The burden on EDs during Hajj due to pilgrim noncompliance with treatment for chronic conditions

BaDawood, Areej Omar; Bossei, Asseil Ali; AlSabhani, Mohammed Fahad; AlAhmari, Sana Moghram; Shata, Mohammed Tariq; Hamam, Anas

doi:10.24911/sjemed/72-1571844482

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…A possible reason for this observation is that not all pilgrims with chronic illnesses seek medical care unless their conditions decorate or they run out of medications [ 20 ]. Also, health issues linked to these conditions typically require a higher level of medical care [ 4 , 21 ]. For example, among Indian pilgrims in 2016, cardiovascular disease represented 4.6% of primary care morbidity but 27.1% of tertiary care referrals [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Pattern of utilization, disease presentation, and medication prescribing and dispensing at 51 primary healthcare centers during the Hajj mass gathering

Yezli

Yassin

Mushi

et al. 2022

BMC Health Serv Res

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Background The majority of pilgrims seeking healthcare during Hajj are seen at primary healthcare centers (PHCCs). Data on the utilization of these facilities during Hajj can aid in directing optimal health services delivery and allocation of resources during the pilgrimage. Method We investigated the pattern of disease presentation, caseload, and medication prescribing and dispensing at 51 PHCCs during the 2019 Hajj. Data on patients’ demographics, diagnoses, and prescribed medications were retrieved from each PHCC’s electronic records and analyzed. Data were also used to calculate six of the World Health Organization (WHO) indicators for drug use at these facilities. Results Data were captured for 99,367 patients who were mostly Hajj pilgrims (95.4%), male (69.1%) from the Eastern Mediterranean (60.8%) and had a mean age of 46.6 years (SD = 14.9). Most patients (85.2%) were seen in Mina and towards the end of Hajj. The majority of patients (96.0%) had a single diagnosis; most commonly, respiratory (45.0%), musculoskeletal (17.2%), and skin (10.5%) diseases. Patients were prescribed 223,964 medications, mostly analgesics (25.1%), antibacterials for systemic use (16.5%), anti-inflammatory and antirheumatic products (16.4%), and cough and cold preparations (11.9%). On average, 2.25 (SD = 0.94) medications were prescribed per consultation, with low (1.3%) prevalence of polypharmacy. An antibiotic and an injectable were prescribed in 43.6 and 2.67% of patient encounters, respectively. Most (92.7%) of the prescribed drugs were actually dispensed, in an average time of 8.06 min (SD = 41.4). All PHCCs had a copy of the essential drugs list available, on which all the prescribed drugs appeared. Conclusion Respiratory illnesses are the main reason for PHCCs visits during Hajj, and analgesics and antibiotics are the most common medications prescribed to pilgrims. Our results, including the calculated WHO drug use indicators, contribute to evidence-based optimization of primary healthcare services during Hajj.

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Section: Discussionmentioning

confidence: 99%

Pattern of utilization, disease presentation, and medication prescribing and dispensing at 51 primary healthcare centers during the Hajj mass gathering

Yezli

Yassin

Mushi

et al. 2022

BMC Health Serv Res

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“…Despite free 3 Journal of Diabetes Research healthcare provision for pilgrims during Hajj and the availability of medication during the event, it is prudent for pilgrims to bring their insulin with them in enough quantities to ensure they do not suddenly run out of the medication during Hajj. In general, most pilgrims with underlying health conditions bring their medication with them for Hajj, however, not always in sufficient quantities [23,24].…”

Section: Discussionmentioning

confidence: 99%

Insulin Knowledge, Handling, and Storage among Diabetic Pilgrims during the Hajj Mass Gathering

Yezli

Yassin

Mushi

et al. 2021

Journal of Diabetes Research

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Background. Diabetes is one of the most common underlying health conditions among Hajj pilgrims. Many diabetics manage their condition using insulin, which requires appropriate storage conditions to maintain its stability and effectiveness. We aimed to investigate insulin knowledge, storage, and handling among diabetic pilgrims during Hajj to identify specific areas for improvement. Method. Adult diabetic pilgrims from 22 countries were interviewed using a structured questionnaire during the 2019 Hajj. Results. The study enrolled 277 diabetic pilgrims with a mean age of 58.4 years ( SD = 10.4 , range: 20-83) and male : female ratio of 1.6 : 1. Most participants (86.4%) were literate and reported using insulin for a mean of 7.1 years ( SD = 5.3 , range: 1-23). Over 95% of pilgrims brought their insulin with them from their country of origin, where they also received most of their insulin storage information, mainly from physicians (77.8%) and pharmacists (59.6%). Pilgrims’ knowledge regarding insulin storage was just above average ( mean knowledge score = 0.51 ; SD = 0.23 ). Pilgrims who were literate and previously received education on insulin storage, those with a higher level of education, and those with a longer duration of insulin therapy, had significantly higher knowledge scores. Pilgrims’ storage and handling of their insulin during Hajj also varied depending on the stages of their pilgrimage journey. Conclusion. Inadequate knowledge and inappropriate practices regarding insulin handling and storage were identified among diabetic Hajj pilgrims, which could compromise the quality of insulin and lead to health hazards. Improving diabetic pilgrims’ knowledge of diabetes management, including insulin storage, will be beneficial during the pilgrimage and beyond.

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“…In the current study, underlying health conditions were common among pilgrims, particularly diabetes and hypertension, which is in line with other reports from Hajj [ 5 ]. Pilgrims with such conditions often take medication to manage their illnesses which they bring with them from outside KSA; although not always in sufficient quantities [ 6 , 21 ]. In a 2017 study, over half of pilgrims with chronic conditions brought their medications on Hajj, but only 12% reported having enough quantities covering their stay at the event [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a 2017 study, over half of pilgrims with chronic conditions brought their medications on Hajj, but only 12% reported having enough quantities covering their stay at the event [ 6 ]. Pilgrims should be encouraged to bring their chronic illnesses medications with them in sufficient amounts to ensure that they do not run out and to avoid deterioration of their underlying health conditions [ 21 ]. On the other hand, bringing unnecessary medication in excessive amounts can promote misuse and self-medication, as well as creating issues regarding the handling, storage and disposal of such drugs.…”

Section: Discussionmentioning

confidence: 99%

“…Only 28.2% of pilgrims accessed information on medication storage from the medication label in the current study. Studies have shown that not all medication users consult the medication label or the package insert for information [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. In one study among Hajj pilgrims, only 54.2% reported that they do read the information on medications’ labels before using them.…”

Section: Discussionmentioning

confidence: 99%

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Medication Handling and Storage among Pilgrims during the Hajj Mass Gathering

et al. 2021

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We aimed to investigate the knowledge and practices of Hajj pilgrims regarding medication storage and handling during the Hajj mass gathering. In this cross-sectional study, adult pilgrims from 30 countries were interviewed using a structured questionnaire during the 2019 Hajj. The study enrolled 1221 participants with a mean age of 50.8 years (SD = 12.5, range = 18–98) and male:female ratio of 1.7:1. Most pilgrims were literate, 50.4% had a university or higher education, and 38% reported at least one underlying health condition. Most pilgrims reported receiving education regarding the proper way to store their medication during Hajj, mainly from physicians (73.7%) and pharmacists (39.4%). Although 68.2% of pilgrims had good knowledge regarding medication storage and the potential effect of inappropriate storage conditions on medications and health, inadequate knowledge and poor practice were identified among some. Level of education, having an underlying health condition and receiving health education on mediation storage were independently associated with good knowledge. Most pilgrims took their medications with them during Hajj, although storage and handling of their medication also varied depending on the stages of their Hajj pilgrimage journey. Improving Hajj pilgrims’ awareness and knowledge about appropriate storage and handling of their medications are beneficial in reducing the risk of associated adverse health outcomes, both during Hajj and beyond the mass gathering.

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The burden on EDs during Hajj due to pilgrim noncompliance with treatment for chronic conditions

Cited by 4 publications

References 7 publications

Pattern of utilization, disease presentation, and medication prescribing and dispensing at 51 primary healthcare centers during the Hajj mass gathering

Pattern of utilization, disease presentation, and medication prescribing and dispensing at 51 primary healthcare centers during the Hajj mass gathering

Insulin Knowledge, Handling, and Storage among Diabetic Pilgrims during the Hajj Mass Gathering

Medication Handling and Storage among Pilgrims during the Hajj Mass Gathering

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