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Background: HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management. Method: This retrospective study included HER2-positive breast cancer patients aged 18 or older who received at least 1 dose of HER2-targeting treatment between 2016 and 2020. The primary endpoint was the incidence of cardiotoxicity, defined as LVEF <50% with a 10% decline, LVEF drop by >15%, or onset of symptomatic heart failure. Secondary endpoints included the proportion of patients with baseline LVEF 50% to 55% developing cardiotoxicity, those discontinuing HER2 therapy due to heart failure, those treated with heart failure medications, and those continuing HER2 therapy while on heart failure medications. Another secondary outcome was the development of a hospital protocol for monitoring cardiotoxicity in these patients. Results: A total of 212 patients were included, with a median age of 56.5 years (interquartile range: 43-58 years). Twenty-two patients (10.37%) experienced cardiotoxicity from HER2-targeted treatment. Thirteen patients (6.13%) had asymptomatic heart failure with LVEF decrease of more than 10% to less than 50%. Five patients (2.35%) with LVEF less than 40% had asymptomatic heart failure, while 4 patients (1.88%) had symptomatic heart failure regardless of LVEF decline. HER2-targeted treatment was temporarily discontinued in 3 (13.63%) patients and permanently in 4 (18.18%) patients due to cardiotoxicity. The remaining 15 patients resumed treatment without interruption. Only 13 out of 22 patients were referred to cardiologists and prescribed heart failure medications. Conclusion: Close monitoring of LVEF in patients receiving HER2-targeting therapy can help health care providers initiate anti-heart failure medications to prevent LVEF deterioration and maintain HER2-targeting therapy. [ABSTRACT FROM AUTHOR]

Background: Pharmacovigilance (PV) is an essential part of the healthcare system's framework. In Saudi Arabia, pharmacovigilance is still a relatively new concept though it is well established in many countries. Study Aim: In this study, we aim to evaluate knowledge, attitude, and practice regarding pharmacovigilance and barriers to reporting adverse drug reactions (ADRs) among the general public in Saudi Arabia. Methods: This is a cross-sectional study that used a self-administered online questionnaire to assess knowledge, attitude, and practice of PV and ADRs. The study included only the adult population in Saudi Arabia. A scoring system was generated with a scale from 0 to 100, where 80% was set as a cut-off point, as any higher score resembled adequate knowledge, a positive attitude, and good practice. We used the Statistical Package for Social Sciences (SPSS) version 26 for performing the statistical analysis, where para-normal tests were used to associate scores with the socio-demographic characteristics of participants. Results: The study collected 1098 complete responses. The mean age (±SD) of participants was 37.9± 11.2 years. Females comprised 68.9% of the participants. The average knowledge score among participants was 37.8± 18.5, where only 4.3% of respondents had adequate knowledge. The average attitude score was 90.1± 19.2, where 83.4% had a positive attitude. The average practice score was 70.4± 18, and 34.5% of participants had good practice. Conclusion: The study found that the majority of participants had inadequate knowledge, a positive attitude, and poor practice. Individuals holding a master's degree or higher and those working in the healthcare sector had the highest knowledge scores, whereas the group aged 31 to 50 years old, participants from the Al Jawf region, participants who are married with children, holders of a master's degree or higher, and healthcare workers had the best attitude scores. Higher practice scores were seen among married individuals with children and those who work in the healthcare sector. [ABSTRACT FROM AUTHOR]

Background: Effective medication management, disposal, and donation are vital for public health and environmental sustainability. Improper handling of medications can lead to drug misuse, accidental poisoning, and environmental damage. This study examines current practices and challenges in Saudi Arabia, identifying opportunities for improvement. Method: A cross-sectional survey conducted in October and November 2023 targeted the general population in Saudi Arabia. This study employed convenience sampling to explore medication usage, storage, disposal practices, and awareness of donation procedures. Data were analyzed through both descriptive and inferential statistical methods. Results: This study involved 430 respondents. Of these, 73.0% held a university degree, yet 66.3% were unaware of drug donation programs, and 84.2% lacked knowledge about proper medication disposal. Despite this, 71.4% believed that drug donation programs positively impact healthcare, and 87.9% saw them as reducing drug waste and environmental pollution. However, 48.1% expressed concerns about the potential misuse of donated medicines. Awareness and knowledge were significantly higher among participants aged 30 and above. Conclusions: The findings highlight the need for enhanced public awareness, clear medication disposal guidelines, and ethically governed donation practices in Saudi Arabia. These measures can improve healthcare outcomes, protect the environment, and support global health and sustainability goals. [ABSTRACT FROM AUTHOR]

