-sectional study used the 2019 Global Adult Tobacco Survey. Three outcome variables were employed, including tobacco users’ awareness of fixed SCCs, mobile SCCs, and utilization of fixed SCCs. Several independent variables were examined, including sociodemographic characteristics and tobacco use. Multivariable logistic regression analyses were performed. Results One thousand six hundred sixty-seven tobacco users were included in this study. There were 60%, 26%, and 9% of tobacco users who were aware of fixed SCCs, aware of mobile SCCs, and visited fixed SCCs, respectively. The likelihood of being aware of SCCs increased among users residing in urban areas (fixed SCCs: OR = 1.88; 95% CI = 1.31–2.68; mobile SCCs: OR = 2.09; CI = 1.37–3.17) while it decreased among those reported self-employed (fixed SCCs: OR = 0.31; CI = 0.17–0.56; mobile SCCs: OR = 0.42; CI = 0.20–0.89). The likelihood of visiting fixed SCCs increased among educated tobacco users aged 25–34 (OR = 5.61; CI = 1.73–18.21) and 35–44 (OR = 4.22; CI = 1.07–16.64) while the odds of visiting SCCs decreased among those who were working in the private sector (OR = 0.26; CI = 0.09–0.73). Conclusion The decision to quit smoking must be supported by an effective healthcare system that provides accessible and affordable smoking cessation services. Knowing the factors that influence the awareness and utilization of SCCs would help policymakers dedicate efforts targeting those who desire to quit smoking yet face limitations in using SCCs.

المخلص: أهداف البحث: يعد نقص المعرفة أحد العوائق التي تعيق استخدام الفحص الصحي الدوري. تهدف هذه الدراسة إلى استكشاف المعرفة حول الفحص الصحي الدوري بين البالغين المقيمين في منطقة الجوف بالمملكة العربية السعودية، وتحديد الخصائص المرتبطة بمثل هذه المعرفة. طرق البحث: تم إجراء مسح مقطعي يستهدف البالغين (≥ 18 عاما) المقيمين في منطقة الجوف، المملكة العربية السعودية، لجمع المعلومات حول خصائصهم الاجتماعية والديموغرافية، واحتياجاتهم من الرعاية الصحية، والمعرفة والممارسات تجاه الفحص الصحي الدوري. تم إجراء الإحصائيات المقارنة وتحليل الانحدار الخطي متعدد المتغيرات لتحديد الخصائص المرتبطة بالمعرفة حول الفحص الصحي الدوري. النتائج: أكمل ما مجموعه 624 مستجيبا الاستطلاع وشاركوا في هذه الدراسة. من بين المشاركين، كان متوسط درجة المعرفة بالفحص الدوري الصحي 5.26 بنطاق من 0 إلى 7. أظهر تحليل الانحدار أن درجة المعرفة بالفحص الصحي الدوري كانت أعلى بشكل ملحوظ بين الإناث، المشاركين بدرجة الكلية، وأولئك الذين عملوا في مجال الرعاية الصحية مقارنة بنظرائهم. الاستنتاجات: أظهر هذا البحث ارتفاعا نسبيا في درجة المعرفة بالفحص الصحي الدوري بشكل عام بين البالغين الذين شملهم الاستطلاع في المملكة العربية السعودية، لكن الاختلاف في درجة المعرفة، حيث يكون الذكور، وذوي المستويات التعليمية المنخفضة وأولئك الذين لا يعملون في مجال الرعاية الصحية أقل دراية بالدوريات بشكل ملحوظ. الفحوصات الصحية من أقرانهم حتى بعد التحكم في الخصائص الأخرى التي قد تؤثر على مستويات المعرفة. قد توفر الأبحاث التي تتناول المعرفة بالمواضيع الصحية الأخرى والسلوكيات الصحية، بما في ذلك الاستفادة من الخدمات الصحية، إرشادات لأولئك الموجودين في المملكة العربية السعودية في الجهود المبذولة لتحسين المعرفة واستخدام الفحوصات الصحية الدورية بشكل عام وبين مجموعات محددة. Abstract: Objectives: A lack of knowledge is one of the key barriers that hinders the use of Periodic Health Examinations (PHEs). This study aimed to investigate the knowledge of PHE among adults residing in Al-Jouf region, KSA, and determine characteristics associated with such knowledge. Methods: A cross-sectional survey targeting adults (≥18 years) residing in Al-Jouf region, KSA, was conducted to gather information relating to their sociodemographic characteristics, needs for healthcare, and knowledge about and practices toward PHE. Comparative statistics and multivariate linear regression analysis were conducted to determine the key characteristics associated with knowledge about PHE. Results: A total of 624 respondents completed the survey and participated in this study. Among the participants, the mean PHE knowledge score was 5.26 (SD = 0.05) with a range of 0–7. Regression analysis showed that the PHE knowledge score was significantly higher among females, respondents with a college degree, and those worked in the healthcare field when compared to their counterparts. Conclusion: Analysis revealed a relatively high overall knowledge score for PHE among surveyed adults in KSA although knowledge score varied in males, those with lower educational levels and those who did not work in the healthcare field; these cohorts were significantly less knowledgeable about PHE than their peers even after controlling for other characteristics that may affect knowledge levels. Research to address knowledge of other health topics and health behaviors, including the utilization of health services, may provide guidance to those in KSA to improve the knowledge and use of PHE overall and within specific groups.

