Displaying publications 1 - 20 of 36 in total

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  1. Chew CC, Lim XJ, Letchumanan P, George D, Rajan P, Chong CP
    Trials, 2024 Apr 25;25(1):279.
    PMID: 38664701 DOI: 10.1186/s13063-024-08111-y
    BACKGROUND: Allergic rhinitis is a chronic respiratory disorder that significantly impacts patients' quality of life (QoL) and work performance. Pharmacists are recognized as suitable professionals to provide patient education and pharmaceutical care for managing allergic rhinitis patients. However, local clinical practice guidelines, particularly regarding pharmaceutical care in public healthcare institutions, are lacking. This study protocol outlines a randomized controlled trial (RCT) designed to evaluate the effectiveness of a pharmacist-led educational model (AR-PRISE Model) in managing allergic rhinitis in adult patients compared to standard pharmaceutical care. The AR-PRISE model delivers patient educational material and a pharmaceutical care algorithm.

    METHOD: This is a 6-month, single-center, prospective, randomized, two-arm, and parallel-group controlled trial. The trial recruits patients attending the otorhinolaryngology clinics of a tertiary referral hospital. Participants are randomized into control or intervention groups in a 1:1 ratio using permuted block randomization. The total number of participants estimated is 154, with each group requiring 77 participants. The control group receives standard pharmaceutical care, while the intervention group receives pharmacist-led education according to the AR-PRISE model. Both groups are assessed for middle turbinate endoscopy findings, disease severity, knowledge level, symptom control, medication adherence, and QoL at baseline and the end-of-study follow-up (day 180 ± 7). Depending on feasibility, intermediate follow-ups are conducted on days 60 ± 7 and 120 ± 7, either virtually or face-to-face. During intermediate follow-ups, participants are assessed for symptom control, medication adherence, and QoL. The intention-to-treat analysis includes all participants assigned to each group. An independent T-test compares the mean difference in knowledge level between the two groups. A two-way repeated measures ANOVA analysis is employed to determine between-group differences for scores of symptom control, adherence rate, and QoL. A P-value 

    Matched MeSH terms: Pharmacy Service, Hospital
  2. Ramachandram DS, Tan CH, Selvaraj A, Appalasamy JR, Kow CS
    Int J Pharm Pract, 2024 Feb 15;32(1):100-103.
    PMID: 38029419 DOI: 10.1093/ijpp/riad085
    OBJECTIVE: The aim of this study was to examine the impact of pharmacy automation on the workload and satisfaction of pharmacists and pharmacy assistants in an inpatient setting.

    METHODS: This was an observational, cross-sectional survey using a convenience sampling method conducted at the University Malaya Medical Centre (UMMC) In-Patient Pharmacy. A validated online questionnaire assessed user satisfaction and task duration.

    RESULTS: A total of 21 pharmacists and 18 pharmacy assistants participated in the survey. Most pharmacists (n = 17/21) were confident in the system, and both pharmacists and pharmacy assistants perceived it to be beneficial for patients (n = 33/39) and for reducing medication errors (n = 32/39). Pharmacy assistants spent approximately 5.34 hours on traditional work including filling medication orders (1.44 hours) after automated tablet dispensing and packaging system (ATDPS) implementation. Pharmacists spent 1.19 hours filling medication orders and 1.71 hours checking/verifying them, in contrast.

    CONCLUSION: Pharmacists focused mainly on clinical duties with healthcare colleagues, while pharmacy assistants handled various medication orders. Nevertheless, ATDPS reduced pharmacy staff workload in medication handling, achieving user satisfaction.

    Matched MeSH terms: Pharmacy Service, Hospital*
  3. Hamid H, Zulkifli K, Naimat F, Che Yaacob NL, Ng KW
    Curr Pharm Teach Learn, 2023 Dec;15(12):1017-1025.
    PMID: 37923639 DOI: 10.1016/j.cptl.2023.10.001
    INTRODUCTION: With the increasing prevalence of artificial intelligence (AI) technology, it is imperative to investigate its influence on education and the resulting impact on student learning outcomes. This includes exploring the potential application of AI in process-driven problem-based learning (PDPBL). This study aimed to investigate the perceptions of students towards the use of ChatGPT) build on GPT-3.5 in PDPBL in the Bachelor of Pharmacy program.

