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Fulltext Snapshot of antimicrobial stewardship programs in the hospitals of Pakistan: findings and implications

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.
Fulltext Exploring healthcare professionals' knowledge, attitude, and practices towards pharmacovigilance: a cross-sectional survey

Hussain R, Hassali MA, Hashmi F, Akram T

J Pharm Policy Pract, 2021 Jan 04;14(1):5.
PMID: 33397478 DOI: 10.1186/s40545-020-00287-3

BACKGROUND: Spontaneous reporting of adverse drug reactions (ADRs) is a method of monitoring the safety of drugs and is the basic strategy for the post-marketing surveillance of the suspected drugs. Despite its importance, there is very little reporting of ADRs by healthcare professionals. The present study has evaluated the knowledge, attitude and practices of health care professionals (HCPs) regarding pharmacovigilance activities in Lahore, Pakistan.
METHODS: A cross-sectional questionnaire-based survey was employed, and a convenience sampling was opted to collect the data among physicians, pharmacists and nurses working in tertiary care public hospitals of Lahore, Pakistan from September 2018 to January 2019.
RESULTS: Of the 384 questionnaires distributed, 346 health care professionals responded to the questionnaire (90.10% response rate). Most participants had good knowledge about ADR reporting, but pharmacist had comparatively better knowledge than other HCPs regarding ADR (89.18%) pharmacovigilance system (81.08%), its centres (72.97%) and function (91.89%). Most of the participants exhibited positive attitude regarding ADR reporting, such as 49.1% of physicians (P
Fulltext A qualitative insight on complementary and alternative medicines used by hypertensive patients

Ibrahim IR, Hassali MA, Saleem F, Al Tukmagi HF

J Pharm Bioallied Sci, 2016 Oct-Dec;8(4):284-288.
PMID: 28216951 DOI: 10.4103/0975-7406.199349

BACKGROUND: The self-treatment with complementary and alternative medicines (CAMs) in chronic diseases is portraying an expanding trend worldwide. Yet, little is known concerning patients' motives to use CAM in the control of blood pressure.
OBJECTIVE: This study aims to explore the self-use of CAM in the management of hypertension and explore patients' attitudes, perceived benefits, and disclosure to the physician.
MATERIALS AND METHODS: A qualitative technique was adopted and face-to-face interviews, using a validated interview guide, were carried out among twenty hypertensive patients. A purposive sampling method was used to recruit patients at Al-Karama Teaching Hospital in Baghdad; the capital of Iraq; from January to April 2015. All the interviews were audio-recorded, then transcribed verbatim and examined for thematic relationships.
RESULTS: Three major themes were identified through thematic content analysis of the interviews. These encompassed patients' understanding of CAM; experience and perceived benefits; and communication with the doctors. The use of CAM was prevalent among the majority of the respondents. The most commonly used therapies were biological-based practices (herbal remedies, special diet, vitamins, and dietary supplements); traditional therapies (Al-Hijama or cupping); and to a less extent of manipulative body-based therapies (reflexology). Factors influencing the use of CAM were traditions, social relationships, religious beliefs, low-cost therapy, and safety of natural products.
CONCLUSION: The use of CAM was common as a practice of self-treatment among hypertensive patients in Iraq. This was underpinned by the cultural effects, social relationships, religious beliefs, and the perception that natural products are effective and safe. Understanding patients' usage of CAM is of great importance as long as patient's safety and interaction with the standard prescribed treatment are major concerns.
Fulltext Patient-physician Communication Barrier: A Pilot Study Evaluating Patient Experiences

