The drug prescribing patterns of ambulatory care physicians in the Ministry of Health (MOH) hospitals were studied by examining 10,291 systematically sampled prescriptions obtained from 22 general hospitals covering the various health regions within Saudi Arabia. An audit of prescription information revealed that documentation was not generally complete. Information relating to patient age and diagnosis was missing in 18.6% and 9.8% of the prescriptions, respectively. The average number of drugs per prescription was 2.1 ± 0.95. The most frequently prescribed drug categories were systemic anti-infectives, analgesics/antipyretics, and vitamin preparations, respectively. Paracetamol, ampicillin, antacid preparations, and vitamin B complex were the specific drugs that ranked high in the frequency of prescription. The patterns of drug use observed in this study indicate a trend for the overprescribing of certain categories of drugs. The need to improve current drug policy and drug prescribing is discussed with a recommendation for the establishment of a Pharmacoepidemiology Unit to monitor drug use in Saudi Arabia. Arabia. 1993; 13(2): 172-177 Since its establishment in the mid 1950s, the health care system within the Kingdom of Saudi Arabia (KSA) has undergone tremendous changes. The process of modernization and expansion of the system was very rapid by all standards [1]. Although the Ministry of Health (MOH) is the main authority responsible for the provision of health care in the country, other government sectors such as the Ministry of Defense, National Guard, and the Ministry of Interior have started providing health care for their employees and dependents. The government health care policy is to provide free health service, including drugs, to all its citizens and resident expatriates. The provision of drugs on a large scale, in addition to ensuring their subsequent proper use, is a massive undertaking for the MOH. Due to this, proper guidelines and adequate controls for drug distribution and appropriate usage need to be developed. SA Bawazie, Prescribing Patterns of Ambulatory Care Physicians in SaudiThe need to develop a national drug policy and promote rational drug use in Saudi Arabia was recognized early and effective measures to address these issues were undertaken by the passage of two important laws governing the profession of pharmacy and the registration of pharmaceuticals in 1978 [2]. Legislation alone, however, cannot ensure the proper use of drugs. Documentation of drug utilization information is an essential step in the process of instituting rational drug use. This issue is a global priority.The rapid expansion of the pharmaceutical industry in the developed countries in the late 1960s has been responsible for developing countries being flooded with products of both proven and questionable qualities. This, coupled with the industry's intensive advertising campaign in these countries which have weak health education programs, has adversely influenced the pattern of drug use among the population...

Objective The purpose of this study was to determine consumer attitudes towards community pharmacy and their preferences for the introduction of new services. Methods A self‐completion questionnaire was developed and 1,144 consumers in 55 community pharmacies were invited to complete it. The questionnaire covered consumers' choice of pharmacy; their perceptions of, and actual interactions with, community pharmacists; advice from pharmacists about general health and prescribed medicines; and privacy in the pharmacy. Respondents were asked for their views about five possible new services. Setting The study was based in community pharmacies in Riyadh City, Saudi Arabia. Key findings The response rate was 79.6%. Fifty‐nine per cent of respondents often or sometimes visited a particular pharmacy. One‐quarter of respondents perceived community pharmacists as having a good balance between health and business matters, while 56.1% thought pharmacists were more concerned with the business. The majority of respondents (69.7%) said they felt comfortable asking the pharmacist for advice. Just under half (44.8%) felt that pharmacists allowed them enough time to discuss their problem fully and listened well. In addition, 58.5% of respondents indicated that their pharmacists showed sensitivity to privacy by speaking more quietly across the counter. In 14.4% of situations pharmacists were reported to use a private area within the pharmacy when discussing personal or private matters. Most respondents (65.2%) indicated that their pharmacist was willing to discuss their health problems and tried to understand their feelings. Consumers' priorities for new services were: monitoring blood pressure; measuring weight, height and temperature; monitoring blood sugar; and monitoring cholesterol. Conclusion This study showed that most pharmacy customers feel comfortable seeking advice from their pharmacist. Although many pharmacists were reported to show sensitivity to a possible lack of privacy in the pharmacy, few respondents reported that their pharmacy had a private area for discussion. Customers' views on possible new services were generally positive, with the exception of patient medication records.

This paper reviews the key design features, accomplishments of and lessons learned from two regional group procurement mechanisms dealing with vaccines that have been in operation for more than 25 years. The Pan American Health Organization (PAHO) EPI Revolving Fund purchases vaccines and immunization supplies on behalf of more than 35 countries in the Latin American and Caribbean region. Based on a 'central contracting' model, the program handles most aspects of procurement-from tendering to contracting with and paying producers--using a common fund to pay producers before being reimbursed by countries once goods are received in-country. The Gulf Cooperation Council (GCC) Group Purchasing Program among seven Persian Gulf States issues joint tenders for vaccines, as well as drugs and other medical goods. Through this 'group contracting' program, countries are responsible for contracting with and paying producers on their own, once the group has selected winning bids. Both programs have experienced substantial growth in the past two decades and are considered to have contributed to or accelerated achievements of immunization programs in both regions, including the introduction of new vaccines. The paper identifies several features of both programs--both those designed to attract country participation and those designed to ensure the programs' financial viability--which help explain their success and longevity.

A simple, rapid, sensitive, and reproducible high-performance liquid chromatographic (HPLC) method for simultaneous determination of the antiepileptic drugs (ethosuximide, primidone, lamotrigine, phenobarbital, phenytoin, and carbamazepine) and two metabolites (carbamazepine-diol and carbamazepine-epoxide) in human plasma is described. The procedure involves extraction of the drugs from human plasma (100 microL) with ether using 9-hydroxymethyl-10-carbamyl acridan as an internal standard. The extract was evaporated and reconstituted with mobile phase and then injected onto the chromatograph. The drugs and the internal standard were eluted from a Supelcosil LC-18 stainless steel column at ambient temperature with a mobile phase consisting of a 0.01M phosphate buffer/methanol/acetonitrile (65/18/17, v/v/v) adjusted to a pH of 7.5 with phosphoric acid and a flow rate of 1 mL/min. The effluent was monitored at 220 nm. Quantitation was achieved by using peak area ratio of each drug to the internal standard. The intraassay and interassay coefficients of variation (CV) ranged from 2.43% to 6.25% and from 3.02% to 5.85%, respectively. The absolute (extraction) and relative (analytical) recoveries for the drugs ranged from 70.7% to 104.4% and from 88.3% to 106.1%, respectively. Stability tests showed that the drugs were stable in plasma for at least 4 weeks when stored at -20 degrees C. The method was applied clinically for monitoring the AEDs in epileptic patients.

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