Introduction: Seasonal influenza is a contagious viral respiratory condition typically occurring in the fall to early spring months of the year globally. The risk of infection from seasonal influenza can be greatly reduced with vaccination. Unfortunately, research has indicated that the seasonal influenza vaccination rate in Saudi Arabia is low. This study assessed the uptake of seasonal influenza vaccination among adults residing in Al-Jouf region, Saudi Arabia. Materials and Methods: A cross-sectional survey targeting adults (20–80 years) residing in Al-Jouf region, Saudi Arabia, was conducted to gather information about their sociodemographic characteristics, chronic conditions, knowledge about periodic health examinations (PHE), regular use of PHE, and uptake of seasonal influenza vaccination. Comparative statistics and a multivariate logistic regression analysis were conducted to determine characteristics associated with the uptake of seasonal influenza vaccination. Results: A total of 624 respondents completed the survey and participated in this study. Among the participants, 27.4% indicated they visited their primary healthcare centers or hospitals every year to get a seasonal influenza vaccination. The regression analysis showed that the odds of getting a seasonal influenza vaccination were higher among employed respondents (Odds Ratio [OR] = 1.73; P = 0.039), respondents who were employees of the healthcare sector (OR = 2.31; P = 0.001), and those with a higher PHE Knowledge Score (OR = 1.22; P = 0.008), compared to their counterparts. Conclusions: Seasonal influenza is a serious condition warranting appropriate prevention measures, including vaccination. However, this study confirmed low rates of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Interventions to boost vaccination uptake, in particular among unemployed individuals, those not working in the healthcare sector, and those with lower PHE knowledge Scores, are therefore recommended.