    METHODS: Eighteen students with prior experience in traditional PDPBL processes participated in the study, divided into three groups to perform PDPBL sessions with various triggers from pharmaceutical chemistry, pharmaceutics, and clinical pharmacy fields, while utilizing chat AI provided by ChatGPT to assist with data searching and problem-solving. Questionnaires were used to collect data on the impact of ChatGPT on students' satisfaction, engagement, participation, and learning experience during the PBL sessions.

    RESULTS: The survey revealed that ChatGPT improved group collaboration and engagement during PDPBL, while increasing motivation and encouraging more questions. Nevertheless, some students encountered difficulties understanding ChatGPT's information and questioned its reliability and credibility. Despite these challenges, most students saw ChatGPT's potential to eventually replace traditional information-seeking methods.

    CONCLUSIONS: The study suggests that ChatGPT has the potential to enhance PDPBL in pharmacy education. However, further research is needed to examine the validity and reliability of the information provided by ChatGPT, and its impact on a larger sample size.

    Matched MeSH terms: Pharmacy Service, Hospital*
  4. Ooi GS, Ong SC, Kwan SM
    Int J Pharm Pract, 2021 Oct 18;29(5):515-520.
    PMID: 34302464 DOI: 10.1093/ijpp/riab045
    OBJECTIVE: In Malaysia, due to provisional registered pharmacist (PRP) training places in government hospitals being oversubscribed, pharmacy graduates wait for about a year before starting their training. Therefore, a policy was implemented to allow pharmacy graduates to select their preferred areas of PRP training. This study was conducted to explore the perception and preferences of final year pharmacy students on the current PRP training system.

    METHODS: This qualitative interview study was conducted among final year pharmacy students. Participants were recruited using convenience sampling until data saturation (i.e., when additional interviews didn't lead to any new themes). All interviews were audio-recorded, transcribed verbatim, and evaluated by thematic analysis.

    KEY FINDINGS: Twenty-two final year pharmacy students were interviewed. Fifteen of them preferred the government sector as their choice training, three chose the community sector, two preferred private hospitals and another two preferred the pharmaceutical industry. The majority of the students gave positive feedback towards the liberalization of PRP training sites. Most of them chose clinical pharmacy as their preferred training site despite knowing of the saturation issue in government hospitals. This was mainly due to the opportunity to gain clinical experience and knowledge from the government sector. A small number of students preferred the pharmaceutical industry based on their personal interests and opportunities for career advancement.

    CONCLUSION: Pharmacy students generally chose their PRP training site based on personal interest, future career advancement and working environment. A better understanding of career pathways and opportunities in the pharmaceutical industry by the students is required.

    Matched MeSH terms: Pharmacy Service, Hospital*
  5. Saadah LM, Khan AH, Syed Sulaiman SA, Bashiti IA
    BMC Health Serv Res, 2021 Sep 08;21(1):937.
    PMID: 34496856 DOI: 10.1186/s12913-021-06966-4
    BACKGROUND: Clinical pharmacy interventions (CPI) usually require prior medical authorization. Physicians approve 80% of CPI and reject 20%. If pharmacists show that physicians should authorize all 100% CPI, the profession will step closer to a fully independent prescriber status. This study used an artificial neural network (ANN) model to determine whether clinical pharmacy (CP) may improve outcomes associated with rejected CPI.

    METHOD: This is a non-interventional, retrospective analysis of documented CPI in a 100-bed, acute-care private hospital in Amman, Jordan. Study consisted of 542 patients, 574 admissions, and 1694 CPI. Team collected demographic and clinical data using a standardized tool. Input consisted of 54 variables with some taking merely repetitive values for each CPI in each patient whereas others varying with every CPI. Therefore, CPI was consolidated to one rejected and/or one accepted per patient per admission. Groups of accepted and rejected CPI were compared in terms of matched and unmatched variables. ANN were, subsequently, trained and internally as well as cross validated for outcomes of interest. Outcomes were length of hospital and intensive care stay after the index CPI (LOSTA & LOSICUA, respectively), readmissions, mortality, and cost of hospitalization. Best models were finally used to compare the two scenarios of approving 80% versus 100% of CPI. Variable impacts (VI) automatically generated by the ANN were compared to evaluate the effect of rejecting CPI. Main outcome measure was Lengths of hospital stay after the index CPI (LOSTA).

