YAZED ALRUTHIA - Academia.edu (original) (raw)

Papers by YAZED ALRUTHIA

Cost effectiveness and resource allocation, Feb 14, 2024

Background The study aimed to examine the direct medical cost and impact of tocilizumab (TOZ) ver... more Background The study aimed to examine the direct medical cost and impact of tocilizumab (TOZ) versus adalimumab (ADM) and etanercept (ETC) on reducing the levels of two inflammatory markers (e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) among patients with rheumatoid arthritis (RA) using real-world data from Saudi Arabia. Method This was a single-center retrospective cohort study in which data for biologic-naïve RA patients aged ≥ 18 years and treated with TOZ, ADM, ETC were retrieved from the electronic medical records (EMRs) of a universityaffiliated tertiary care center in Riyadh, Saudi Arabia. Patients were followed up at least one year after the treatment initiation. Bottom-up microcosting was utilized to estimate the direct medical costs. Additionally, inverse probability treatment weighting and bootstrapping with 10,000 replications were conducted to generate 95% confidence levels for costs and the mean reductions in CRP and ESR levels. Results The number of patients who met the inclusion criteria and were included in the analysis was 150 patients (TOZ (n = 56), ADM (n = 41), ETC (n = 53)). Patients on TOZ had 3.96 mg/L (95%

Global Journal on Quality and Safety in Healthcare

Introduction There is an increased interest in cost consciousness concerning healthcare spending ... more Introduction There is an increased interest in cost consciousness concerning healthcare spending worldwide. In the Arab world, a major transformation is underway in the healthcare sectors to achieve national and government visions to attain better outcomes with optimal value. This article contains expert recommendations on how decision-makers can implement pharmacoeconomic principles at a national level in the Arab world. Methods A multidisciplinary panel of experts was formed of policymakers, clinical pharmacists, health economists, and chronic disease control and public health experts from different countries and healthcare sectors. The panel developed consensus recommendations for different stakeholders using a framework analysis method. Results The experts discussed the limitations and opportunities of implementing the pharmacoeconomics concept in evaluating new technologies in their respective countries. Common limitations recognized in the included countries were a lack of inf...

Value in Health, May 1, 2014

Journal of The Saudi Pharmaceutical Society, Sep 1, 2017

Background: Metformin is widely used with gonadotropins by women with polycystic ovary syndrome (... more Background: Metformin is widely used with gonadotropins by women with polycystic ovary syndrome (PCOS) during in vitro fertilization (IVF) to increase their chances of pregnancy. The aim of this study was to evaluate the efficacy of metformin in improving the rates of clinical pregnancy among women with PCOS undergoing IVF. Methods: This was a retrospective cohort study of women with PCOS, aged 18-40 years, undergoing IVF during 2006-2012 at a University Hospital in Riyadh, Saudi Arabia. Baseline patient data including menstrual frequency, biochemical parameters such as fasting serum insulin (FSI) concentration, comorbidities, and the rates of ovulation and pregnancy were collected. Pregnancy rates were compared between the metformin and non-metformin groups. Results: A total of 210 women with PCOS met the inclusion criteria and were included in the study. Of the 210 women with PCOS, 109 of them received metformin in addition to gonadotropins. Patients who received metformin were 16% less likely to be pregnant in comparison with those who did not receive metformin (OR = 0.840; 95% CI = 0.710-0.993; P = 0.0415), when controlled for baseline prolactin level, testosterone level, lipid panel, FSI concentration, fasting plasma glucose (FPG) concentration, comorbidities, duration of infertility, daily metformin dosage, and the previous use of clomiphene and/or leuprolide. Conclusions: Metformin co-treatment during IVF may negatively affect pregnancy rates. Further welldesigned, randomized, double-blind placebo-control clinical trials are needed to confirm the findings of this study.

Journal of The Saudi Pharmaceutical Society, Jul 1, 2017

Objectives: There is some evidence that the efficacy of metformin as an ovulation stimulation age... more Objectives: There is some evidence that the efficacy of metformin as an ovulation stimulation agent depends on the body mass index (BMI) of the treated anovulatory women with polycystic ovary syndrome (PCOS). The aim of this study was to examine the likelihood of successful ovulation among obese (BMI P30 kg/m 2) versus non-obese (BMI <30 kg/m 2) women with PCOS. Methods: A total of 243 medical charts of women with PCOS who visited King Khaled University Hospital (KKUH) in Riyadh, Saudi Arabia, between 2006 and 2012 were reviewed. Patients' sociodemographic, laboratory, and medical data were collected. Descriptive statistics and multiple logistic regression analyses were performed to compare the patients' baseline data and successful ovulation among the obese and non-obese anovulatory women with PCOS, respectively. Results: One hundred and nine women with PCOS who were prescribed metformin for P3 months were included in the study. Almost 60% of the women who were included in the study were obese. The likelihood of ovulation among obese women with PCOS was 77.9% (odds ratio = 0.221, 95% CI 0.052-0.947, P = 0.042) less than that in their non-obese counterparts.

