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  1. Fulltext Economic Burden of the Inadequate Management of Allergic Rhinitis and Urticaria in Asian Countries Based on the GA²LEN Model
    Kulthanan K, Chusakul S, Recto MT, Gabriel MT, Aw DCW, Prepageran N, et al.
    Allergy Asthma Immunol Res, 2018 Jul;10(4):370-378.
    PMID: 29949833 DOI: 10.4168/aair.2018.10.4.370
    PURPOSE: Across Hong Kong, Malaysia, the Philippines, Singapore, Thailand and Vietnam, (referred to as Asia) approximately 30-53 million individuals of the 151 million employed suffer from allergic rhinitis (AR) and urticaria. It is estimated that approximately 90% of patients with these allergic conditions are insufficiently treated, impacting the socioeconomic burden in terms of absence from work and decreased productivity. This study aims to estimate the socioeconomic burden of allergies in Asia and the cost savings that their adequate management can provide. Due to the limited availability of regional data, this study focused AR and urticaria in selected countries.

    METHODS: Published literature, information from statistical bureaus, clinician surveys and extrapolation of selected data from the European Union were used to determine the socioeconomic costs of AR and urticaria.

    RESULTS: Many patients in Asia suffer from perennial allergies and experience symptoms of AR and urticaria for up to 298 days per year. An estimate of the indirect costs of patients insufficiently treated for AR and urticaria amounts to USD 105.4 billion a year, which equates to USD 1,137-2,195 per patient due to absenteeism and presenteeism. Adherence to guideline-approved treatment can lead to estimated savings of up to USD 104 billion.

    CONCLUSIONS: The current study suggests that within Asia, the socioeconomic impact of AR and urticaria is similar to that seen in the European Union in spite of the lower wages in Asia. This is due to the mainly perennial allergens prevailing in Asia, whereas the sensitization patterns observed in the European Union are dominated by seasonal exposure to pollen. These results underline the need for governmental initiatives to increase public awareness on the prevention and treatment of these and other allergic diseases as well as greater research funding and large-scale studies to reduce their growing socioeconomic burden in coming years.

    Matched MeSH terms: Cost Savings
  2. Understanding waste for lean health information systems: a preliminary review
    Kalong NA, Yusof MM
    Stud Health Technol Inform, 2013;192:749-53.
    PMID: 23920657
    Despite the rapid application of the Lean method in healthcare, its study in IT environments, particularly in Health Information Systems (HIS), is still limited primarily by a lack of waste identification. This paper aims to review the literature to provide an insight into the nature of waste in HIS from the perspective of Lean management. Eight waste frameworks within the context of healthcare and information technology were reviewed. Based on the review, it was found that all the seven waste categories from the manufacturing sector also exist in both the healthcare and IT domains. However, the nature of the waste varied depending on the processes of the domains. A number of additional waste categories were also identified. The findings reveal that the traditional waste model can be adapted to identify waste in both the healthcare and IT sectors.
    Matched MeSH terms: Cost Savings/economics*; Cost Savings/methods*
  3. Designing a prehospital system for a developing country: estimated cost and benefits
    Hauswald M, Yeoh E
    Am J Emerg Med, 1997 Oct;15(6):600-3.
    PMID: 9337371
    Many of the costs associated with prehospital care in developed countries are covered in budgets for fire suppression, police services, and the like. Determining these costs is therefore difficult. The costs and benefits of developing a prehospital care system for Kuala Lumpur, Malaysia, which now has essentially no emergency medical services (EMS) system, were estimated. Prehospital therapies that have been suggested to decrease mortality were identified. A minimal prehospital system was designed to deliver these treatments in Kuala Lumpur. The potential benefit of these therapies was calculated by using statistics from the United States corrected for demographic differences between the United States and Malaysia. Costs were extrapolated from the current operating budget of the Malaysian Red Crescent Society. Primary dysrhythmias are responsible for almost all potentially survivable cardiac arrests. A system designed to deliver a defibrillator to 85% of arrests within 6 minutes would require an estimated 48 ambulances. Kuala Lumpur has approximately 120 prehospital arrhythmic deaths per year. A 6% resuscitation rate was chosen for the denominator, resulting in seven survivors. Half of these would be expected to have significant neurological damage. Ambulances cost $53,000 (US dollars) to operate per year in Kuala Lumpur; 48 ambulances would cost a total of $2.5 million. Demographic factors and traffic problems would significantly increase the cost per patient. Other therapies, including medications, airway management, and trauma care, were discounted because both their additional cost and their benefit are small. Transport of patients (including trauma) is now performed by police or private vehicle and would probably take longer by ambulance. A prehospital system for Kuala Lumpur would cost approximately $2.5 million per year. It might save seven lives, three of which would be marred by significant neurological injury. Developing countries would do well to consider alternatives to a North American EMS model.
    Matched MeSH terms: Cost Savings
  4. Economic Impact of Pneumococcal Protein-D Conjugate Vaccine (PHiD-CV) on the Malaysian National Immunization Programme
    Aljunid S, Maimaiti N, Ahmed Z, Muhammad Nur A, Md Isa Z, Azmi S, et al.
    Value Health Reg Issues, 2014 May;3:146-155.
    PMID: 29702920 DOI: 10.1016/j.vhri.2014.04.008
    OBJECTIVE: To assess the cost-effectiveness of introducing pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in the National Immunization Programme of Malaysia. This study compared introducing PHiD-CV (10 valent vaccine) with current no vaccination, as well as against the alternative 13-valent pneumococcal conjugate vaccine (PCV13).