    RESULTS: ANN configurations converged within 18 s and 300 trials. All models showed a significant reduction in LOSTA with 100% versus 80% accepted CPI of about 0.4 days (2.6 ± 3.4, median (range) of 2 (0-28) versus 3.0 ± 3.8, 2 (0-30), P-value = 0.022). Average savings with acceptance of those rejected CPI was 55 JD (~ 78 US dollars) and could help hire about 1.3 extra clinical pharmacist full-time equivalents.

    CONCLUSIONS: Maximizing acceptance of CPI reduced the length of hospital stay in this model. Practicing Clinical Pharmacists may qualify for further privileges including promotion to a fully independent prescriber status.

    Matched MeSH terms: Pharmacy Service, Hospital*
  6. Yeo YL, Chang CT, Chew CC, Rama S
    Res Social Adm Pharm, 2021 05;17(5):1021-1023.
    PMID: 33234450 DOI: 10.1016/j.sapharm.2020.11.011
    Matched MeSH terms: Pharmacy Service, Hospital*
  7. Mai CW, Tan JSH, Koay GWL, Lim LYX
    Pharmacy (Basel), 2020 Sep 13;8(3).
    PMID: 32933158 DOI: 10.3390/pharmacy8030170
    Dietary supplementation is increasingly sought after by consumers looking to meet the demands of a modern lifestyle. Effective supplementation requires knowledge of the purpose and proper use of nutritional supplements. Unverified or inadequate guidance on supplementation can propagate misconceptions and increase undue fears of side effects. Community pharmacists are best placed to guide consumers on nutritional supplement use. In this review, a panel comprised of community pharmacists, pharmacy academia, and dietitians (n = 6) convened to provide an experience- and evidence-based guidance on rational drug use, patient education, and integrated and personalized nutrition care in both community and hospital pharmacy settings. A novel framework to guide community pharmacist-led consultations on supplementation is proposed. The four-step CARE (Categorize, Assess, Recommend, Empower) guide was developed to facilitate and optimize outcomes of pharmacist-led nutritional supplement consultation. Telehealth advancements in the form of digital health applications and personalized nutrigenomic DNA testing support Integrative Nutrition Care, and will further promote appropriate supplementation use to improve overall well-being in the community. Practical implementation of the CARE guide is necessary to ascertain its applicability for optimizing outcomes of pharmacist-led consultation and the recommendation of nutritional supplements.
    Matched MeSH terms: Pharmacy Service, Hospital
  8. Cheong MWL
    PMID: 32838225 DOI: 10.1002/jac5.1315
    Introduction: The Coronavirus disease 2019 (COVID-19) pandemic has significantly affected health care systems around the world. In many hospitals and health care facilities, services and health care workers have been reorganized and restructured to meet the demands of the pandemic. The impact of the pandemic on hospital-based clinical pharmacists and their ability to deliver pharmaceutical care is currently unknown.

    Objective: This study aimed to explore the impact of the COVID-19 pandemic on hospital-based clinical pharmacists working in Malaysia and the implications on how clinical pharmacy is perceived as a health care service.

    Methods: A qualitative study was designed to meet the research objectives. Nineteen hospital-based clinical pharmacists consented and participated in one-on-one, semi-structured interviews. The interviews were transcribed and analyzed using an iterative thematic analysis approach.

    Results: The experiences and views of the participants were reported. Three main themes were developed: 'Reassignment and other changes in clinical pharmacist roles', 'Adapting clinical pharmacy services to COVID-19', and 'The need for clinical pharmacists in the ward'. The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment. Despite this, clinical pharmacists continued to support patient care in hospitals through the use of technology. The withdrawal of clinical pharmacy services, however, raises concern that the role of clinical pharmacists is still poorly recognized.

    Conclusion: Clinical pharmacists in hospitals continue to support patient care despite the disruption caused by the COVID-19 pandemic. Greater support and recognition of their role is required in order to empower and enhance their ability to deliver pharmaceutical care.This article is protected by copyright. All rights reserved.

    Matched MeSH terms: Pharmacy Service, Hospital
  9. Dewi EK, Dahlui M, Chalidyanto D, Rochmah TN
    Expert Rev Pharmacoecon Outcomes Res, 2020 Jun;20(3):289-294.
    PMID: 31203686 DOI: 10.1080/14737167.2019.1633308
    BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery.

    RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs.

    RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs.

    CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.

    Matched MeSH terms: Pharmacy Service, Hospital/economics*
  10. Saleh MS, Hong YH, Muda MR, Dali AF, Hassali MA, Khan TM, et al.
    Eur J Hosp Pharm, 2020 05;27(3):173-177.
    PMID: 32419939 DOI: 10.1136/ejhpharm-2018-001679
    Objective: The increase in antimicrobial resistance and the lack of new antimicrobial agents in drug discovery pipelines have called for global attention to mitigate the problem of antimicrobial misuse. While an antimicrobial stewardship (AMS) programme has been implemented in Malaysia, the perception and practices of public hospital pharmacists remain unknown. The aim of this study was to determine the perception and practices of Malaysian public hospital pharmacists towards the AMS programme in the state of Selangor, Malaysia.

    Methods: A cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.

    Results: Of the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).

    Conclusions: Overall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.

    Matched MeSH terms: Pharmacy Service, Hospital/organization & administration*
  11. Lee JL
    Int J Clin Pharm, 2020 Apr;42(2):604-609.
    PMID: 32095976 DOI: 10.1007/s11096-020-00996-4
    Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysian pediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing error and 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of a prescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers is an important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.
    Matched MeSH terms: Pharmacy Service, Hospital/standards*
  12. Kubas MA, Halboup AM
    Int J Clin Pharm, 2020 Feb;42(1):51-56.
    PMID: 31713107 DOI: 10.1007/s11096-019-00936-x
    Background Studies have revealed that the inclusion of a clinical pharmacist as a member in multidisciplinary medical team has been associated with improved medication use, reduced adverse drug reaction, reduced cost of treatment, and improved health outcomes. Objective The objectives of this study were to evaluate the implementation of clinical pharmacy recommendations and services, the acceptance rate by the physicians, and the anticipated outcomes of the recommendations at a hospital in Yemen. Methods Different units of the University of Science and Technology Hospital, Sana'a were included in this study. All the recommendations and services provided by the clinical pharmacist during daily activities were documented between June 2013 and November 2015. The provided recommendations were classified based on the type, acceptance rate, and the anticipated outcomes. Main outcome measure Type and quality of clinical pharmacists' recommendations, anticipated impact of the recommendations on health outcomes, and their acceptance rate. Results Throughout the study period, a total of 957 patients in different hospital units were visited and provided with a total of 3307 interventions and services. The most frequent types of clinical pharmacist's interventions were drug discontinuation (23.6%, n = 782), inappropriate dose interval or time (n = 735, 22.2%), and add medication (18.9%, n = 626). Overall, 61.8% (n = 2044) of the provided recommendations were accepted by the physicians. The most anticipated outcomes were improved the effectiveness of therapy (45.1%, n = 1909), avoid adverse drug reactions (29%, n = 1228), and decrease the cost of medications (18.8%, n = 797). Conclusion Clinical pharmacist's recommendations resulted in improving drug therapy and decreasing adverse effects for inpatients at the University of Science and Technology Hospital. This suggests that the implementation of clinical pharmacy services is essential and has a positive outcome on patient care.
    Matched MeSH terms: Pharmacy Service, Hospital/standards; Pharmacy Service, Hospital/trends*
  13. Ching, Melissa Lim Ven, Chin, Ling Hui, Yin, Ng Wai
    MyJurnal
    Comfort and acceptance by healthcare professionals are crucial for effective operation of clinical pharmacy services. To date, there is no published report on the perceptions towards clinical pharmacy services from Tawau, Sabah or anywhere else in Malaysia. The objective of this study is to evaluate the comfort, perceptions and expectations of healthcare professionals towards the clinical pharmacy services in Tawau Hospital. This crosssectional, questionnaire-based study was carried out in 10 wards of Tawau Hospital with clinical pharmacy services, from June to July 2014. Validated questionnaires with consent were anonymously distributed to doctors and nurses. The self-administered questionnaires consisted of four sections: demographic, comfort level, expectations, and experiences dealing with clinical pharmacists. A 4-point Likert scale, where 1 = strongly disagree, while 4 = strongly agree, was used to indicate the level of agreement. Of 292 questionnaires administered, 269 were completed, giving a response rate of 92.1%. Compared to nurses, higher percentage of doctors were less comfortable with clinical pharmacists providing drugrelated education, suggesting the use of drugs to prescribers, designing pharmacotherapy regimes, and monitoring safety and outcomes of the designed regimens. The participants have great expectations, perceptions and experiences with clinical pharmacists of Tawau Hospital. Majority of the healthcare professionals who have direct contact with clinical pharmacists in their work were generally receptive and have high expectations towards patient-oriented clinical pharmacy services.
    Matched MeSH terms: Pharmacy Service, Hospital
  14. Saleem Z, Hassali MA, Hashmi FK, Godman B, Ahmed Z
    Heliyon, 2019 Jul;5(7):e02159.
    PMID: 31384689 DOI: 10.1016/j.heliyon.2019.e02159
    Objective: We are unaware of the extent of antimicrobial stewardship programs (ASPs) among hospitals in Pakistan, which is a concern given the population size, high use of antibiotics across sectors and increasing antimicrobial resistance (AMR) rates. Consequently, we sought to address this by undertaking a comprehensive survey.