Frontiers in Pediatrics

Novel therapeutic strategies have shown some promise in treating spinal muscular atrophy (SMA). H... more Novel therapeutic strategies have shown some promise in treating spinal muscular atrophy (SMA). However, the outcomes and acceptance of these new strategies are yet to be explored. We aimed to investigate physicians' opinions and perceptions toward management strategies of SMA across Saudi Arabia. This is a cross-sectional survey using a self-administered, structured questionnaire sent to physicians who care for SMA patients during the Saudi Pediatric Neurology Society annual conference. A total of 72 clinicians of different neurological subspecialties were included. 48.6% prescribed nusinersen to their patients, with 39% of them having patients started on nusinersen. Though, 8.3% prescribed onasemnogene abeparvovec for 1–3 patients, while none of their patients started on the treatment. 64.3% stated that the only treatment available for SMA in their settings is supportive care. Around 69.4% described having a moderate to high knowledge on SMA gene therapy, and 79.2% would recom...

BMC Health Services Research

Introduction The advent of new disease-modifying therapies (DMTs), such as monoclonal antibodies ... more Introduction The advent of new disease-modifying therapies (DMTs), such as monoclonal antibodies (mAbs), resulted in significant changes in the treatment guidelines for Multiple sclerosis (MS) and improvement in the clinical outcomes. However, mAbs, such as rituximab, natalizumab, and ocrelizumab, are expensive with variable effectiveness rates. Thus, the present study aimed to compare the direct medical cost and consequences (e.g., clinical relapse, disability progression, and new MRI lesions) between rituximab and natalizumab in managing relapsing-remitting multiple sclerosis (RRMS) in Saudi Arabia. Also, the study aimed to explore the cost and consequence of ocrelizumab in managing RRMS as a second-choice treatment. Methods The electronic medical records (EMRs) of patients with RRMS were retrospectively reviewed to retrieve the patients’ baseline characteristics and disease progression from two tertiary care centers in Riyadh, Saudi Arabia. Biologic–naïve patients treated with ri...

Journal of Clinical Medicine

Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-relat... more Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-related quality of life. This study used nationally representative United States (US) data to examine nuances of the impact of depression and/or anxiety on HRQoL in different cancer groups (e.g., cancer only, cancer and depression, cancer and anxiety, cancer and both conditions). Methods: Adult patients aged 18 years and older with a cancer diagnosis were identified from the Medical Expenditure Panel Survey data for 2012–2016. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. Multivariate linear regressions were used, controlling for a multitude of factors. Results: Around 12% of the 1712 identified patients with cancer had depression, 13% had anxiety, and 8.4% had both depression and anxiety. Patients with comorbid depression and anxiety had the lowest mean scores of both PCS and MCS compared to patients in other groups. In addition, cancer patients...

International Journal of Environmental Research and Public Health, Jan 20, 2023

BMC Emergency Medicine, Nov 29, 2022

Journal of Interprofessional Care

Interprofessional education (IPE) has potential benefits for improving the quality of patient car... more Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction of IPE, and (iv) suggestions on how to implement IPE and overcome challenges to establish an IPE curriculum. Participants were generally supportive of IPE and aware of the constraints that might impede its implementation. Moreover, they identified potential barriers and incentives to promote IPE. Although participants appreciated the long-term benefits of IPE, creating a supportive environment will require the involvement of the academic community, including students, faculty members, and the University's top management.

Journal of Clinical Medicine, Jul 18, 2022

Health Policy and Technology

Patient Preference and Adherence

Background: The recent approval of innovative therapies for spinal muscular atrophy (SMA), such a... more Background: The recent approval of innovative therapies for spinal muscular atrophy (SMA), such as nusinersen, has brought hope to patients and their families. Objective: The aims of this study were to compare the characteristics and HRQoL of SMA patients treated with nusinersen and those treated with the standard of care. Methods: This was a cross-sectional, interviewer-administered telephone questionnaire, which used a purposive sampling of SMA patients through a social support network. EuroQol five-dimensions-3-level (EQ-5D-3L) and the visual analog scale (VAS) have been used to assess the HRQoL. Different descriptive and inferential tests have been performed to compare the characteristics, EQ-5D responses, and mean scores of EQ-VAS between patients on nusinersen and the standard of care. Results: Eleven out of 36 SMA patients (30.55%) have been treated with nusinersen. Patients with type I SMA represented 54% of those treated with nusinersen (P=0.012). Only 12.5% of SMA patients living in the Mecca region are treated with nusinersen in comparison to 50% of patients living in the Riyadh region (P=0.029). No difference was noticed in the proxy-responses for the five domains of the EQ-5D or the mean VAS scores for patients on nusinersen and the standard of care despite controlling for the SMA type and the ability to breathe independently (β= 1.39, 95% CI=-5.15-7.93, P=0.667). However, the mean VAS score for patients who are unable to breathe independently was significantly lower than their counterparts who are able to breathe independently even after controlling for the SMA type and nusinersen treatment (β=-31.61, 95% CI=-51.59-11.63, P=0.003). Conclusion: The results of this study highlight the uncertainty about the impact of nusinersen on SMA patients' HRQoL. Therefore, the impact of nusinersen on HRQoL should be examined using more robust study designs.

