Sami Alshammary

• MBBS,ABFM, SBFM,JBFM, AFS,IIWCC,MME
• Consultant at King Fahad Medical City

Introduction: Palliative care is a multidisciplinary approach that aims to improve the quality of life of patients with life-threatening illnesses. It has been recognized as a crucial part of patient care in oncology. Palliative care service was established in the comprehensive cancer center of King Fahad Medical City (KFMC), Riyadh, Saudi Arabia i...

Palliative care is one of the six care systems in Saudi Arabia and has undergone significant growth over the past thirty years. However, challenges persist regarding this development. This paper examines these obstacles in the context of the rising demand for palliative services and explores potential strategies to address them. Keywords: life-thre...

Nystagmus, characterized by involuntary eye movements, can arise from several causes, with benign paroxysmal positional vertigo being the most prevalent. Additionally, central lesions such as tumors may also induce nystagmus. This case report describes the amelioration of vertical nystagmus in a patient with advanced glioma after treatment with the...

Introduction Continuous assessment of community health needs is essential to predict, recognize, and act on healthcare issues. Conducting community health needs assessments (CHNAs) in Saudi Arabia has become a priority to overcome the current healthcare challenges and keep pace with the Saudi Arabia 2030 vision. Studies reporting community health n...

We have noticed it’s common to see hiccups in palliative patients and in most cases need pharmacological intervention. As a part of a patient’s standard care and comfort, the presence of treatment guidelines for persistent hiccups is of paramount importance. In our cases, gabapentin appears to be effective in treating persistent hiccups

In response to the request of the Saudi Health Council, an expert palliative multi- disciplinary central committee was created to develop a model of the essential Saudi palliative medication list (EML), to be updated every 2 years, based on the World Health Organization (WHO) criteria for EML. Our problem is that most palliative patients do not hav...

Background: Palliative care (PC) plays a crucial role in improving the quality of life for terminally ill patients and their families. In Saudi Arabia, the Reform of Healthcare Vision 2030 has recognized the importance of PC and aimed to enhance its availability and quality. Objectives: This study evaluates the current state of PC in Saudi Arabia...

The prevalence of pain in cancer and palliative patients is alarmingly high, markedly affecting patients' and caregivers' quality of life. Hence, optimal analgesic management strategies are imperative for these specific patient demographics. This case report examines the effectiveness of Fentanyl versus Hydromorphone in the context of a 37-year-old...

The Kingdom of Saudi Arabia’s (KSA) Ministry of Health’s (MOH) healthcare transformation strategy aims to improve the quality of life of Saudi citizens in line with the ’Vision 2030’ strategic objectives. The MOH is reforming the way healthcare will be managed in the future and is in the process of transferring healthcare service delivery responsib...

Optimal pain management plays a pivotal role in enhancing the quality of life among cancer patients. Opioids, notably Fentanyl and Hydromorphone, are frequently employed for alleviating cancer-related pain. Cancer patients necessitate effective pain management to enhance their overall well-being. Opioids, such as Fentanyl and Hydromorphone,are prom...

To end of life a patient or expedite demise by using any medical interventions on voluntary patient’s demand, known as Assisted Dying (AD), it includes: Physician Assisted Suicide (PAS) and euthanasia [1]. PAS in which doctor offers a patient medications to be administered by the patient purposely to commit suicide on voluntary patient’s request [1...

Background: One of the most prevalent bacterial infections in children is urinary tract infection (UTI), which has become a major concern with increasing resistance of the pathogens to the routinely used antimicrobial agents. The aim of the study is to determine the antimicrobial susceptibility patterns of pediatric UTI-causing pathogens, includin...

Learning Objectives 1. Understand the concept of FOCUS-PDSA 2. Know how FOCUS-PDSA is used for quality improve- ment and enhancement processes 3. Learn the difference between FOCUS-PDSA and other frameworks or tools

Hiccups may appear to be a common normal phenomenon that does not warrant treatment in the general population. However, severe and persistent hiccups can become annoying and distressing and may decrease the quality of life, especially in cancer patients. The management of hiccups remains challenging. Despite trying many pharmacological and non-phar...

There is a global agreement that palliative care should be universally accessible. However, in low- and mid- dle-income countries and conflict zones, most people lack access to it. In the Eastern Mediterranean Region (EMR), no country has achieved integration of palliative care into its health care system, and only 4 countries have better-than-iso...