    METHODS: A lifetime Markov cohort model was adapted using national estimates of disease burden, outcomes of pneumococcal disease, and treatment costs of disease manifestations including pneumonia, acute otitis media, septicemia, and meningitis for a hypothetical birth cohort of 550,000 infants. Clinical information was obtained by review of medical records from four public hospitals in Malaysia from the year 2008 to 2009. Inpatient cost from the four study hospitals was obtained from a diagnostic-related group-based costing system. Outpatient cost was estimated using clinical pathways developed by an expert panel. The perspective assessed was that of the Ministry of Health, Malaysia.

    RESULTS: The estimated disease incidence was 1.2, 3.7, 70, and 6.9 per 100,000 population for meningitis, bacteremia, pneumonia, and acute otitis media, respectively. The Markov model predicted medical costs of Malaysian ringgit (RM) 4.86 billion (US $1.51 billion) in the absence of vaccination. Vaccination with PHiD-CV would be highly cost-effective against no vaccination at RM30,290 (US $7,407) per quality-adjusted life-year gained. On comparing PHiD-CV with PCV13, it was found that PHiD-CV dominates PCV13, with 179 quality-adjusted life-years gained while saving RM35 million (US $10.87 million).

    CONCLUSIONS: It is cost-effective to incorporate pneumococcal vaccination in the National Immunization Programme of Malaysia. Our model suggests that PHiD-CV would be more cost saving than PCV13 from the perspective of the Ministry of Health of Malaysia.

