Co-design and development of a community pharmacy-based CVD risk screening service in Saudi Arabia : a multi-stakeholders Nominal Group Technique (NGT) consensus method

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Noorsaeed, Solafa Mohamedwaly M. and Almansour, Hadi and Weir, Natalie Mcfadyen and Kurdi, Amanj (2025) Co-design and development of a community pharmacy-based CVD risk screening service in Saudi Arabia : a multi-stakeholders Nominal Group Technique (NGT) consensus method. In: 83rd FIP World Congress of Pharmacy and Pharmaceutical Sciences, 2025-08-31 - 2025-09-03.

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Abstract

Introduction: Cardiovascular diseases (CVDs) are the leading cause of death in Saudi Arabia, making their prevention a top public health priority. Despite the success of community pharmacy-based CVD risk screening programmes internationally, no similar programme exists in Saudi Arabia. Therefore, this study aims to co-design a community pharmacy-based CVD risk screening service in Saudi Arabia through stakeholder involvement and consensus-building. Methods: A modified nominal group technique (NGT) consensus method was employed, integrating a pre-NGT questionnaire for ideas generation (January 2025) and an in-person NGT meeting for discussion, ranking, and consensus formation (7th February 2025). Purposive sampling was adopted to recruit experts from Saudi Arabia, including experts in CVD, health and pharmaceutical policy, and service delivery. A comprehensive list of ideas regarding the service-targeted populations, screening processes, and post-screening interventions were collected from a literature review and pre-NGT questionnaire. Experts discussed and ranked these ideas by priority. The total ranking scores depended on the number of participants and items in each list, with higher scores indicating higher priority. A difference of >10 points between scores served as a cut-off for identifying top priorities. A consensus level of 70% was considered acceptable. Qualitative analysis of the recorded discussion was performed to narrate the justification of the group’s priorities. The study obtained an ethical approval, and the methodology was piloted before commencement. Results: Six experts with 10.5 median years of experience attended the NGT meeting including a clinical pharmacist, a community pharmacist, a representative from the Ministry of Health, a public health representative, and two community pharmacy owners. During the NGT meeting, 6 ideas for age groups, 12 for targeted populations, 10 for screening processes and 8 for post-screening interventions derived from a literature review and the pre-NGT questionnaire were considered. A 100% consensus was achieved on the final priorities. The top prioritised age group was ≥ 40 years, with the top 5 priorities given to individuals with comorbid conditions like pre-diabetes/diabetes, hypertension, dyslipidaemia or currently on treatment for those conditions, with a family history of CVDs, or any risk factors like obesity, inactivity, unhealthy diet, smokers or former smokers, currently on medications that cause CV harm, without pre-existing comorbid conditions and not currently on treatment for any comorbid conditions. The top 6 screening process priorities included calculating the CVD risk scores, collecting patients’ demographics, medical, and lifestyle data, point of care testing, anthropometric measurements, diabetes risk assessment, and medication adherence assessment. The top 3 interventions focused on providing education, physician referrals with follow-ups, and medication therapy management with follow-ups. Several reasons emerged to justify the group’s priorities, with the most common justification being the importance, practicality, and pharmacists' capabilities. Conclusion: This study has mapped a potential model for a CVD risk screening service tailored to Saudi Arabia’s context. Further research is required to achieve national consensus using an e-Delphi, evaluate the proposed model, and prioritise implementation strategies. Establishing this service is expected to improve public health outcomes and support Vision 2030 goals in addressing the burden of CVDs in Saudi Arabia.

ORCID iDs

Noorsaeed, Solafa Mohamedwaly M., Almansour, Hadi, Weir, Natalie Mcfadyen ORCID logoORCID: https://orcid.org/0000-0003-1422-9415 and Kurdi, Amanj ORCID logoORCID: https://orcid.org/0000-0001-5036-1988;
CORE (COnnecting REpositories)