Cancer and other chronic diseases are already a significant and growing public health problem in the Eastern Mediterranean Region (EMR). Cancer is the fourth-ranked cause of death in the region, and the burden is predicted to increase in the future. Given the impact of the late presentation of cancer and the growing incidence of other chronic i...

Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can be helpful and cost effective in improving patient’s quality of life.

The COVID-19 pandemic prompted a number of shifts on healthcare. Conventional face-to-face visits were shifted during lockdown to virtual ones. Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can be helpful an...

This article described our experience in implementing a quality improvement project to overcome the bed overcapacity problem at a comprehensive cancer centre in a tertiary care centre. We formed a multidisciplinary team including a representative from patient and family support (six members), hospice care and home care services (four members), mult...

Abstract Background: The World Health Organization Office for the Eastern Mediterranean Region (EMR), and a recently created palliative care experts’ network from the EMR, decided to develop region-specific indicators to monitor national palliative care development. Aims: To identify relevant and feasible macroindicators of palliative care develop...

Background: There is global agreement that palliative care should be universally accessible. However, in low- and middle-income countries and conflict zones, most people lack access to it. In the Eastern Mediterranean Region (EMR), no country has achieved integration of palliative care into its healthcare system, and only 4 countries have better th...

Objective: During the COVID-19 pandemic, there was a significant decrease in the number of operated elective cases due to the shutdown procedures. This situation created a substantial surgical backlog. Several visits are generally necessary before a surgical decision making and booking the surgery time. Improving patient access by creating “one-sto...

Background: The COVID-19 pandemic prompted a number of shifts on healthcare. Conventional face-to-face visits were shifted during lockdown to virtual ones. Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can b...

Background Coronavirus 19 pandemic impacted the health system with more pressure on the critical areas, leading to direct manpower working in the Operating Room to help treat this new problem by postponing elective surgical cases and affecting some urgent ones. However, elective surgical services start to recover by establishing one or more hospita...

Palliative care is a specialty of its own consisting of comprehensive multidisciplinary healthcare delivery to patients with a wide range of life-threatening and life-shortening diseases, including cancer. Its primary goal is to relieve symptoms of suffering such as physical pain, psychosocial and spiritual problems that affect the quality-of-lif...

This article described our experience in implementing a quality improvement project to overcome the bed overcapacity problem at a comprehensive cancer centre in a tertiary care centre. We formed a multidisciplinary team including a representative from patient and family support (six members), hospice care and home care services (four members), mult...

Palliative Care: "Palliative care means the specialized care of people who are dying – care aimed at alleviating suffering (physical, emotional, psychosocial or spiritual), rather than curing. The term palliative care is generally used in association with people who have an active, progressive and advanced disease, with little or no prospect of cur...

Background: COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This...

COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This paper exami...

Background: The COVID-19 pandemic prompted a number of shifts on healthcare. Conventional face-to-face visits were shifted during lockdown to virtual ones. Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can b...

Abstract: Healthcare systems worldwide have undergone Major transformation, many countries of the world are struggling to improve healthcare quality, control costs, and provide access to healthcare for their citizens (Al Harbi,M. . 2018), In Saudi Arabia, over the past few decades, the healthcare system has expanded and improved significantly. The...

In response to the request of the Saudi Health Council, an expert palliative multi-disciplinary central committee was created to develop a model of the essential Saudi palliative medication list (EML), to be updated every 2 years, based on the World Health Organization (WHO) criteria for EML. Objectives: Our aim was to explore the degree of consen...

In response to the Saudi Health Council (SHC) request, an expert of palliative MDT central committee was formulated to develop a Model of Essential Saudi Palliative Medication lists (EML) and to be updated every two years, based on the WHO criteria OF EML (safety, efficacy and cost effectiveness of each medicine listed). To develop national PC Es...

Aim: This study aims to describe health-related quality of life (HRQL), identify factors associated with HRQL physical and mental health domains, and explore the association between perceived social supports and HRQL among cancer palliative patients in Saudi Arabia. Methods: A cross-sectional study is applied. The validated European Organization fo...

Prognostication is important for patients and their family members as they need this information for the preparation and planning of their future. It is important for physicians as they desire to be accurate in their prognostication skills in order to plan and deliver better care to their patients; healthcare managers require it as they need this i...

Background The World Health Organization (WHO) has recognized access to palliative care as a basic human right. Palliative care service has been established in Saudi Arabia for more than two decades; however, it is still limited to secondary and tertiary healthcare institutions. While primary care is the first level of care in the Saudi healthcare...