    Study site: UKM Medical Centre, Hospital Kuala Lumpur, Hospital
    Alor Setar, and Hospital Queen Elizabeth, Kota Kinabalu
    Matched MeSH terms: Cost Savings
  5. Fulltext Annual energy usage reduction and cost savings of a school: end-use energy analysis
    Roslizar A, Alghoul MA, Bakhtyar B, Asim N, Sopian K
    ScientificWorldJournal, 2014;2014:310539.
    PMID: 25485294 DOI: 10.1155/2014/310539
    Buildings are among the largest consumers of energy. Part of the energy is wasted due to the habits of users and equipment conditions. A solution to this problem is efficient energy usage. To this end, an energy audit can be conducted to assess the energy efficiency. This study aims to analyze the energy usage of a primary school and identify the potential energy reductions and cost savings. A preliminary audit was conducted, and several energy conservation measures were proposed. The energy conservation measures, with reference to the MS1525:2007 standard, were modelled to identify the potential energy reduction and cost savings. It was found that the school's usage of electricity exceeded its need, incurring an excess expenditure of RM 2947.42. From the lighting system alone, it was found that there is a potential energy reduction of 5489.06 kWh, which gives a cost saving of RM 2282.52 via the improvement of lighting system design and its operating hours. Overall, it was found that there is a potential energy reduction and cost saving of 20.7% when the energy conservation measures are earnestly implemented. The previous energy intensity of the school was found to be 50.6 kWh/m(2)/year, but can theoretically be reduced to 40.19 kWh/mm(2)/year.
    Matched MeSH terms: Cost Savings*
  6. Ergonomics improvements of the visual inspection process in a printed circuit assembly factory
    Yeow PH, Sen RN
    Int J Occup Saf Ergon, 2004;10(4):369-85.
    PMID: 15598361
    An ergonomics improvement study was conducted on the visual inspection process of a printed circuit assembly (PCA) factory. The process was studied through subjective assessment and direct observation. Three problems were identified: operators' eye problems, insufficient time for inspection and ineffective visual inspection. These problems caused a huge yearly rejection cost of US 298,240 dollars, poor quality, customer dissatisfaction and poor occupational health and safety. Ergonomics interventions were made to rectify the problems: reduced usage of a magnifying glass, the use of less glaring inspection templates, inspection of only electrically non-tested components and introduction of a visual inspection sequence. The interventions produced savings in rejection cost, reduced operators' eye strain, headaches and watery eyes, lowered the defect percentage at customers' sites and increased the factory's productivity and customer satisfaction.
    Matched MeSH terms: Cost Savings
  7. Generic medicines in the Malaysian health care system: Opportunities and challenges
    Wong ZY, Alrasheedy AA, Hassali MA, Saleem F
    Res Social Adm Pharm, 2016 04 20;12(5):807-10.
    PMID: 27157864 DOI: 10.1016/j.sapharm.2016.04.002
    Matched MeSH terms: Cost Savings
  8. Fulltext Assessment of medication adherence and the costs associated with a calendar blister pack intervention among hypertensive patients in Malaysia: A randomized controlled trial
    Tan BY, Shafie AA, Hassali MAA, Saleem F
    SAGE Open Med, 2017;5:2050312117709189.
    PMID: 28839933 DOI: 10.1177/2050312117709189
    OBJECTIVES: To assess the efficacy and costs of a calendar blister packaging intervention used to improve medication adherence.

    METHOD: A parallel randomized controlled trial was conducted with 73 hypertensive patients (intervention group = 35, control group = 38) at Hospital Kulim, Malaysia, for 7 months.

    RESULTS: The intervention group demonstrated a significant improvement in medication possession ratio (p cost per patient in the intervention group was MYR 2178.66 (~USD 526.95) (95% confidence interval = 1786.39-2570.94) compared to MYR 2693.09 (~USD 651.37) (95% confidence interval = 1903.23-3482.95) in the control group.

    CONCLUSION: This study provides evidence that calendar blister packaging has a positive impact on medication adherence, blood pressure and also has the potential for considerable cost savings.

