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Background: Anticoagulation therapy is crucial for managing various cardiovascular and thrombotic conditions; however, optimal delivery remains challenging in primary care. Pharmacist-led anticoagulation services have emerged as a potential strategy for enhancing patient care and outcomes in such settings. Understanding the perspectives of key stakeholders is critical for successful implementation. Objectives: This study aimed to explore the perceptions of key stakeholders involved in the implementation of pharmacist-led anticoagulation clinics in primary care settings. Methods: A cross-sectional study was conducted using structured, pilot-tested questionnaires between August and October 2023. Patients receiving warfarin, pharmacists, and physicians working across various primary healthcare centres were invited to complete an online survey. Each group of stakeholders had individualised questionnaires to assess their perceptions and expectations with regard to developing pharmacist-led anticoagulation clinics in primary care. Descriptive statistics were used to analyze the data. Results: The response rates for the survey were 29.4% for physicians, 10.4% for patients, and 48.6% for pharmacists. Participants expressed positive perceptions toward pharmacist-led anticoagulation clinics, acknowledging benefits such as improved access to care, enhanced medication management, and increased patient education. The respondents expressed confidence in the expertise and skills of pharmacists in this role. However, healthcare providers strongly agree that pharmacists should receive additional training specific to anticoagulation management. Establishing standardised protocols and fostering interprofessional collaboration were identified as the main facilitators for practical implementation. Conclusions: Broad support exists for pharmacist-led anticoagulation clinics in primary care, though additional pharmacist training and accountability concerns need to be addressed for successful implementation. [ABSTRACT FROM AUTHOR]

Aims: To predict the future health and economic burden of cardiovascular disease (CVD) in type 2 diabetes (T2D) in Qatar. Materials and Methods: A dynamic multistate model was designed to simulate the progression of fatal and non‐fatal CVD events among people with T2D in Qatar aged 40‐79 years. First CVD events [i.e. myocardial infarction (MI) and stroke] were calculated via the 2013 Pooled Cohort Equation, while recurrent CVD events were sourced from the REACH registry. Key model outcomes were fatal and non‐fatal MI and stroke, years of life lived, quality‐adjusted life years, total direct medical costs and total productivity loss costs. Utility and cost model inputs were drawn from published sources. The model adopted a Qatari societal perspective. Sensitivity analyses were performed to test the robustness of estimates. Results: Over 10 years among people with T2D, model estimates 108 195 [95% uncertainty interval (UI) 104 249‐112 172] non‐fatal MIs, 62 366 (95% UI 60 283‐65 520) non‐fatal strokes and 14 612 (95% UI 14 472‐14 744) CVD deaths. The T2D population accrued 4 786 605 (95% UI 4 743 454, 4 858 705) total years of life lived and 3 781 833 (95% UI 3 724 718‐3 830 669) total quality‐adjusted life years. Direct costs accounted for 57.85% of the total costs, with a projection of QAR41.60 billion (US$11.40 billion) [95% UI 7.53‐147.40 billion (US$2.06‐40.38 billion)], while the total indirect costs were expected to exceed QAR30.31 billion (US$8.30 billion) [95% UI 1.07‐162.60 billion (US$292.05 million‐44.55 billion)]. Conclusions: The findings suggest a significant economic and health burden of CVD among people with T2D in Qatar and highlight the need for more enhanced preventive strategies targeting this population group. [ABSTRACT FROM AUTHOR]

Introduction: The Middle East and North Africa region accounts for the largest prevalence of type 2 diabetes (T2D). Qatar ranks top 10 for global T2D prevalence, with 17 percent in 2022. Also, 50 to 70 percent of the cardiovascular events occurred in T2D. We sought to estimate the future health and economic burden of cardiovascular disease (CVD) in T2D from 2023 to 2032. Methods: A dynamic multistate model in people with T2D was constructed. The demographic profile of the population was based on Qatari citizens and residents with T2D aged 40 to 90 years in 2022. First CVD events (i.e., myocardial infarction [MI] and stroke) were calculated via the 2013 Pooled Cohort Equation using data from Primary Health Care Corporation. Recurrent CVD events were sourced from the global Reduction of Atherothrombosis for Continued Health (REACH) registry. Outcomes were MI and stroke, years of life lived, quality-adjusted life years (QALYs), total direct and productivity loss costs. Utility and cost model inputs were drawn from published sources. The model adopted a Qatari societal perspective. Results: The model estimates 123,524 non-fatal MIs (95% uncertainty interval [UI]: 116,923, 130,065), 70,466 non-fatal strokes (95% UI: 67,945, 73,476) and 15,410 CVD deaths (95% UI: 15,217, 15,794), respectively. T2D population accrued 4,834,146 (95% UI: 4,781,235, 4,881,695) total years of life lived and 3,817,246 (95% UI: 3,756,963, 3,870,616) total QALYs. Direct costs accounted for 59.52 percent of the total costs, with a projection of QAR43.59 billion (USD11.98 billion) (95% UI: QAR9.14 billion [USD2.5 billion], QAR134.20 billion [USD36.87 billion]), while the total indirect costs were expected to exceed QAR29.65 billion (USD8.14 billion) (95% UI: QAR2.40 billion [USD659.34 million], QAR113 billion [USD31.04 billion]). Conclusions: This study highlights that the considerable rising burden of CVD in T2D in Qatar will impact not only the healthcare system but also the society overall. The findings may be used to prioritize strategies targeting T2D to prevent CVD burden. [ABSTRACT FROM AUTHOR]