Conectar
by Fahad Alzahrani, Nawaf Almutairi, Abdullah Aloufi, Abdulmalik Kattan, Abdulaziz Hakeem, Mohammed Alharbi, Naif Alarawi, Haifa A. Fadil, Ehsan Habeeb
ObjectivesEvidence-based medicine (EBM) combines clinical expertise, patient values, and the best available evidence to guide healthcare decision-making. Despite its importance in pharmacy practice, EBM adoption in Saudi Arabian pharmacies remains under-researched. This study aimed to assess the knowledge, attitudes, and practices regarding EBM among hospital and community pharmacists in the Madinah Region, Saudi Arabia.
MethodsA cross-sectional study was conducted with 206 pharmacists from September to November 2023. Data were collected through a validated online self-administered questionnaire to evaluate pharmacists’ knowledge, attitude, and practice (KAP), as well as their understanding of EBM technical terms.
Ethical approvalThe study was approved by the Scientific Ethics Committee of the College of Pharmacy at Taibah University, Madinah region, Saudi Arabia (reference number COPTU-REC-77–20230827). All participants received a consent form before participating.
ResultsPharmacists demonstrated moderate knowledge (76.5%), neutral attitudes (76%), and fair practices (68%) toward EBM, with hospital pharmacists scoring higher than community pharmacists. Moreover, 83.3% believed that EBM could enhance patient health outcomes, 80.0% were willing to learn, and 35.9% believed that EBM focuses solely on research without considering clinical experience. Time constraints (34.0%) were a major barrier, and 46.1% of the participants lacked appropriate training. EBM education was correlated with higher knowledge and attitude scores; however, it had no significant impact on practice scores. Significant barriers identified were the difficulty in conveying technical terms (16%) and limited access to adequate training opportunities.
ConclusionDespite positive attitudes toward EBM, many pharmacists perceive it as a potential threat to good clinical practice. This perception underscores the need for targeted educational initiatives that promote EBM benefits, address misconceptions, and provide practical support for its integration in both hospital and community pharmacy settings.
Chest pain is a major cause of emergency ambulance calls, often linked to acute myocardial infarction (AMI), a critical condition requiring immediate hospitalisation. Current diagnostic methods, such as history taking and ECG, have limitations, especially for non-ST-elevation myocardial infarction. High-sensitivity cardiac troponin (cTn) assays are more diagnostically sensitive, but the downside is that it needs hospital-based testing, which can delay diagnosis and the necessary treatment protocol. Point-of-care cTn testing, on the other hand, is much faster and done nearer to the patient; hence, it may fundamentally change the prehospital care pathway in terms of diagnostic accuracy, clinical utility and related safety.
To present a protocol for a systematic review and meta-analysis that will assess the diagnostic accuracy, clinical utility and safety of point of care (POC) troponin tests, with or without clinical decision aids, for ruling out AMI in adults presenting with cardiac chest pain to emergency ambulance services in prehospital settings.
This protocol follows BMJ guidelines and adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 reporting standards. It is registered with PROSPERO (ID: CRD42024533117). A comprehensive search strategy will identify relevant studies in MEDLINE, EMBASE and CINAHL, focusing on literature from 2000 onwards. Eligibility criteria include adults with chest pain suspected of AMI, excluding those with ST-elevation myocardial infarction. The primary target is type 1 AMI, with secondary outcomes including major adverse cardiac events at 30 days. Risk of bias assessment will be performed using tools such as Quality Assessment of Diagnostic Accuracy Studies version 2, Risk of Bias 2, and Risk of Bias in Non-randomised Studies of Interventions, while the quality of the economic evaluations will be appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Data items extracted will include patient demographics, test characteristics and outcomes. Where possible, meta-analyses will be conducted by fitting hierarchical models for diagnostic accuracy and random effects models for clinical and cost-effectiveness estimates. Subgroup analyses are proposed to quantify the effect of variables such as gender, ethnicity and type of troponin assay on the estimated parameters.
Ethical approval is not required. The results will be published in a peer-reviewed journal and presented at international conferences.
This protocol is registered with PROSPERO, the International Prospective Register of Systematic Reviews, under the ID CRD42024533117. Any future amendments will be updated in the PROSPERO record.
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