    Matched MeSH terms: Cost Savings
  9. Fulltext Ergonomics in industrially developing countries: a literature review
    Huck-Soo L, Richardson S
    J Hum Ergol (Tokyo), 2012 Dec;41(1-2):1-16.
    PMID: 25665194 DOI: 10.11183/jhe.41.1
    The two final decades of the 20th century saw a significant increase in ergonomics activity (and resulting publications) in industrially developing countries (IDCs). However, a few ergonomics papers from Singapore, for example, were published in 1969 and 1970. This paper reviews developments in ergonomics in industrially developing countries from 1969 relying heavily on published papers although their quality varies considerably. Some criticism of these papers is offered. Most were concerned with the use of work tools, workstation operations, material handling and working environments especially in tropical climates. The similar problems encountered in a variety of countries are discussed, and the importance of low-cost solutions stressed. This study presents an overview of er gonomics research in IDCs. It concentrates on ASEAN countries whilst recognising the valuable work done in other areas.
    Matched MeSH terms: Cost Savings
  10. Fulltext Furnace Modelling Using State Space Representation
    Razidah Ismail
    Scientific Research Journal, 2006;3(1):37-52.
    MyJurnal
    The state space modeling approach was developed to cope with the demand
    and performance due to the increase in system complexity, which may have
    multiple inputs and multiple outputs (MIMO). This approach is based on timedomain
    analysis and synthesis using state variables. This paper describes the
    development of a state space representation of a furnace system of a combined
    cycle power plant. Power plants will need to operate optimally so as to stay
    competitive, as even a small improvement in energy efficiency would involve
    substantial cost savings. Both the quantitative and qualitative analyses of the
    state space representation of the furnace system are discussed. These include
    the responses of systems excited by certain inputs and the structural properties
    of the system. The analysis on the furnace system showed that the system is
    bounded input and bounded output stable, controllable and observable. In
    practice, the state space formulation is very important for numerical computation
    and controller design, and can be extended for time-varying systems.
    Matched MeSH terms: Cost Savings
  11. Fulltext Ranking the Meso Level Critical Factors of Electronic Medical Records Adoption Using Fuzzy Topsis Method
    Ahmadi H, Nilashi M, Ibrahim O, Raisian K
    Curr Health Sci J, 2016 03 29;42(1):82-93.
    PMID: 30568817 DOI: 10.12865/CHSJ.42.01.12
    As Electronic Medical Records (EMRs) have a great possibility for rising physician's performance in their daily work which improves quality, safety and efficiency in healthcare, they are implemented throughout the world (Boonstra and Broekhuis, 2010). In physician practices the rate of EMRs adoption has been slow and restricted (around 25%) according to Endsley, Baker, Kershner, and Curtin (2005) in spite of the cost savings through lower administrative costs and medical errors related with EMRs systems. The core objective of this research is to identify, categorize, and analyse meso-level factors introduced by Lau et al, 2012, perceived by physicians to the adoption of EMRs in order to give more knowledge in primary care setting. Finding was extracted through questionnaire which distributed to 350 physicians in primary cares in Malaysia to assess their perception towards EMRs adoption. The findings showed that Physicians had positive perception towards some features related to technology adoption success and emphasized EMRs had helpful impact in their office. The fuzzy TOPSIS physician EMRs adoption model in meso-level developed and its factors and sub-factors discussed in this study which provide making sense of EMRs adoption. The related factors based on meso-level perspective prioritized and ranked by using the fuzzy TOPSIS. The purpose of ranking using these approaches is to inspect which factors are more imperative in EMRs adoption among primary care physicians. The result of performing fuzzy TOPSIS is as a novelty method to identify the critical factors which assist healthcare organizations to inspire their users in accepting of new technology.