Intrathecal chemotherapy procedures are stressful to patients and caregivers, especially the first time. Providing the patient and caregiver with sufficient information to address their concerns before the scheduled procedure is necessary. This study aims to determine whether the use of video instructions could enhance learning outcomes and decreas...

Introduction: Palliative cancer care is becoming a core aspect of cancer treatment. Cancer patients are increasingly demanding a multidimensional approach to care, including physical, emotional, psychological, and spiritual dimensions. Health- related quality of life (HRQL) is essential to the attainment of these functions. At the end of life c...

Persistent hiccups is distressing for both patients and their families, particularly if the patients have advanced cancer. The lack of clear management guidelines renders hiccups management challenging for health professionals. We report our management of persistent hiccups in a 63-year- old man following a long robotic prostatectomy for advanced...

Background People with cancer usually experience some degree of depression, anxiety, and fear, as if embracing the fact that cancer has become part of their lives. Additionally, religious beliefs can influence a patient's support system, as well as the patient's own emotional response, behavior, and decision-making, which can create a conflict with...

CASE HISTORY A 66 years old male developed metastatic thyroid cancer, post total thyroidectomy, and radioactive iodine five years ago was treated with external beam radiation of the neck and was transferred to the palliative care team. This patient had been treated using cyberknife (9 lesions were treated) and craniotomy twice for metastatic brain...

Palliative care is required for a wide range of diseases. Worldwide, there is a major population of adults in need of palliative care who have chronic diseases such as cardiovascular diseases, cancer, chronic respiratory diseases, AIDS and diabetes. Many other conditions may require palliative care, including kidney failure, chronic liver disease,...

Inadequate antidote stocking is a global problem in hospitals. Insufficient supplies and delays in the administration of antidotes could lead to death and additional potentially negative clinical consequences. Our objective was to determine the availability of antidotes in hospitals listed on the Saudi Ministry of Health website in the Riyadh Provi...

As part of the health care reforms and transformation project of the Vision 2030, a group of expert healthcare professionals was tasked with the development of a model of care for patients with life-shortening illnesses in Saudi Arabia. This Care Design Group (CDG 1-3) held a series of workshops and conducted surveys and online discussions to syste...

Background: Overwork has grave consequences for staff health either physically or psychologically. Burnout has an impact on health care turnover, patient’s safety, patient satisfaction and patient’s perception towards health professionals. The study aims to assess the prevalence of burnout, a prevalence of psychosocial distress, occupational predic...

Ruqyah defined in Islam as the recitation of the Quran seeking the refuge in Allah, remembrance, and supplications that are used as a means of treating sicknesses and other problems as the Quran is a source of healing . Cancer is a life-threatening disease that often has a tremendous impact on patient’s quality of life, also is associated with the...

Introduction: : Pain is one of most common symptoms in cancer patients. The pain in cancer patients is severe and progressive. The majority of the cancer patient's complaining of uncontrolled pain which makes their life miserable. Unfortunately, the pain in cancer patients is under-diagnosed and under treatment in the majority of cases. Objectives...

ntroduction: Prognostication or estimation of time of death is important for the patients and their family members as they need this information for preparation and planning their future and for the physicians as they desire to be accurate in their prognostication skills in order to plan and deliver better care. Objectives The study aims to evaluat...

Imagine a boat in the middle of the sea, a small boat with only you on it. Think of why you were on this boat, what reasons got you there, and where would your coming destination be. Try to think of things you might be afraid of during your journey, what might your concerns be? Now imagine being in similar isolation in real life; incapability to co...

Palliative sedation is a unique concern for the patient as well as the family. It is a difficult serious ethical dilemma for the physicians to handle. The conflicting ethical principles of autonomy, beneficence and nonmaleficence in continuing versus discontinuing all supportive devices raise concerns among health professionals whether this is euth...

Imagine a boat in the middle of the sea, a small boat with only you on it. Think of why you were on this boat, what reasons got you there, and where would your coming destination be. Try to think of things you might be afraid of during your journey, what might your concerns be? Now imagine being in similar isolation in real life; incapability to co...

Objective: To explore the communication needs of cancer patients with barriers to communication, while under palliative care especially towards the last phase of life. Methods: We use a reflective learning process in the context of an incident that happened in the palliative care unit in King Fahad medical city, Riyadh. Case: 50-year-old male wit...

Abstract: Breaking bad news to patients with a cancer diagnosis is not an easy task for physicians. The diagnosis must be explicitly stated and understood, and the prognosis must be well-discussed in the most gentle and comfortable manner. It is important that the disclosure is performed in a way that patients will not lose all hope and get very...

