Displaying publications 21 - 40 of 113 in total

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  1. Prescribing patterns for upper respiratory tract infections: A prescription-review of primary care practice in Kota Setar district, Kedah, Malaysia. [Abstract]
    Md Rezal RS, Hassali MA, Saleem F, Kumar R
    Value Health, 2015 Nov;18(7):A848-9.
    PMID: 26534536 DOI: 10.1016/j.jval.2015.09.420
    Conference abstrract
    Objectives: Antimicrobial resistance is associated with irrational use of antibiotics in general practice. We aimed to assess the frequency with which patients with Upper Respiratory Tract Infections were prescribed with antibiotics and the patterns of antibiotic prescription at primary healthcare centres in Malaysia.
    Methods: The study targeted all primary public healthcare centres in the district of Kota Setar, Kedah, Malaysia. A retrospective prescription analysis was conducted whereby prescriptions from 1st January 2014 to 31st March 2014 were screened and retrieved for antibiotics prescribed for upper respiratory infections. The data was entered into Microsoft Excel spread sheet, and exported to Statistical Package for Social Sciences, version 20 for further analysis. Frequencies and percentages were used to summarize the data. The Jonckheere–Terpstra test was used to evaluate the trend of antibiotic prescription. 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.
    Results: For the period of three months, 123,524 prescriptions were screened and analysed. 2270 (31.8%) prescriptions contained antibiotics prescribed for all URTIs visits. Among all antibiotics, macrolides were the most commonly prescribed antibiotic, constituting of 61% (n=1404) of total antibiotics prescribed for all cases. The Jonckheere–Terpstra test revealed a statistical relationship between prescribers and the diagnosis of the disease (p=0·001). Furthermore, a weak positive trend of association was reported with FMS being more accurate in diagnosis followed by MOs and AMOs (τ=0·122).
    Conclusions: Practicing physicians should adhere to the standard treatment practices, as antibiotic use in viral aetiology is ineffective, and encourages the persistence development of resistance. A comprehensive development of national antibiotic stewardship program is recommended to ensure organised and regulated control of antibiotic use in Malaysia.
  2. Association among calendar packaging and medication adherence: Findings from a focus group discussion among hypertensive patients in Penang, Malaysia. [Abstract]
    Tan BY, Shafie AA, Hassali MA, Saleem F, Kumar R
    Value Health, 2015 Nov;18(7):A831.
    PMID: 26534439 DOI: 10.1016/j.jval.2015.09.317
    Objectives: Medication adherence to treatment recommendations has major impact on health outcomes. Numerous interventions to improve medication adherence among the patients have been studied in clinical trials, including calendar packaging and patient reminder letters. Therefore, this study is aimed to explore hypertensive patient’s perceptions towards calendar packaging and its impact on medication adherence.
    Methods: A qualitative method was adopted, whereby two focus group sessions were conducted among 16 conveniently sampled hypertensive patients from a community based non-governmental organisation in the state of Penang, Malaysia. A pre validated focus group guide was constructed and used for data collection. Collected data was transcribed verbatim and analysed by thematic content analysis to identify the emerging themes.
    Results: Each focus group consisted of 8 hypertensive patients. Thematic content analysis resulted into 3 major themes (knowledge and familiarity with the medicines names and their packaging; perception about the packaging and labelling of medicines; knowledge and views of calendar packaging) and each theme was further divided into 2 sub themes. Majority of the hypertensive patients were not familiar with their medication names, however they were able to identify their medications based on the appearance and packaging. Participants agreed that calendar packaging is a great intervention to increase awareness among patients about regular medicine use and increase medication adherence.
    Conclusions: The study concluded that hypertensive patients relied on the packaging and labelling on the medications to identify their medications. Thus, packaging and labelling of the medications play an important role in improving medication adherence and reduce medication errors. This finding can help to enhance the drug manufacturers to pay attention on the drug packaging in order to increase medication adherence among the patients.
  3. Does Treatment Adherence Correlates With Health-Related Quality of Life: Findings From A Cross Sectional Analysis of Type 2 Diabetes Mellitus Patients In Pakistan
    Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Value Health, 2015 Nov;18(7):A613.
    PMID: 26533443 DOI: 10.1016/j.jval.2015.09.2129
  4. Association between knowledge and medication adherence in patients with type 2 diabetes mellitus in Pakistan. [Abstract]
    Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Value Health, 2015 Nov;18(7):A613.
    PMID: 26533439 DOI: 10.1016/j.jval.2015.09.2128
    Objectives: Diabetes mellitus is a serious health problem. Medication adherence is a key determinant of therapeutic success in patients with diabetes mellitus. The purpose of this study was to assess medication adherence and its potential association with diabetes related knowledge in patients with type 2 diabetes mellitus.
    Methods: This study was carried out at the outpatient clinics of a public sector teaching hospital in Sargodha, Pakistan. Besides demographic and disease-related questions, previously validated questionnaires, Morisky Medication Adherence Scale and Michigan diabetes knowledge test was used to assess the medication adherence and diabetes related knowledge, respectively. Descriptive statistics were used to determine the demographic and disease characteristics of the patients while Spearman rank correlation was employed to measure the association between medication adherence and knowledge.
    Results: Three hundred and ninety two patients were interviewed. Out of 392 patients, 245 (62.5%) of the patients had average knowledge about diabetes while 282 (71.9 %) were categorized as poor adherent. Only 13 patients (3.3 %) were considered as good adherent in the study. The correlation coefficient between total scores of knowledge and total medication adherence score was 0.036 (p< 0.05), indicating a weak correlation between knowledge scores and adherence level.
    Conclusions: Knowledge of diabetes mellitus among these patients was average; however, adherence to drug therapy was also poor. Patients’ knowledge about diabetes had positive association with medication adherence. Improving diabetes knowledge of people can result in better adherence, which may result in better control of diabetes.
  5. 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
  6. Fulltext Knowledge and perception about health risks of cigarette smoking among Iraqi smokers
    Dawood OT, Rashan MA, Hassali MA, Saleem F
    J Pharm Bioallied Sci, 2016 Apr-Jun;8(2):146-51.
    PMID: 27134468 DOI: 10.4103/0975-7406.171738
    BACKGROUND:
    Smoking is a major public health problem, especially in Iraq. There is very little information had been documented regarding smoking risk factors and quit intention among Iraqi smokers.

