@article {68, title = {The Clinical Outcomes of Pharmacist Interventions in Total Parenteral Nutrition services in Riyadh City, Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {June 2019}, pages = {135-140}, type = {Research Article}, chapter = {135}, abstract = {

Objectives: Total parenteral nutrition (TPN) is the perilous component of nutritional care for neonatal, pediatric and adult patients. TPN is designated for someone who cannot or should not consume nutrients through their regular oral pathway. In this study, we explored the clinical outcomes of pharmacist intervention in Parenteral Nutrition at the public hospital in Riyadh city, Saudi Arabia. Methods: In prospective cohort studies, we simulated the data of 12 months of 2015 related to TPN services for neonatal, pediatric and adult patients. Most of the TPN units at hospitals works eight hours per day and seven days per a week. The hospital in Riyadh, Saudi Arabia has 300 beds. The pharmacist intervention consisted of an International Study Model, measure level of activity, rational of clinical intervention, recommendation, and patient with outcome impact. The data were analyzed through Survey Monkey system. Results: The total number of pharmacist interventions were 402 of recognized TPN-related problems. The total number of TPN orders was 394 prescribed to 82 patients. The majority of patients were neonates 303 (75.56\%) followed by Pediatrics 97 (24.19\%). The highest number of critical care interventions were found to be potentially serious 108 (28.8\%) and potentially significant 174 (46.4\%). The documented rationale of clinical intervention activities was inappropriate dose 93 (24.8\%) drug therapy omission 50 (13.3\%) and inappropriate route of administration 41 (10.9\%). Most of the patient outcomes were laboratory value improved 170 (45.33\%) and patient condition improved 137 (36.53\%). Conclusion: TPN clinical pharmacist had an essential vital role of preventing a TPN-related problem, improve patient outcome, and avoid the unnecessary supplementary cost. Increasing TPN clinical pharmacist assigned for all TPN services at all health care system in Saudi Arabia.

}, keywords = {Assessment, Clinical outcomes, Interventions, Pharmacist, Total Parenteral Nutrition program}, doi = {10.5530/ijpcs.2019.8.23}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Nisreen Al-Shubaar and Abdulaziz Abdullah Qohal and Lila Yahya Alameer} } @article {44, title = {Cost of Total Parenteral Nutrition Services at the Ministry of Health, Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {January 2019}, pages = {39-44}, type = {Research Article}, chapter = {39}, abstract = {

Objectives: The estimation of cost of total parenteral nutrition (TPN) is a part of the pharmacoeconomic program at the Ministry of Health (MOH), Saudi Arabia. In this study, we explored the cost analysis of TPN services by using American Model with local cost. Methods: Simulation was performed for all 6 months of TPN services for neonate, pediatric and adult patients. King Salman Hospital in Riyadh, Saudi Arabia was chosen as the study site; it has 300 beds. The physician or the pharmacist prescribed TPN to their patients. The pharmacist reviews and prepares TPN. The nurse administers TPN and follows up with the doctor or the pharmacist. TPN was prepared through sterile 797 standards and automated compounding facilities. The costing was derived from MOH information database. The cost was calculated based on the variable expenses including personal cost, material cost and supply cost. Fixed costs included direct cost, non-salary cost and overhead cost. All costs were estimated in US dollar currency and local prices. Results: A total number of 112 patients were prescribed with (1631) TPN orders; the total volume of TPN was 619,161.90 mL. Of these, 103 (91.96\%), 6 (5.36\%) and 3 (2.68\%) were prescribed for neonatal, adult and pediatric patients, respectively. Of those with TPN orders, 1484 (90.99\%), 108 (6.62\%) and 39 (2.39\%) were prescribed for neonatal, adult and pediatric patients, respectively. The total average number of orders per day was 4.47. Of those, 4.07, 0.3 and 0.11 was for neonatal, adult and pediatric patients, respectively. The average duration of TPN for adults, neonatal and pediatric patients was 18, 14.4 and 13 days, respectively. The total average direct cost for active ingredient in the TPN was 61.81 USD. Of those, 38.54 USD (62.35\%), 16.63 USD (26.91\%) and 6.64 USD (10.74\%) was for pediatric, adult and neonatal patients. The estimated cost of TPN services for neonatal, adult and pediatric patients was 863.74 USD, 691.3 USD and 618.16 USD per day, respectively. The total annual and daily estimated expenditures of TPN orders were 629,865.02 USD and 212.22 USD; 44,795.24 USD and 207.39 USD; and 5,303.77 USD and 68.00 USD respectively for neonatal, adult and pediatric patients. The total annual and daily estimated cost were 314,764.70 USD and 3,055.97 USD; 22,398.12 USD and 3,733.02 USD; and 2,652.00 USD and 884.00 USD respectively for neonatal, adult and pediatric patients. Conclusion: In this study, we performed cost-estimation of the TPN in Saudi Arabia. This is the first study at MOH in Saudi Arabia. It is an essential basic element of pharmacoeconomic program and cost analysis of TPN-related healthcare services.

}, keywords = {Cost, Ministry of Health, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/ijpcs.2019.8.8}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Amjad Ahmad AL qahtani and Nesreen Al-Shubbar and Maha F Al-Yahya and Estiqlal Hussain Al-Smail} }