Introduction Saudi Arabia is expected to witness a slight reduction in tobacco use. The Saudi government offers free-of-charge smoking cessation services. Yet, factors influencing the desire to quit smoking are not comprehensively investigated in Saudi Arabia. This study examines the factors influencing the desire to quit among smoking adults in Saudi Arabia and investigates whether using alternative tobacco products, such as e-cigarettes, is associated with the desire to quit smoking. Methods Data from the 2019 nationally representative Global Adults Tobacco Survey (GATS) was used. GATS utilized a face-to-face household cross-sectional survey that collected data from adults aged ≥15 years. Several factors including, sociodemographic characteristics, use of alternative tobacco products, attitude toward tobacco control, and awareness of smoking cessation clinics (SCCs), were examined to predict the desire to quit. Logistic regression analysis was conducted. Results A total of 11381 individuals completed the survey. Of the total sample, 1667 participants were tobacco smokers. The majority of the tobacco smokers were interested in quitting smoking (82.4%); 58% of cigarette smokers and 17.1% of waterpipe smokers were interested in quitting smoking. The desire to quit smoking was positively associated with the awareness of SCCs (AOR=3; 95% CI: 1.8–5), attitude toward raising tobacco taxes (AOR=2.3; 95% CI: 1.4–3.8), and a strict rule of smoking inside the home (AOR=2; 95% CI: 1.1–3.9). No statistical association was found between the desire to quit smoking and the use of e-cigarettes. Conclusions The desire to quit tobacco smoking among Saudi smokers increased with awareness of SCCs, favoring taxes on tobacco products, and implementing strict rules of smoking inside the home. The study reveals valuable insights into the main factors that could inform the development of more effective policy interventions targeting smokers in Saudi Arabia.

The most common side effect for cancer patients using epidermal growth factor receptor inhibitors (EGFRI) is the development of an itchy papulopustular rash. In severe cases, the patients are forced to stop taking the medications, hence affecting treatment outcomes. We herein report a case of a 50-year-old patient who developed a papulopustular rash after starting erlotinib. He treated himself with Ziziphus spina-christi leaves which is a plant well known for its anti-inflammatory and antibacterial properties in the middle east. We hypothesize that the anti-inflammatory, soothing, and antibacterial activity of the Ziziphus tree might actually represent a possible better treatment of the rash than available treatments, particularly in patients on EGFR blockers, and hence improve treatment outcomes.

The Internet of Things (IoT) is a swiftly developing technology in all sectors, with the number of devices that connect to the Internet has increased remarkably in recent years. However, most of these devices use cheap hardware and lack a concrete security defence system. This may encourage hackers to recruit these devices and use them to launch Distributed Denial of Service (DDoS) attacks, which is one of the main causes of concern among security engineers. This paper investigates the possibility of using a matrix profile to detect DDoS attacks in an IoT-based environment. According to our empirical experiments, the preliminary findings illustrate that the matrix profile algorithm can efficiently detect IoT-based DDoS attacks.

BACKGROUND: Periodic Health Examinations (PHEs) typically occur annually and provide an important opportunity for providers to screen their patients for undiagnosed health conditions and monitor existing conditions, such as diabetes and hypertension. Unfortunately, PHEs are reported to be low in Saudi Arabia. This study's aim was to assess the regular uptake of PHEs by adults residing in Al-Jouf region, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey was conducted among adults (aged ≥ 20 years) residing in five communities in the Al-Jouf Region on sociodemographic characteristics, self-reported chronic conditions, knowledge of PHEs, and their regular uptake. Chi-square tests and multivariate logistic regression analysis were performed to determine the factors associated with regular uptake of PHEs. RESULTS: total of 624 participants completed the survey questionnaire. Of the participants, 27.7% reported a regular uptake of PHEs. The odds of regular uptake of PHEs were higher among older respondents (odds ratio [OR] =1.98; P = 0.002), those who reported that they had diabetes (OR = 3.25; P < 0.001), hypertension (OR = 4.11; P = 0.001), hyperlipidemia (OR = 2.66; P = 0.003), and those with a higher PHEs knowledge score (OR = 1.35; P < 0.001). However, the odds regular uptake of PHEs among respondents residing in the three governorates and Skaka city were significantly lower (OR = 0.27; P = 0.001 and OR = 0.30; P = 0.002, respectively) than their counterparts. CONCLUSION: Low rates of PHEs uptake were observed among the survey participants in the Al-Jouf Region of Saudi Arabia. The characteristics of individuals associated with low uptake of PHEs were identified. Tailored interventions, such as the use of community health workers and clinic communications, could target these individuals to increase the uptake of PHEs.