    Matched MeSH terms: Cost Savings
  12. Use of ammonium-enriched skim latex serum to compost rubber biomass wastes and its effect on planting brassica alboglabra
    Jutarut Iewkittayakorn, Juntima Chungsiriporn, Prukraya Pongyeela
    Sains Malaysiana, 2017;46:1763-1769.
    Ammonium-enriched skim latex serum - used for absorption of contaminating ammonia gas - when composted with other rubber tree wastes, is promising as a good compost. The objective of this research was to utilize ammonium-enriched skim latex serum (S) as a raw composting ingredient after being combined with para sawdust (W1) and para rubber leaves (W2). Several ratios of S, W1 and W2 were experimented in a 15L composting vessel to determine the most effective compost. The best ratio was found to be 3:1:3 by weight at 12-day retention. The modified 30 L composting reactor employed with the derived optimum mixing conditions yielded N, P and K of 2.40, 1.51 and 14.84 %w/w. The growth of Brassica alboglabra after application of this compost combined with a chemical fertilizer generated the highest fresh weight (4.48 g/plant). Thus, compost from these wastes could be used as a fertilizer and logically should contribute to cost saving of waste disposal.
    Matched MeSH terms: Cost Savings
  13. Fulltext Increasing the percentage of appropriate tests conducted in the serology laboratory, Hospital Sultanah Nur Zahirah
    Azlina Yahya, Osama Abdul Nasir
    Q Bulletin, 2019;1(28):36-44.
    MyJurnal
    Wastage due to unnecessary laboratory test requests is a major problem in government hospitals because they have cost implications. Although screening of infectious marker tests such as Human Immunodeficiency Virus (HIV), Hepatitis B surface Antigen (HBsAg), Hepatitis B antibody (AHBS) and Hepatitis C Virus (HCV)) before testing have been put in place, inappropriate tests were still being carried out in the Serology laboratory, which resulted in wasted human resources and reagents, increased workload and increased maintenance costs. Based on the verification studies using the Laboratory Information System (LIS), we observed only 70% of the tests followed the ordering guidelines or test specifications. Thus, we aim to increase the standard to more than 95% of the infectious marker test requests which were appropriate according to a few guidelines.
    A cross-sectional study was conducted for all infectious marker tests received at Serology Laboratory from January 2015 to June 2016 to verify the problem. A workplace audit and questionnaire survey on the staff were carried out to gain more information. Low level of knowledge, unavailability of standardised guidelines for quick and easy reference, lack of staff and inefficient work processes were among the main contributing factors. Empowering new staff to screen specimens, developing simple and informative screening guidelines, providing adequate trays and refrigerators for screening purposes and strengthening and developing a more effective process of care were the strategies taken during this study.
    The appropriate tests carried out from July to September 2015, October to December 2015, January to March 2016 and April to June 2016 were 99%, 98.80%, 99.50%, 98.90% respectively. During the same period, 711, 411, 710 and 768 tests were rejected. We monitored the performance and managed to achieve 100% appropriate testing for the period of July 2016 to June 2018 and an estimation of MYR 73,437.50 cost saving was achieve
    Matched MeSH terms: Cost Savings
  14. Fulltext International patients with congenital heart disease: what brings them to India?
    Maheshwari S, Animasahun BA, Njokanma OF
    Indian Heart J, 2012 Jan-Feb;64(1):50-3.
    PMID: 22572426 DOI: 10.1016/S0019-4832(12)60011-X