    Method: In this cross-sectional observational study in Punjab, an instrument of the measure was developed based on health care facility characteristics and ASPs after an extensive literature review. The questionnaire was circulated by mail or through drop off surveys to medical superintendents or directors/heads of pharmacy departments of hospitals.

    Results: Out of 254, a total of 137 hospitals fully completed the questionnaire - 11 primary, 65 secondary, 46 tertiary and 15 specialized hospitals. The use of antimicrobial prescribing guidelines (68.7%), provision of infectious diseases consultation services (66.4%), clinical pharmacy service (65.7%), use of drug and therapeutics committees to approve antimicrobial prescribing (65.5%), regular audit by doctors on antimicrobial prescribing (54.1%) and use of a restricted formulary for antimicrobial (50.4%) were the most common ASPs. However, most of these activities were only somewhat or moderately successful. Whereas, electronic antimicrobial prescribing approval systems (15.3%), using a sticker to notify prescribers regarding the need to obtain approval for the antimicrobial prescribed (16.1%) and participation in the national antimicrobial utilization surveillance program (19.7%) were only seen in a few hospitals.

    Conclusion: Study inferred that there are inadequate ASPs in the hospitals of Pakistan. A multidisciplinary approach, clinical leadership and availability of motivated and trained individuals are essential elements for the success of future ASPs.

    Matched MeSH terms: Pharmacy Service, Hospital
  15. Satibi S, Rokhman MR, Aditama H
    Malays J Med Sci, 2019 Jul;26(4):110-121.
    PMID: 31496900 DOI: 10.21315/mjms2019.26.4.13
    Background: There have been no existing performance indicators to measure the overall quality of pharmacy services, including the aspects of drug management and clinical pharmacy services, at primary health centres in Indonesia. This study aimed to obtain these indicators based on a consensus of experts.

    Methods: The modified Delphi method was used to obtain the consensus. The initial indicators, based on a literature review, were evaluated and assessed by members of the expert panel through three rounds of repetition until the consensus was reached. The expert panel members were selected based on their knowledge of or expertise in pharmacy service performance and geographical considerations. Analysis of the expert panel consensus level was determined by calculating the mean and interquartile range.

    Results: Fifteen expert panel members started the first round (93.7% of the 16 targets) with 12 of them (75%) completing the third round of the modified Delphi method. Three expert panel members were representatives of the Regency Health Office, and the others were pharmacist practitioners at primary health centres from three different regencies. The consensus results were 26 indicators of drug management, 19 indicators of clinical pharmacy services, and two indicators of overall pharmacy performance.

    Conclusion: The consensus indicators for measuring drug management, clinical pharmacy services, and overall pharmacy performance can be used as a reference and standard to measure the quality of pharmacy services at primary health centres. Therefore, the measurement results are more relevant if compared between one and other studies.