Background: Breaking bad news to patients with a cancer diagnosis is not an easy task for physicians. The diagnosis must be explicitly stated and understood, and the prognosis must be well-discussed in the most gentle and comfortable manner. It is important that the disclosure is performed in a way that patients will not lose all hope and get ver...

Abstract: Inadequate antidote stocking is a global problem in hospitals. Insufficient supplies and delays in the administration of anti�dotes could lead to death and additional potentially negative clinical consequences. Our objective was to determine the availability of antidotes in hospitals listed on the Saudi Ministry of Health website in the R...

Cardiopulmonary resuscitation can be medically futile and lead to prolonged suffering in some patients with disseminated malignancies. The aim of this study is to identify physicians’ awareness, knowledge, and attitudes towards performing or withholding Cardiopulmonary resuscitation in cancer patients in the Middle East and the process they preferr...

Implantable cardiac electronic devices (ICED and pacemakers) in palliative care patients are a unique problem for the patient, family and a difficult area for the physicians to handle. The conflicting ethical principles of autonomy, beneficence, and non-maleficence in continuing versus discontinuing these devices raise concerns among health profess...

Venous thromboembolism (VTE) in cancer patients is a distressing problem for the patient and a difficult area for the physician to manage. There is lack of evidence-based clinical guidelines for the prophylaxis and management of venous thromboembolism in cancer patients receiving palliative care. This case reflection is an account of what we learnt...

Background: Breaking bad news to patients with cancer diagnosis is not an easy task for physicians. The diagnosis must be explicitly stated and understood, and prognosis must be well-discussed in the most gentle and comfortable manner. It is important that the disclosure is performed in a way that patients will not lose all hope and get very depres...

Intractable hiccupping is distressing for both patients under palliative care and their families, particularly if the patients have advanced cancer. The lack of clear management guidelines renders hiccup management challenging for health professionals. We report our management of intractable hiccups in a 70‑year‑old man with a progressive malignant...

https://eapcnet.wordpress.com/2016/05/04/palliative-care-in-north-africa-and-the-middle-east-saudia-arabia/

Background: Hospital admission can be scary for a child, most especially for hospitalized pediatric cancer patients, but studies show that there is growing evidence that environmental modification has a great impact in patient experience and health outcomes. Majority of pediatric cancer patients and their family was not satisfied with the unit envi...

Pruritus or itch is an uncommon symptom observed in palliative care, even more uncommon in cancer patients. However, if a patient experiences pruritus, the 'itch-scratch' cycle can damage the skin integrity and can increase the susceptibility of patients to infection owing to their frail immune system. The outcome can be very distressing, dramatica...

Background: The terminally ill diabetic inpatients who had blood glucose monitoring continued until the day of death ranged from 32% to 76% according to previous studies. Researches regarding the management of diabetes in palliative care services in Saudi Arabia are insufficient, although it is of high prevalence. Balancing the goals of avoiding sy...

Background: Saudi Commission for Health Specialties (SCFHS) has adopted CanMEDS competency framework for developing curriculum for postgraduate training programmes. Purpose: The purpose of this paper is to share the process of developing postgraduate curricula under SCFHS's patronage and to identify potential barriers to implement newly developed c...

Interdisciplinary medical education lacks standardized curricula for teaching palliative care in Saudi Arabia. Objectives: To describe the development, implementation and initial evaluation of an educational program in palliative care for health professional in Saudi Arabia.

Saudi Commission for Health Specialties has adopted CanMEDS competency framework for developing curriculum for post-graduate training programmes. Over the last one-and-half years, Saudi Commission has been working with several residency and fellowship programmes to develop formal curricula. Two facilitators of this workshop have been involved in co...

We describe a case of liver failure in a child with repeated therapeutic doeses of paracetamol after being given multiple doses to manage pyrexia during a viral illness. The child was treated successfully with only a single loading dose of N-acetylcysteine. This case highlights the importance of parental advice and physician vigilance in preventing...

Palliative care is a relatively new medical speciality in Saudi Arabia, but it has shown tremendous growth in the last two decades. Nevertheless, there are challenges to this development. The paper reviews these barriers in context of the growing need for palliative care and possible ways to overcome these challenges. Keywords: Cancer, life-threat...

The purpose of this study was to describe the development, implementation, and evaluation of an educational program in family medicine for general practitioners in Saudi Arabia from 2009 to 2011. A continuing medical education program called Family Medicine Education (FAME) was developed with 7 modules each consisting of 12-14 hours of teaching to...