Hadi A Almansour1, Alemayehu B Mekonnen2, Nouf M Aloudah3, Tariq M Alhawassi4, Kevin Mc Namara5, Betty Chaar6, Ines Krass6, Bandana Saini6. 1. School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. Electronic address: halm7156@uni.sydney.edu.au. 2. School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. 3. College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. 4. College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. 5. Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Vic, Australia; Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Vic, Australia. 6. School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: In common with many developed countries, Saudi Arabia is currently experiencing an increasing cardiovascular disease (CVD) burden. However, systematic screening programs for early identification and minimization of CVD risk within community or general clinical settings are limited. Globally, research suggests that pharmacists can play an effective role in identifying, assessing, managing and referring people at risk of CVD in the community as well as in the hospital setting. This role is not yet developed in Saudi Arabia. OBJECTIVES: This study aimed to explore the perspectives of hospital and community pharmacists in Saudi Arabia about potential roles in CVD risk screening. The purpose of the study was to propose potential interventions to facilitate the development of pharmacist delivered models for CVD risk prevention and management services in Saudi Arabia. METHODS: A qualitative study was conducted using semi-structured in-depth interviews and focus group discussions with a purposive convenience sample of hospital and community pharmacists in Saudi Arabia. Data collection continued until saturation was achieved. All interviews were audio recorded, transcribed verbatim and thematically analyzed. RESULTS: A total of 50 pharmacists (26 hospital and 24 community pharmacists) participated in this study. Twenty hospital and eight community pharmacists were interviewed individually, while the remaining participants contributed to three focus groups discussions. Currently, it appears that CVD risk prevention services are rarely provided, and when offered involved provision of discrete elements only such as blood pressure measurement, rather than a consolidated evidence based approach to risk assessment. Participating pharmacists did not appear to have a clear understanding of how to assess CVD risk. Four key themes were identified: pharmacists' perception about their current roles in CVD, proposed future clinical and service roles, impeding factors and enabling factors. Subthemes were mainly related to determinants likely to influence future CVD services. These subthemes included public perception of pharmacists' roles, pharmacist-physician collaboration, legislative restrictions, systemic issues, sociocultural barriers, organizational pharmacy issues, lack of professional motivation, government and organizational support and professional pharmacy support frameworks. These influencing factors need to be addressed at micro, meso and macro systems level in order to facilitate development of new pharmacist delivered cognitive services in Saudi Arabia. CONCLUSIONS: Pharmacists in Saudi Arabia are willing to expand their role and offer pharmacy-based services, but influencing determinants have to be addressed at the individual, professional and health system levels. Further work is needed to clarify and develop practical and appropriate protocols for pharmacist CVD prevention and management services within the Saudi public and health care system. Such work should be guided by implementation science frameworks rather than embarking on conventional research trial pipelines where public benefit of generated evidence is delayed or limited.
BACKGROUND: In common with many developed countries, Saudi Arabia is currently experiencing an increasing cardiovascular disease (CVD) burden. However, systematic screening programs for early identification and minimization of CVD risk within community or general clinical settings are limited. Globally, research suggests that pharmacists can play an effective role in identifying, assessing, managing and referring people at risk of CVD in the community as well as in the hospital setting. This role is not yet developed in Saudi Arabia. OBJECTIVES: This study aimed to explore the perspectives of hospital and community pharmacists in Saudi Arabia about potential roles in CVD risk screening. The purpose of the study was to propose potential interventions to facilitate the development of pharmacist delivered models for CVD risk prevention and management services in Saudi Arabia. METHODS: A qualitative study was conducted using semi-structured in-depth interviews and focus group discussions with a purposive convenience sample of hospital and community pharmacists in Saudi Arabia. Data collection continued until saturation was achieved. All interviews were audio recorded, transcribed verbatim and thematically analyzed. RESULTS: A total of 50 pharmacists (26 hospital and 24 community pharmacists) participated in this study. Twenty hospital and eight community pharmacists were interviewed individually, while the remaining participants contributed to three focus groups discussions. Currently, it appears that CVD risk prevention services are rarely provided, and when offered involved provision of discrete elements only such as blood pressure measurement, rather than a consolidated evidence based approach to risk assessment. Participating pharmacists did not appear to have a clear understanding of how to assess CVD risk. Four key themes were identified: pharmacists' perception about their current roles in CVD, proposed future clinical and service roles, impeding factors and enabling factors. Subthemes were mainly related to determinants likely to influence future CVD services. These subthemes included public perception of pharmacists' roles, pharmacist-physician collaboration, legislative restrictions, systemic issues, sociocultural barriers, organizational pharmacy issues, lack of professional motivation, government and organizational support and professional pharmacy support frameworks. These influencing factors need to be addressed at micro, meso and macro systems level in order to facilitate development of new pharmacist delivered cognitive services in Saudi Arabia. CONCLUSIONS: Pharmacists in Saudi Arabia are willing to expand their role and offer pharmacy-based services, but influencing determinants have to be addressed at the individual, professional and health system levels. Further work is needed to clarify and develop practical and appropriate protocols for pharmacist CVD prevention and management services within the Saudi public and health care system. Such work should be guided by implementation science frameworks rather than embarking on conventional research trial pipelines where public benefit of generated evidence is delayed or limited.
Authors: Hadi A Almansour; Nouf M Aloudah; Tariq M Alhawassi; Betty Chaar; Ines Krass; Bandana Saini Journal: Explor Res Clin Soc Pharm Date: 2021-09-29
Authors: Hadi A Almansour; Nouf M Aloudah; Tariq M Alhawassi; Betty Chaar; Ines Krass; Bandana Saini Journal: Saudi Pharm J Date: 2020-03-18 Impact factor: 4.330
Authors: Sandra C Thompson; Lee Nedkoff; Judith Katzenellenbogen; Mohammad Akhtar Hussain; Frank Sanfilippo Journal: Int J Environ Res Public Health Date: 2019-12-15 Impact factor: 3.390