National Pharmacy Pain Management Program at Ministry of Health in Saudi Arabia
Yousef Ahmed Alomi*
National Clinical Pharmacy, and Pharmacy Practice Programs, Head, Pharmacy R & D Administration Ministry of Health, Saudi Arabia
Submission: June 14, 2016; Published: June 29, 2017
*Corresponding author: Yousef Ahmed Alomi,The Past General Manager of General Administration of Pharmaceutical Care, Head, National Clinical Pharmacy, and Pharmacy Practice Programs, Head, Pharmacy R & D Administration, Ministry of Health, P.O.BOX 100, Riyadh 11392, Riyadh, Saudi Arabia, Tel: +966504417712; Email: yalomi@gmail.com
How to cite this article: Alomi YA. National Pharmacy Pain Management Program at Ministry of Health in Saudi Arabia. J of Pharmacol & Clin Res. 2017; 3(2): 555606. DOI: 10.19080/JPCR.2017.03.555606
Abstract
Over short of time, the General Administration of Pharmaceutical Care established several pharmacy practice programs based on patient demand, preventing drug misadventures, and poor health care provider's knowledge and perception and national and international hospital pharmacy accreditation's requirements. National pain management program was among them. The system initially started in the 2000s in Saudi Arabia, and the first program at Ministry of Health hospital stated in 2008, and then become national program in 2013. The program had astrategic plan, and policy and procedures, with Key performance indication to measure the implementation of the program. The program prevents drug misuse and avoid additional economic burden on health care system in Saudi Arabia
Keywords: Pain Management; Pharmaceutical care; Pharmacy; Ministry of Health; Saudi Arabia
Introduction
The history of starting pain management services in Saudi Arabia is not clear. However, may be the first hospital started the program at Armed forced hospital in 1994. The clinical audit study from 1994-2003 and more 10,000 patients described the acute pain services at the hospital [1]. The pain management clinic established at Jeddah teaching hospital in January 2000 and provided the services through the year of 2004 [2]. In 2008, the hospital director of the biggest hospital at Ministry of Health (1400 beds) assigned the author as a head of regional drug information center. The author established the infrastructure of all clinical services including but not limited to the following poising control services, anticoagulation program, pharmacokinetics services, oncology pharmacy services, Surgical and Orthopedic pharmacy services, pharmacoeconomic program, and pain management program [3]. The pain management program activated at the same hospital in 2010. The program consisted of goal and objectives, the job description of a pain management clinical pharmacist, policy and procedures of pain management services, pain management guidelines. The local hospital committee founded and headed by the director of aesthetics department, coordinated by trained pain management clinical pharmacist, and membership representative of the surgical, medical department, pediatrics development, nursing department, and quality management departments. The pain management guidelines designed as physician order form; both adult acute, and chronicpain management. Each type of pain treatment list medication based on MOH formulary. The options list made as first-line therapy, second choice, and last line therapy.
The medications chosenbased on update guidelines of adult's pain management, updated literature and pharmacoeconomic based. If the treating doctors wish to choose another option, he has to write the justification on that. All physician formats approved by a local hospital of pain management. Also, the committee formulated the pain management team contained anesthesiologist, nurse, and pain management clinical pharmacist. They do daily around five days per a week for postoperative patients, and consultation received from different departments at the hospital. The pharmacist should follow the adherence of the program, recommended the appropriate drug therapy based individual patient, and follow up and document any drug-related problems, thus correct them accordingly. Measurement patient quality of life and a cost impact required from clinical pharmacist. The program continued until 2012.
Pharmacy Pain Management Program
The demand for pain management program is very high in Kingdom of Saudi Arabia. The program required for hospital accreditation process at national and international accreditation institutions [4-5]. The pain management medication is underutilization in Saudi Arabia. In a study at teaching hospital in Riyadh city, the authors found with 160 oncologic patients 40% of whose suffered from pain not given any medication for pain while more 50% of then received inappropriate painkiller [6]. Also, the background of medical doctor or pharmacists or nurses showed poor knowledge and negative perception toward pain management medication during studentship [7-9]. The author not familiar with any published literature at in Saudi Arabia, and Gulf countries or the Middle East described national pharmacy pain management program
National Pharmacy Pain Management Program in Kingdom Of Saudi Arabia
In late 2012, the author promoted to General Manager of Pharmaceutical care. The author and his administration revised the general plan of MOH 2010-2020, updated the general plan of pharmaceutical care, and founded more thirty pharmacy practices and clinicalpharmacy program. Pain management services were one of them [10-13]. The author established a new central committee of pain management consisted of representing twenty regions over all the kingdom of Saudi Arabia. The committee updates all policy and procedures of previous hospital pain management, update the physician orders format, all related thing of the program. The member shared in designing Saudi clinical guidelines treatment of skill cell disease. The central committee established a plan for next five years as explored in (Table 1). The central committee started strategic plan over a five-year period, and the program beganwith nine hospitals then expanded to different regions as explored in (Table 2). The central committee founded key performance indicators to follow up the implementation of the program as shown in (Table 3), and the effective day of applying pain management at all MOH health care institution was on 4 September 2012 by a memorandum sent by General Manager of Pharmaceutical care.



Conclusion
National pharmacy pain management program is critical system at Ministry of Health institutions in Saudi Arabia. The program is unique national wise and Gulf countries level. The implementation of the program prevents drug misuse, improve medication safety system, prevent medications errors, improve patient outcome and avoid unnecessary economic burden on health care organizations.
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