Khan T, Hassali M, Al-Haddad M

J Young Pharm, 2011 Jul;3(3):250-5.
PMID: 21897668 DOI: 10.4103/0975-1483.83778

This study aims to identify the patient-physician communication barriers in the primary healthcare setting in Pulau Penang, Malaysia. A cross-sectional study was designed to attain the objectives of the study. A self-developed 17-item study tool was used to explore respondent's perception about the barriers they have faced while communicating with physician. The reliability scale was applied and internal consistency of the study tool was estimated on the basis of Cronbach's alpha (α = 0.58). The data analysis was conducted using statistical package for social sciences students SPSS 13(®). Chi Square test was used to test the difference between proportions. A total of n = 69 patients responded to this survey. A higher participation was seen by the male respondents, 39 (56.5%). About 52 (76.5%) of the respondents were satisfied with the information provided by the physician. In an effort to identify the patient-physician barriers, a poor understanding among the patients and physician was revealed. 16 (23.5%) respondents disclosed lack of satisfaction from the information provided to them. Overall, it is seen that lack of physician-patient understanding was the main reason that result hindrance in the affective communication. Moreover, there is a possibility that a low level of health literacy among the patients and inability of the physician to affectively listen to patients may be the other factors that result in a deficient communication.
Community pharmacists' attitudes, perceptions, and barriers toward adverse drug reaction reporting in Malaysia: a quantitative insight

Elkalmi RM, Hassali MA, Ibrahim MI, Jamshed SQ, Al-Lela OQ

J Patient Saf, 2014 Jun;10(2):81-7.
PMID: 24618640 DOI: 10.1097/PTS.0000000000000051

This study was designed to explore awareness and attitudes of community pharmacists toward the national ADR reporting system activities in the northern states of Malaysia.
Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia

Hassali MA, Al-Haddad M, Shafie AA, Tangiisuran B, Saleem F, Atif M, et al.

J Patient Saf, 2012 Jun;8(2):76-80.
PMID: 22561848 DOI: 10.1097/PTS.0b013e31824aba86

OBJECTIVE: This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia.
METHODS: A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry.
RESULTS: A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers.
CONCLUSIONS: General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.
Fulltext The need to cover generic medications and generic substitution practice in the curricula of pharmacy colleges in Saudi Arabia

Alrasheedy AA, Hassali MA, Aljadhey H, Al-Tamimi SK

Am J Pharm Educ, 2014 Jun 17;78(5):108.
PMID: 24954948 DOI: 10.5688/ajpe785108
Fulltext Is there a need for a formulary of clinically interchangeable medicines to guide generic substitution in Saudi Arabia?

Alrasheedy AA, Hassali MA, Aljadhey H, Ibrahim MI, Al-Tamimi SK

J Young Pharm, 2013 Jun;5(2):73-5.
PMID: 24023460 DOI: 10.1016/j.jyp.2013.06.006

The escalating healthcare expenditure is a major challenge to sustainability of the healthcare systems. To confront the escalating health expenditure in general and medicines expenditure in particular, many countries promoted the use of generic medicines. To promote generic medicines, many countries have adopted a generic substitution (GS) policy and generic prescribing. To effectively implement the GS policy, it is evident in the literature that it is essential to have an evidence-based guide on therapeutic equivalence and formulary of interchangeable medicines to guide responsible GS. In Saudi Arabia, GS is permissive and pharmacists are given the right to perform GS. While the prescriber's approval is not a requirement, patient consent is required when performing GS. Although there are some general drug references, such as the Saudi National Formulary (SNF) and list of registered medicines in the Saudi market, but there is currently no information available to healthcare professionals that documents the therapeutic and bioequivalence between medicines. Thus, it is essential to have a formulary of interchangeable medicines to guide appropriate GS or at least to include such vital information regarding therapeutic equivalence and brand interchangeability as part of the SNF. That, in turn, will not only make healthcare professionals more confident when providing GS, but will also enable the avoidance of situations where GS is inappropriate.
Fulltext Adaptation and validation of a questionnaire assessing patient satisfaction with pharmacy services in general hospitals

Al-Jumah KA, Hassali MA, Al-Zaagi I

Patient Prefer Adherence, 2014;8:371-5.
PMID: 24707170 DOI: 10.2147/PPA.S58565

OBJECTIVE: The aim of this study was to cross-culturally adapt the Armando Patient Satisfaction Questionnaire into Arabic and validate its use in the general population.
METHODS: The translation was conducted based on the principles of the most widely used model in questionnaire translation, namely Brisling's back-translation model. A written authorization allowing translation into Arabic was obtained from the original author. The Arabic version of the questionnaire was distributed to 480 participants to evaluate construct validity. Statistical Package for Social Sciences version 17.0 for Windows was used for the statistical analysis.
RESULTS: The response rate of this study was 96%; most of the respondents (52.5%) were female. Internal consistency was assessed using Cronbach's α, which showed that this questionnaire provides a high reliability coefficient (reaching 0.9299) and a high degree of consistency and thus can be relied upon in future patient satisfaction research.
Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications

Ali MH, Alrasheedy AA, Kibuule D, Godman B, Hassali MA, Ali HMH

Expert Rev Anti Infect Ther, 2019 11;17(11):927-937.
PMID: 31689134 DOI: 10.1080/14787210.2019.1689818

Background: Multidrug-resistant tuberculosis (MDR-TB) has a socioeconomic impact and threatens global public health. We assessed treatment outcomes of MDR-TB and predictors of poor treatment outcomes in Sudan given current high prevalence rates.Methods: Combined retrospective and prospective cohort study at Abu-Anga hospital (TB specialized hospital in Sudan). All patients with MDR-TB between 2013 and 2017 were targeted.Results: A total of 156 patients were recruited as having good records, 117 (75%) were male, and 152 (97.4%) had pulmonary TB. Patients were followed for a median of 18 months and a total of 2108 person-months. The overall success rate was 63.5% and the mortality rate was 14.1%. Rural residency (P < 0.05) and relapsing on previous treatments (P < 0.05) were determinants of time to poor MDR-TB treatment outcomes.Conclusion: Overall, more attention needs to be given to special MDR-TB groups that are highly susceptible to poor outcomes, i.e. rural patients. As a result, it is highly recommended to maintain total coverage of medicines for all MDR-TB patients for the entire period of treatment in Sudan. It is also recommended to instigate more treatment centers in rural areas in Sudan together with programs to enhance adherence to treatments including patient counseling to improve future outcomes.
Fulltext Determinants of health-related quality of life among warfarin patients in Pakistan

Iqbal MS, Muthanna FMS, Kassab YW, Hassali MA, Al-Saikhan FI, Iqbal MZ, et al.

PLoS One, 2020;15(6):e0234734.
PMID: 32555595 DOI: 10.1371/journal.pone.0234734

INTRODUCTION: The effect of anticoagulation control on overall Health-Related Quality of Life (HRQoL) in patients taking warfarin in Pakistan has not been explored yet. Therefore, this study aimed to evaluate HRQoL among warfarin patients in Pakistan.
METHODS: This cross-sectional study was conducted among patients on warfarin in Pakistan. By purposive sampling, data were collected using demographic data collection form and the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF). The WHOQOL-BREF is comprised of four domains; physical, psychological, social relationships, and environment. Descriptive and inferential statistical analysis was done using SPSS version 22.
RESULTS: Out of 295 warfarin patients, more females than males (<0.001) were observed (n = 184, 62.4%, and n = 111, 37.6% respectively). One hundred and eighteen (40.0%) patients were less than 30-years of age, whereas one hundred and seventy-seven (60.0%) patients were above 30-years of age. Mean scores for the physical (62.44±15.36), psychological (67.84±15.54), social (64.27±26.28) and environment domains (63.45±17.66) were observed.
CONCLUSION: Patients had overall lower to moderate but satisfactory HRQoL scores in all four domains. Age, gender, employment status, education level, the indication of use and duration of warfarin therapy was associated with one or more domains of HRQoL among warfarin patients. The findings of this study would serve as a primary database for future studies. This study highlights how non-clinical factors could impact HRQoL in studied patients.
Knowledge and Barriers Among Physicians Toward Adverse Drug Reaction Reporting at a Tertiary Care Hospital in Saudi Arabia