    Factors that have led to the increasing popularity of medical travel include the high cost of healthcare, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
    Matched MeSH terms: Cost Savings
  15. Impact of pharmacist recommendations on the cost of drug therapy in ICU patients at a Malaysian hospital
    Zaidi ST, Hassan Y, Postma MJ, Ng SH
    Pharm World Sci, 2003 Dec;25(6):299-302.
    PMID: 14689820
    To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions.
    Matched MeSH terms: Cost Savings/economics
  16. Fulltext SYNTHESIS AND CHARACTERIZATION OF TiO2/ZnO-EPOXY BEADS AND THEIR PERFORMANCE FOR THE DEGRADATION OF DYE
    MOHAMAD HANIF AKMAL HUSSIN, WAN RAFIZAH WAN ABDULLAH, MOHAMAD AWANG
    UMT Journal of Undergraduate Research, 2020;2(2):9-14.
    MyJurnal
    Semiconductor oxides such as titanium dioxide (TiO2) and zinc oxide (ZnO) are used as the photocatalyst for removing contaminants. In addition, TiO2 and ZnO nanoparticles in the suspension form makes it difficult to be recovered and recycled. This study was conducted to investigate the efficiency of immobilizing TiO2 and ZnO nanoparticles in epoxy beads. The immobilization process using different ratios of photocatalysts TiO2/ZnO (1:0, 3:1, 1:1, 1:3 and 0:1) fixed on epoxy material. These epoxy beads were used for dye removal in photocatalysis using methylene blue (MB) solution at a concentration of 10mg/L. Besides, epoxy beads also characterized using scanning electron microscope (SEM), attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy and thermogravimetric analysis (TGA). The results showed that the highly recommended epoxy bead is 3:1 ratio of TiO2/ZnO because it has good performance in dye degradation that proved from reducing concentration of MB to 2.4mg/L (76%). However, TiO2/ZnO characterization of 3:1 by SEM show on the surface the particle are found to be spherical in shape which is relatively high efficiency for the degradation, ATR-FTIR pattern in broad band 4000 cm-1 - 400cm-1 which correspond to hydroxyl stretching to be adsorbed at peak (474.49 cm-1 - 3722.61cm-1) respectively to the optimum for the degradation and TGA rate of change are 5mg to 2.5mg that residue (49.78%) due to decomposition or oxidation from mass loss. These findings are very effective and economical technique to be cost saving and highly efficient photocatalyst.
    Matched MeSH terms: Cost Savings
  17. Cost Analysis of Using a Closed-System Transfer Device (CSTD) for Antineoplastic Drug preparation in a Malaysian Government-Funded Hospital
    Chan HK, Lim YM
    Asian Pac J Cancer Prev, 2016 11 01;17(11):4951-4957.
    PMID: 28032722
    Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal® closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal® CSTD and other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle sets were used for the same amounts of preparations. Results: The use of the PhaSeal® CSTD incurred a cost of MYR 383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion: Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal® CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia. Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and high-cost antineoplastic drugs are more commonly used.
    Matched MeSH terms: Cost Savings
  18. Fulltext Budget impact analysis of increasing prescription of renin-angiotensin system inhibitors drugs to standard anti-hypertensive treatments in patients with diabetes and hypertension in a hypothetical cohort of Malaysian population
    Mohd-Tahir NA, Li SC
    PLoS One, 2019;14(2):e0212832.
    PMID: 30817790 DOI: 10.1371/journal.pone.0212832
    INTRODUCTION: Renin-angiotensin system inhibitors (RAS) drugs have a proteinuria-reducing effect that could prevent the progression of kidney disease in diabetic patients. Our study aimed to assess the budget impact based on healthcare payer perspective of increasing uptake of RAS drugs into the current treatment mix of standard anti-hypertensive treatments to prevent progression of kidney disease in patient's comorbid with hypertension and diabetes.