Saudi Journal of Gastroenterology

Background Crohn's disease (CD) frequently recurs after intestinal resection. Azathioprine (A... more Background Crohn's disease (CD) frequently recurs after intestinal resection. Azathioprine (AZA) and biological therapies have shown efficacy in preventing postoperative recurrence (POR). Data on POR from Middle Eastern populations is lacking. This study aimed to evaluate the rate of endoscopic POR in a cohort of CD patients who underwent ileocecal resection (ICR), and to assess the effectiveness of AZA and biological therapies in reducing the risk of disease recurrence. Methods We performed a retrospective cohort study on 105 CD patients followed at our center, who underwent ileal resection and were at moderate to high risk for POR. Clinical and laboratory data were collected; the primary endpoint was post ICR endoscopic recurrence at 24 months defined by Rutgeerts' score of i2 or more despite treatment. Results In total, 105 patients with Crohn's disease met our inclusion criteria; 76.2% were in remission and did not have endoscopic POR at 24 months. Further, 41.9% were on biological therapy, and 34.3% were mainly on AZA. Out of the 28.2% who had POR, approximately 15% were on biological therapies. Penetrating phenotype was the only predictive factor for decreasing POR (OR = 0.19, 95% CI: 0.04-0.98, P = 0.04) as identified in multiple logistic regression analysis. Conclusions The use of biological therapies post-surgery was not superior than AZA in reducing the endoscopic POR for mod- high risk CD patients. Only penetrating behavior of the CD was associated with significantly lower risk of endoscopic recurrence. This finding is worth further investigation in more robust study designs and among larger samples of patients.

Background: The Coronavirus disease of 2019 (COVID-19) is now a major challenge for healthcare sy... more Background: The Coronavirus disease of 2019 (COVID-19) is now a major challenge for healthcare systems in many countries, including some of the G20 countries like China, Italy and France. The purpose of this paper was to estimate how this disease could impact Italy, Spain and France, in comparison to China, based on the timing of their first response to the epidemic.Methods: The study visually estimated when will the suppression strategies implemented in Italy, Spain and France would change the direction of the daily new infections curve. The study utilizes the publicly available data from the WHO website. The curve representing the response strategy from China was used as a visual reference in this case, assuming that the virus is impacting all populations in the same way, transmitted in similar rate, and the time needed from the implementation of the suppression strategies to the appearance of its impact would be identical in all countries. Then, the total number of cases and deat...

Journal of Crohn's and Colitis, 2020

Background The Ulcerative Colitis (UC) and Chron’s Disease (CD) are two debilitating Inflammatory... more Background The Ulcerative Colitis (UC) and Chron’s Disease (CD) are two debilitating Inflammatory Bowel Diseases (IBD) with an immense negative impact on patients’ health-related quality of life (HRQoL). Although several studies have examined the efficacy of different drugs in the management of IBD, none of these studies has assessed their impact on HRQoL among IBD patients in low incidence areas, such as Saudi Arabia. Therefore, the aim of this study was to examine the impact of Azathioprine, which is one of the commonly utilised immunosuppressive drugs, on HRQoL among a sample of IBD patients in Saudi Arabia. Methods This was a single-centre retrospective cohort study in which adult patients (≥18 years) with a confirmed diagnosis of UC or CD and no malignancies were identified in the hospital IBD registry. Patients’ HRQoL was assessed using the EuroQol five-dimensions- 3-level (EQ5D) at baseline as well as six months after initiation of therapy. The overall HRQoL was assessed usin...

Saudi Pharmaceutical Journal, 2017

Background: Patients with mental disorders, such as depression and anxiety, who seek medical care... more Background: Patients with mental disorders, such as depression and anxiety, who seek medical care in private psychiatric clinics in Riyadh, Saudi Arabia, have recently expressed concerns to doctors about difficulty in filling psychotropic medications, such as Amitriptyline and Aripiprazole, at retail community pharmacies. Objectives: The aim of this study was to investigate whether there is a shortage of some commonly prescribed psychotropic medications in retail community pharmacies in Saudi Arabia, and if so, to explore the possible reasons behind the shortage of these medications. Methods: The availability of 28 commonly prescribed psychotropic medications was checked in multiple retail community pharmacies in 4 different regions of Saudi Arabia. Further, potential reasons behind the shortage of some psychotropic medications in retail community pharmacies were also explored.