Al-Abdulkarim DA, Aljadhey HS, Mahmoud MA, Poff GA, Hassali MA, Ali S

Hosp Pharm, 2021 Aug;56(4):368-373.
PMID: 34381276 DOI: 10.1177/0018578720910385

Background: Spontaneous reporting systems are essential as they help detect serious unknown adverse drug reaction (ADR). However, underreporting of ADR is a commonly associated problem. This research work aims to assess knowledge, barriers, and factors that encourage the reporting of ADR among physicians.
Methods: A total of 600 physicians working at a tertiary referral hospital in Riyadh, Saudi Arabia, were included in this cross-sectional study. A pretested questionnaire was used.
Results: Out of the 600 physicians, 240 (40%) completed the questionnaire. Most of the participants (85.4%) could correctly define ADR; nearly 75% physicians were unaware of the spontaneous reporting of ADR in Saudi Arabia. A total of 175 (72.9%) physicians had not reported any ADR among their patients in the last year; 40% of the physicians said that they did not report ADR because they were unaware of the online reporting of ADR. Providing guidelines and regular bulletins on the reporting of ADR is a critical aspect that encourages physicians to report ADR (51%). Education and training are the most recognized measures for improving the reporting of ADR.
Conclusion: Physicians were adequately aware of ADR but inadequately aware of the reporting system and reporting authorities. Continuing medical education, training, and integration of the reporting of ADR into physicians' various clinical activities may improve ADR reporting.
Fulltext The experiences of implementing generic medicine policy in eight countries: A review and recommendations for a successful promotion of generic medicine use

Hassali MA, Alrasheedy AA, McLachlan A, Nguyen TA, Al-Tamimi SK, Ibrahim MI, et al.

Saudi Pharm J, 2014 Dec;22(6):491-503.
PMID: 25561861 DOI: 10.1016/j.jsps.2013.12.017

Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price. Thus, while providing the same therapeutic outcomes, generic medicines lead to substantial savings for healthcare systems. Therefore, the quality use of generic medicines is promoted in many countries. In this paper, we reviewed the role of generic medicines in healthcare systems and the experiences of promoting the use of generic medicines in eight selected countries, namely the United States (US), the United Kingdom (UK), Sweden, Finland, Australia, Japan, Malaysia and Thailand. The review showed that there are different main policies adopted to promote generic medicines such as generic substitution in the US, generic prescribing in the UK and mandatory generic substitution in Sweden and Finland. To effectively and successfully implement the main policy, different complementary policies and initiatives were necessarily introduced. Barriers to generic medicine use varied between countries from negative perceptions about generic medicines to lack of a coherent generic medicine policy, while facilitators included availability of information about generic medicines to both healthcare professionals and patients, brand interchangeability guidelines, regulations that support generic substitution by pharmacists, and incentives to both healthcare professionals and patients.
Fulltext Community pharmacists' knowledge, behaviors and experiences about adverse drug reaction reporting in Saudi Arabia

Mahmoud MA, Alsowaida Y, Alshammari T, Khan TM, Alrasheedy A, Hassali MA, et al.

Saudi Pharm J, 2014 11;22(5):411-8.
PMID: 25473329 DOI: 10.1016/j.jsps.2013.07.005

OBJECTIVE: To assess community pharmacists' knowledge, behaviors and experiences relating to Adverse Drug Reaction (ADR) reporting in Saudi Arabia.
METHODS: A cross-sectional study was conducted using a validated self-administered questionnaire. A convenience sample of 147 community pharmacists working in community pharmacies in Riyadh, Saudi Arabia.
RESULTS: The questionnaire was distributed to 147 pharmacists, of whom 104 responded to the survey, a 70.7% response rate. The mean age of participants was 29 years. The majority (n = 101, 98.1%) had graduated with a bachelorette degree and worked in chain pharmacies (n = 68, 66.7%). Only 23 (22.1%) said they were familiar with the ADR reporting process, and only 21 (20.2%) knew that pharmacists can submit ADR reports online. The majority of the participants (n = 90, 86.5%) had never reported ADRs. Reasons for not reporting ADRs most importantly included lack of awareness about the method of reporting (n = 22, 45.9%), misconception that reporting ADRs is the duty of physician and hospital pharmacist (n = 8, 16.6%) and ADRs in community pharmacies are simple and should not be reported (n = 8, 16.6%). The most common approach perceived by community pharmacists for managing patients suffering from ADRs was to refer him/her to a physician (n = 80, 76.9%).
CONCLUSION: The majority of community pharmacists in Riyadh have poor knowledge of the ADR reporting process. Pharmacovigilance authorities should take necessary steps to urgently design interventional programs in order to increase the knowledge and awareness of pharmacists regarding the ADR reporting process.
Perceptions and attitudes of pharmacy students towards volunteering at health promotional programs: a cross-sectional study from Malaysia