    METHODS: A Markov model of a Malaysian hypothetical cohort aged ≥30 years (N = 14,589,900) was used to estimate the total and per-member-per-month (PMPM) costs of RAS uptake. This involved an incidence and prevalence rate of 9.0% and 10.53% of patients with diabetes and hypertension respectively. Transition probabilities of health stages and costs were adapted from published data.

    RESULTS: An increasing uptake of RAS drugs would incur a projected total treatment cost ranged from MYR 4.89 billion (PMPM of MYR 27.95) at Year 1 to MYR 16.26 billion (PMPM of MYR 92.89) at Year 5. This would represent a range of incremental costs between PMPM of MYR 0.20 at Year 1 and PMPM of MYR 1.62 at Year 5. Over the same period, the care costs showed a downward trend but drug acquisition costs were increasing. Sensitivity analyses showed the model was minimally affected by the changes in the input parameters.

    CONCLUSION: Mild impact to the overall healthcare budget has been reported with an increased utilization of RAS. The long-term positive health consequences of RAS treatment would reduce the cost of care in preventing deterioration of kidney function, thus offsetting the rising costs of purchasing RAS drugs. Optimizing and increasing use of RAS drugs would be considered an affordable and rational strategy to reduce the overall healthcare costs in Malaysia.

    Matched MeSH terms: Cost Savings
  19. Fulltext Improvement of Blue Ribbon certification by including humanistic value (TFI Buddies)
    Siti Munira Yasin, Harizah Mad Hisma, Mazlifah Omar, Nurhuda Ismail, Zahir Izuan Azhar, Zalina Omar, et al.
    Jurnal Inovasi Malaysia, 2020;4(1):61-78.
    MyJurnal
    Cigarette smoke produces more than 4,000 toxic chemicals and 53 of these chemicals can cause cancer. Smoking increases your health risks such as lung cancer, heart attack and stroke. In Malaysia, between 10% and 12% of causes of death are caused by smoking and this results in over 10,000 deaths a year. According to the National Health Morbidity Survey (NHMS) in 2015, the number of smokers aged 15 and above in Malaysia is estimated to be more than 5 million (22.8%). This alarming amount will lead to increased health costs. Smoking can also lead to a reduction in worker productivity and air pollution and the pollution due to cigarette smoke. Therefore, smokers need to be aware of the effects of smoking habits and the importance of maintaining a tobacco-free environment for the health and well-being of their families, friends and the community around them. To address this, Smoke Busters have created an innovation called Blue Ribbon Star Certification with an additional component of humanization into the TFI Buddies existing Blue Ribbon Certification. The main goal of this innovation is to make University of Technology MARA (UiTM) campuses 100% tobacco free. The first project at the Sungai Buloh Campus resulted in a decrease in the percentage of ‘hotspots’, whereby the number of cigarette butts was found to be greatly reduced. In addition, the percentage of staff with good knowledge and attitude on the effects of cigarettes increased. Feedback from users comprising staff and students also showed a very positive response. The direct impact on faculty and campuses include cost savings in terms of medical expenses and increase in staff productivity. The long-term effects include enhancing UiTM’s image nationally and internationally. From a social point of view, this in addition creates a more caring and responsible generation of colleagues and the environment.
    Matched MeSH terms: Cost Savings
  20. Fulltext Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals
    Sze WT, Kong MC
    Pharm Pract (Granada), 2018 06 17;16(2):855.
    PMID: 30023021 DOI: 10.18549/PharmPract.2018.02.855
    Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch.

    Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals.

    Methods: This study was an interventional study conducted in medical wards of eight Sarawak district hospitals from May to August 2015. In pre-intervention phase, pharmacists performed the conventional practice of reviewing medication charts and verbally informed the prescribers on eligible IV-PO switches. In post-intervention phase, pharmacists attached printed checklist which contained IV-PO switch criteria to patients' medical notes on the day patients were eligible for the switch. Stickers of IV-PO switch were applied to the antibiotic prescription to serve as reminders.

    Results: 79 and 77 courses of antibiotics were studied in the pre-intervention phase and post-intervention phase respectively. Timeliness of switch was improved by 1.63 days in the post-intervention phase (95%CI 1.26:2.00 days, p<0.001). Mean duration of IV antibiotics in the post-intervention phase was shorter than pre-intervention phase (2.81 days (SD=1.77) vs 4.05 days (SD=2.81), p<0.001). The proportion of IV-PO switches that were only performed upon discharge reduced significantly in the post-intervention phase (31.2% vs 82.3%, p<0.001). Length of hospital stay in the post-intervention phase was shortened by 1.44 days (p<0.001). Median antibiotic cost savings increased significantly in the post-intervention phase compared to the pre-intervention phase [MYR21.96 (IQR=23.23) vs MYR13.10 (IQR=53.76); p=0.025)].

    Conclusions: Pharmacist initiated printed AMS recommendations are successful in improving the timeliness of IV-PO switch, reducing the duration of IV, reducing the length of hospitalisation, and increasing antibiotic cost savings.

    Matched MeSH terms: Cost Savings
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