Introduction: Professional certification programs play a crucial role in helping pharmacists develop specialized skills and establish their expertise in the field. This study explores how pharmacists in Saudi Arabia engage with these programs by examining their levels of awareness, attitudes, and participation. It also identifies the key barriers and motivators that influence their decision to pursue certification. Methods: An online survey was conducted among pharmacists in Saudi Arabia to assess participants' knowledge of certification programs, their perceived benefits, the actual participation rates, and their preferences regarding certification areas and assessment methods. Results: Out of 394 participating pharmacists, around 47% had never participated in a professional certification program, and about 27% of our sample were unaware of such programs in Saudi Arabia. Financial constraints and a lack of awareness were noted as the primary barriers to participation. Almost 55% showed an interest in Clinical Pharmacy Specialties certification, while 54% were inclined toward Pharmacy Management and Leadership certifications. A preference for practical assessments in certification programs was suggested by 55% of participants. Conclusions: This study highlights a significant need for increased awareness and accessibility to professional certification programs among pharmacists in Saudi Arabia. Addressing participation barriers is vital to foster professional development and meet the healthcare sector's evolving demands in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Methods: Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. Results: The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. Conclusions: The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system. [ABSTRACT FROM AUTHOR]

Background: Thrombosis is the abnormal formation of blood clots within blood vessels; it results from an imbalance between fibrinolytic, pro-coagulant, and anticoagulant systems. Pediatric arterial thrombosis, especially related to catheter usage, is an emerging issue with limited evidence. This study evaluates the efficacy of enoxaparin in treating arterial thrombosis in pediatric patients at a single center. Methods: A retrospective single-center study included children under 14 years old diagnosed with catheter-related arterial thrombosis (CAT) and treated with low-molecular-weight heparin (LMWH) at King Abdulaziz Medical City between 2016 and 2021. Patients without follow-up at our institution or those using other anticoagulants were excluded. Data collected included age, sex, weight, catheter type, location and degree of thrombosis, ultrasonographic results, treatment duration, hemoglobin and platelet levels, and missed refills. Radiologic confirmation of CAT was required for inclusion. Results: This study included 111 children treated with enoxaparin for non-cerebral arterial thrombosis. The median age at diagnosis was 3 months, with 58% being male patients. Most cases (87%) involved cardiac catheterization, and all were confirmed using ultrasonography. Complete thrombus resolution was achieved in 90% of patients, partial resolution in 8.1%, and 1.8% had no resolution. The median duration of enoxaparin therapy was 20 days. Multivariate analysis indicated that higher age and lower body weight were associated with a higher risk of non-resolution. Indwelling catheters also posed a greater risk of non-resolution compared to cardiac catheters. Conclusions: Enoxaparin proved effective in treating catheter-related arterial thrombosis in children, with high resolution rates and few side effects. This study helps inform treatment strategies in pediatric thrombosis management and highlights the need for further research to refine treatment durations and address patient risk factors. [ABSTRACT FROM AUTHOR]

Saudi Vision 2030 has driven significant changes in ambulatory care pharmacy services in the Kingdom of Saudi Arabia (KSA), transitioning pharmaceutical care from inpatient to outpatient settings. With a growing need to address non‐communicable diseases, particularly cancer, ambulatory care oncology pharmacy services are of paramount importance. This study aims to evaluate the potential benefits and challenges of establishing such services in the KSA and offers recommendations for clinical pharmacists. A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and Google Scholar, encompassing research from inception to September 2023. The search focused on English language studies related to ambulatory care oncology/hematology pharmacy services. Among the 1351 studies found, those assessing the impact of clinical pharmacists on patient outcomes in outpatient oncology clinics were included. The review of the literature highlights the substantial impact of clinical pharmacists in outpatient hematology/oncology settings. A selection of several studies revealed their role in improving patient care, reducing health care costs, and enhancing treatment outcomes. Notable findings include a high acceptance rate of pharmacist interventions with significant cost savings, increased pharmacist involvement in patient encounters, and reduced emergency department visits and inpatient admissions due to pharmacist interventions. These results showed the valuable contributions of clinical pharmacists in the international outpatient oncology setting. Establishing ambulatory care hematology/oncology pharmacy services in Saudi Arabia is critical, considering the rising cancer burden. The value of specialized oncology clinical pharmacists in the outpatient setting is emphasized by various studies conducted in the United States. This review proposes a framework for patient‐centered oncology practices, serving as a valuable resource for the strategic development of ambulatory care oncology pharmacy services in Saudi Arabia. These efforts align with Saudi Vision 2030's broader goals of enhancing health care quality and patient care. [ABSTRACT FROM AUTHOR]

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements., Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums., Results: Out of the 440 participants in the study, who were primarily employees with bachelor's degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor's degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information., Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards.