The Saudi Initiative for asthma

BackgroundThe prevalence of childhood bronchial asthma in Saudi Arabia has increased in less than a decade from 8% to 23%. Innovations in the management of asthma led to the development of evidence based clinical practice guidelines and protocols to improve the patients’ outcomes. The objectives of this study are to examine the compliance of the healthcare providers in the Pediatrics Emergency Department, in King Khalid University Hospital, with the recommendations of the Pediatrics Asthma Management Protocol (PAMP), and to explore the reasons behind non-adherence.MethodsThis study is designed in 2 parts, a patients’ chart review and a focus group interview. The medical records of all the children who presented to the Pediatric Emergency Department (PED) and were diagnosed as asthmatic, during the period from the 1st of January 2009 to the 31st of March 2009, were reviewed to investigate the compliance of healthcare providers (physicians and nurses) with 8 recommendations of the PAMP which are considered to be frequently encountered evidence-practice gaps, and these are 1) documentation of asthma severity grading by the treating physician and nurse 2) limiting the prescription of Ipratropium for children with severe asthma 3) administration of Salbutamol through an inhaler and a spacer 4) documentation of parental education 5) prescription of systemic corticosteroids to all cases of acute asthma 6) limiting chest x-ray requisition for children with suspected chest infection 7) management of all cases of asthma as outpatients, unless diagnosed as severe or life threatening asthma 8) limiting prescription of antibiotics to children with chest infection. The second part of this study is a focus group interview designed to elicit the reasons behind non- adherence to the recommendations detected by the chart review. Two separate focus group interviews were conducted for 10 physicians and 10 nurses. The focus group interviews were tape-recorded and transcribed verbatim. Theory-based content analysis was used to analyze interviews into themes and sub-themes.Results and discussionA total of 657 charts were reviewed. The percentage of adherence by the healthcare providers to the 8 previously mentioned recommendations was established. There was non-adherence to the first 5 of the 8 aforementioned recommendations. Analysis of the focus group interview revealed 3 main themes as reasons behind non-compliance to the 5 recommendations mentioned above and those are 1) factors related to the organization, 2) factors related to the asthma management protocol 3) factors related to healthcare providers.ConclusionThe organizational barriers and the lack of an implementation strategy for the protocol, in addition to the attitude and beliefs of the healthcare providers, are the main factors behind non-compliance to the PAMP recommendations.

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“…SINA was adapted from Global Initiative for Asthma (GINA) and the National Asthma Education and Prevention Program [3,15]. …”

Section: Methodsmentioning

confidence: 99%

Reasons behind non-adherence of healthcare practitioners to pediatric asthma guidelines in an emergency department in Saudi Arabia

Wahabi

Alziedan

2012

BMC Health Serv Res

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“…Thus, it could be argued that guidelines are highly important for supporting staff decision-making. Furthermore, the Saudi initiative for asthma has published guidelines used by most hospitals in Saudi Arabia for managing asthmatic patients (Al-Moamary et al, 2013). And they are regularly updated and published in the Annals of Thoracic Medicine Journal which is the official journal of the Saudi Thoracic Society (STS).…”

Section: Domain C: Prescribing In Context the Healthcare System Infomentioning

confidence: 99%

“…Table 1 shows the ICS drug available in Saudi Arabia and the daily doses in micrograms recommended for adult patients adapted from the Saudi thoracic society (Al-Moamary et al, 2013).…”

Section: Domain B: Prescribing Effectively Safe Professional and Alwmentioning

confidence: 99%

An example of using a decision making framework designed for non-medical prescribers as a method for enhancing prescribing safety for inhaled corticosteroids (ICS)

Almarshad

2015

Saudi Pharmaceutical Journal

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Non-medical prescribing is needed especially with the increased demand for health care and the physicians' time constrains. Also, it is not well regulated in Saudi Arabia unlike the United Kingdom. This report aims to demonstrate the urged need for regulations to maintain a safe non-medical prescribing process. It also adapts the single competency framework provided by the United Kingdom national prescribing centre (NPC, 2012) to be utilised by the respiratory therapist for a safe prescribing process for inhaled corticosteroids (ICS) to control adult asthma as an example. The framework is thought to be an effective tool for safe non-medical prescribing and it is highly recommended to develop a national Saudi framework to maintain the patients' safety and utilise resources.

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“…[4–6] Such concerns have originated from some previously published reports focused on the potential health hazards and mortality from the overuse of solo SABAs. [7] Hence I would like to propose this question: Should we be thinking to avoid the use of any solo beta-agonist inhaler in asthma management?…”

mentioning

confidence: 99%

New FDA safety warnings for LABAs: A call for asthma guidelines revisit for solo beta agonist

Koshak¹

2010

Ann Thorac Med

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The Saudi Initiative for asthma

Cited by 34 publications

References 145 publications

Reasons behind non-adherence of healthcare practitioners to pediatric asthma guidelines in an emergency department in Saudi Arabia

Reasons behind non-adherence of healthcare practitioners to pediatric asthma guidelines in an emergency department in Saudi Arabia

An example of using a decision making framework designed for non-medical prescribers as a method for enhancing prescribing safety for inhaled corticosteroids (ICS)

New FDA safety warnings for LABAs: A call for asthma guidelines revisit for solo beta agonist

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