Background: In each hospital, there are good number of patients who are candidates for the switch-over from intravenous (IV) to oral therapy. The main hindrance that restricts intravenous to oral conversion is the idea that oral medications do not reach the same bioavailability as that of intravenous medications and that the same item must be used both intravenously and orally. Although several drugs commonly used in hospitalized patients are equally bioavailable intravenously and orally, patients usually are not shifted to the oral medication when stable and taking oral medications or eating an oral diet. There are many advantages involved in earlier conversion from the intravenous to the oral therapy, including but not conclusive to less nursing time for medication administration, lower cost, less intravenous catheters needed can lead to increased patient satisfaction and safety. Objective: Establishment of a pharmacist-led IV to oral switch over protocol in the National Neuroscience Institute (NNI) at King Fahad Medical City (KFMC), in an attempt to reduce the annual medication cost. Method: The study was conducted in the NNI of KFMC in Riyadh Saudi Arabia. The study was prospective. We identified five targeted medications that are commonly prescribed in NNI (NHDU, NW1, Stroke) inpatient wards with almost identical oral and intravenous bioavailability. Fort five (45) patients were recruited. Their files were reviewed by the pharmacist and recommendation to switch was communicated to physician either verbally or documented in the patient file. The total cost of the medications was compared between oral and intravenous forms according to the length of stay in the ward. Inclusion and exclusion criteria are mentioned. Difference between oral and IV medication cost were compared using Mann-Whitney U test. All data entry and statistical analyses were performed using SPSS 22.0 software. Results: This study has been in place for six months. Seventy one (71) recommendations were made. Of these recommendations, 11 (15.5%) were rejected and 60 (84.5%) were accepted and implemented, resulting in a cost savings of 10,652 SAR (P=0.001). When annualized, the expected savings is 21,304 SAR or nearly the monthly salary of two full-time pharmacists. Conclusion: This study demonstrates successful implementation of a pharmacist-led switch-over strategy. Duration of IV treatment reduced dramatically and the annual savings significantly improved. This program has been well accepted by physicians and pharmacists. It appears to be having a positive impact on physician awareness of using oral medications when appropriate. This study may be used as a template for the introduction of further pharmacist-led early IV to oral switch-over initiatives.
She holds a diploma of state ingenerate in plant ecology at the age of 24 years. She carried out advanced training and training in the field of Plant Physiology and Biotechnology, in durum wheat lab markers assisted (experimentation in the field and laboratory) at the ICARDA, International Center for Agricultural Research in the Dry Areas, Aleppo Syria, after she pursued her studies in genetic improvement, Plant and Environment (stress abiotic), for obtaining her Master's degree in the University of Constantine with collaboration ICARDA, and now a Ph.D. student.
Drought is a global propagation problem with negative effects on durum wheat production in rainfed ecosystems. Therefore, adequate and effective selection criteria are needed to help develop new varieties that are better adapted to an unpredictable climate. Several drought tolerance indices based on mathematical relationships between yield under irrigated conditions and drought have been proposed to characterize, detect and evaluate the response of population in stressed and unstressed environments. To evaluate the effectiveness of several indices for the identification of durum wheat genotypes combining drought tolerance and high yield potential, the drought indices stress susceptibility index (SSI) and stress tolerance index (STI) used in plant breeding were calculated based on the combination between (Ys) and (Yp) under two contrasting environments (stressed and unstressed). A durum wheat population of 249 lines, selected for their wide variability in responses to water stress and grain yield, were grown in different contrasting environments (irrigated and rainfed) during two growing seasons. Principal components analysis showed associations between drought tolerance indices and grain yield, most of them caused by differences between environments. The results indicated that there was a positive and significant correlation between (Yp), (Ys) and (STI). The SSI index showed a negative correlation with the yield (Ys) under stress environment. These indices can be considered as suitable criteria for the selection of drought-tolerant and high-yielding genotypes under moderate stress in a Mediterranean environment.