    Matched MeSH terms: Pharmacy Service, Hospital
  16. Rajah R, Hanif AA, Tan SSA, Lim PP, Karim SA, Othman E, et al.
    Int J Clin Pharm, 2019 Feb;41(1):237-243.
    PMID: 30506127 DOI: 10.1007/s11096-018-0762-1
    Background Detecting errors before medication dispensed or 'near misses' is a crucial step to combat the incidence of dispensing error. Despite this, no published evidence available in Malaysia relating to these issues. Objective To determine the incidence of medication labeling and filling errors, frequency of each type of the errors and frequency of the contributing factors at the final stage before dispensing. Setting Six Penang public funded hospitals outpatient pharmacies. Methods A prospective multicentre study, over 8 week's period. Pharmacists identified and recorded the details of either medication labeling and/or filling error at the final stage of counter-checking before dispensing. Besides, the contributing factors for each error were determined and recorded in data collection form. Descriptive analysis was used to explain the study data. Main outcome measure The incidence of near misses. Results A total of 187 errors (near misses) detected, with 59.4% (n = 111) were medication filling errors and 40.6% (n = 76) were labeling errors. Wrong drug (n = 44, 39.6%) was identified as the highest type of filling errors while incorrect dose (n = 34, 44.7%) was identified as the highest type of labeling errors. Distracted and interrupted work environment was reported to lead the highest labeling and filling errors, followed by lack of knowledge and skills for filling errors and high workload for labeling errors. Conclusion The occurrence of near misses related to medication filling and labelling errors is substantial at outpatient pharmacy in Penang public funded hospitals. Further research is warranted to evaluate the intervention strategies needed to reduce the near misses.
    Matched MeSH terms: Pharmacy Service, Hospital/methods; Pharmacy Service, Hospital/standards*
  17. Aljunid SM, Aung YN, Ismail A, Abdul Rashid SAZ, Nur AM, Cheah J, et al.
    PLoS One, 2019;14(10):e0211248.
    PMID: 31652253 DOI: 10.1371/journal.pone.0211248
    This study mainly aims to identify the direct cost and economic burden of hypoglycemia for patients with type II diabetes mellitus in Malaysia. A cross-sectional study explored the cost incurred for hypoglycemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC). The study covered patients aged 20-79 years hospitalized with a primary diagnosis of ICD-10 hypoglycemia and discharged between January 2010 and September 2015 according to the casemix database. A costing analysis was done through a step-down approach from the perspective of health providers. Cost data were collected for three levels of cost centers with the help of a hospital-costing template. The costing data from UKMMC were used to estimate the national burden of hypoglycemia among type II diabetics for the whole country. Of 244 diabetes patients admitted primarily for hypoglycemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycemic case requires five days (median) of inpatient stay on average, with a range of 2-26 days, and costs RM 8,949 (USD 2,289). Of the total cost, 30% related to ward (final cost center), 16% to ICU, and 15% to pharmacy (secondary-level cost center) services. Considering that 3.2% of all admissions were hypoglycemia related, the total annual cost of hypoglycemia care for adult diabetics in Malaysia is estimated at RM 117.4 (USD 30.0) million, which translates to 0.5% of the Ministry of Health budget. Hypoglycemia imposes a substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Diabetic management needs to include proper diabetic care and health education to reduce episodes of hypoglycemia.
    Matched MeSH terms: Pharmacy Service, Hospital/economics*
  18. Aljunid SM, Ali Jadoo SA
    Inquiry, 2018 2 14;55:46958018755483.
    PMID: 29436248 DOI: 10.1177/0046958018755483
    The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III ( B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC ( B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.
    Matched MeSH terms: Pharmacy Service, Hospital/economics*
  19. Nies YH, Ali AM, Abdullah N, Islahudin F, Shah NM
    Patient Prefer Adherence, 2018;12:1955-1964.
    PMID: 30319245 DOI: 10.2147/PPA.S168638
    Purpose: The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia.
    Participants and methods: Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews.
    Results: Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy.
    Conclusion: Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.

    Study site: two tertiary care hospitals in Malaysia as well as the National Cancer Society Malaysia.

    Matched MeSH terms: Pharmacy Service, Hospital
  20. Alrasheedy AA, Hassali MA, Wong ZY, Saleem F
    Res Social Adm Pharm, 2017 02 16;13(4):885-886.
    PMID: 28222951 DOI: 10.1016/j.sapharm.2017.02.011
    Matched MeSH terms: Pharmacy Service, Hospital/methods*; Pharmacy Service, Hospital/trends
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