Saleem F, Hassali MA, Ibrahim ZS, Rasheedy AA, Aljadhey H

J Community Health, 2015 Apr;40(2):285-90.
PMID: 25115271 DOI: 10.1007/s10900-014-9930-y

The present study aims to explore the perceptions and understanding of future pharmacists towards volunteerism in health promotional activities. The study was designed as a cross sectional, descriptive survey. All pharmacy undergraduates (n = 293) from the first, second and third professional years enrolled at the School of Pharmaceutical Sciences, Universiti Sains Malaysia were targeted for the study. A pre validated, 15-itemed questionnaire was used for data collection and was analysed by using SPSS. Dichotomous groups were compared with Mann-Whitney U test. The Jonckheere-Terpstra test was used to evaluate the trend of association. Where significant associations were reported, effect size was calculated by using Kendall tau correlation coefficient. p value of <0.05 was considered to be of statistical significance. Out of 200 respondents, 185 completed the study with a response rate of 92.5 %. Agreement with mandatory status of volunteerism at community services was significant with gender (p = 0.003) and year of study (p = 0.045). Confidence in performing health promotional activities (p = 0.001, τ = 0.155) and needed communication skills during health promotional activities (p = 0.022, τ = 0.322) were also significantly associated with year of study with a moderate positive trend from junior to senior classes. Although pharmacy undergraduates showed positive interest and will to volunteer at the health promotional programs, certain issues were also highlighted. Therefore, in order to address these challenges, pharmacy curriculum needs to include a greater emphasis on role of pharmacists in public health. This can be achieved by having a dedicated core course as part of pharmacy curriculum.
Fulltext Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia

Hassali MA, Alrasheedy AA, Ab Razak BA, Al-Tamimi SK, Saleem F, Ul Haq N, et al.

Australas Med J, 2014;7(1):35-44.
PMID: 24567765 DOI: 10.4066/AMJ.2014.1936

Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations.
Fulltext Students' attitude toward use of over the counter medicines during exams in Saudi Arabia

Almalak H, Albluwi AI, Alkhelb DA, Alsaleh HM, Khan TM, Hassali MA, et al.

Saudi Pharm J, 2014 Apr;22(2):107-12.
PMID: 24648821 DOI: 10.1016/j.jsps.2013.02.004

To explore the use of over the counter (OTC) medicines among students during exams in Riyadh City, Kingdom of Saudi Arabia.
Fulltext Does educational intervention improve doctors' knowledge and perceptions of generic medicines and their generic prescribing rate? A study from Malaysia

Hassali MA, Wong ZY, Alrasheedy AA, Saleem F, Mohamad Yahaya AH, Aljadhey H

SAGE Open Med, 2014;2:2050312114555722.
PMID: 26770747 DOI: 10.1177/2050312114555722

To investigate the impact of an educational intervention on doctors' knowledge and perceptions towards generic medicines and their generic (international non-proprietary name) prescribing practice.
Cross Sectional Assessment of Health Related Quality of Life (HRQoL) among patients with cancer in Malaysia

Farooqui M, Hassali MA, Knight A, Shafie AA, Farooqui MA, Saleem F, et al.

Asian Pac J Cancer Prev, 2013;14(5):3017-21.
PMID: 23803072

BACKGROUND: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients.
MATERIALS AND METHODS: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0.
RESULTS: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 (SD±13) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 49.4%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p=0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001).
CONCLUSIONS: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.
Fulltext A cross-sectional assessment of knowledge, attitude and practice among Hepatitis-B patients in Quetta, Pakistan

ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Haseeb A, et al.

BMC Public Health, 2013;13:448.
PMID: 23641704 DOI: 10.1186/1471-2458-13-448

Hepatitis-B is a life threatening infection resulting in 0.6 million deaths annually. The prevalence of Hepatitis-B is rising in Pakistan and furthermore, there is paucity of information about Knowledge, Attitude and Practice among Hepatitis-B patients. Better disease related knowledge is important to have positive attitude and that will bring the good practices which will prevent the further spread of infection. This study aimed to evaluate knowledge, attitude and practice of Hepatitis-B Patients in Quetta city, Pakistan.

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