    OBJECTIVES:
    The main objectives of this study are to determine smokers' knowledge and perception about smoking health risks; and to determine smoking behavior and quitting intentions among Iraqi smokers; as well as to predict the factors that may associate with quit intentions.

    METHODS:
    A cross-sectional study was conducted at the outpatient clinic in Tikrit Teaching Hospital, Tikrit City, Iraq. Adult smokers who are smoking cigarette everyday and able to communicate with the researcher were invited to participate in the study. A self-administered questionnaire was used to collect data from 386 participants.

    RESULTS:
    This study showed that smokers had low awareness about some risk effects of smoking such as lung cancer in nonsmokers (30.1%), impotence in male smokers (52.6%), premature ageing (64%), and stroke (66.3%). In addition, the high score of knowledge and perception was significantly associated with quitting intention.

    CONCLUSION:
    Smokers' knowledge and perception regarding smoking health effects were low, especially in terms of secondhand smokers. Many efforts needed from health policy-makers and health care professionals to disseminate information about the risks of smoking and health benefits of give up smoking.

    KEYWORDS:
    Health risks; knowledge; perception; quit intentions; smoking
  7. Using pictograms to assist caregivers in liquid medication administration: a systematic review
    Chan HK, Hassali MA, Lim CJ, Saleem F, Tan WL
    J Clin Pharm Ther, 2015 Jun;40(3):266-72.
    PMID: 25865563 DOI: 10.1111/jcpt.12272
    WHAT IS KNOWN AND OBJECTIVE: It has been reported that more than 80% of out-of-hospital medication errors among the young children involve liquid formulations. The usefulness of pictorial aids to improve communication of medication instructions has not been extensively investigated for child health. The objective of this study was to determine the effectiveness of pictorial aids used to assist caregivers in the administration of liquid medications.
    METHODS: MEDLINE, CINAHL, PsycINFO, ScienceDirect, Scopus and the Cochrane Library were searched for articles published up to February 2015. Studies that used pictorial aids with liquid medications and measured at least one of the following outcomes were included: dosing accuracy, comprehension of medication instructions, recall of information and adherence of caregivers. Two authors independently selected studies, extracted data and assessed methodological quality of studies using the Cochrane Collaboration's tool.
    RESULTS AND DISCUSSION: Five experimental studies (four hospital based and one community based) with a total of 962 participants were included. A wide range of liquid formulations were studied, including both prescription and over-the-counter medications. The existing findings suggest that pictographic interventions reduced dosing errors, enhanced comprehension and recall of medication instructions and improved adherence of caregivers. Incorporating pictorial aids into verbal medication counselling or text-based instructions was more beneficial than using the single approach alone. Mixed results were identified for the relationship between health literacy of caregivers and effectiveness of pictorial aids.
    WHAT IS NEW AND CONCLUSION: The evidence remains limited due to the small number of studies found and variations in methodological quality. This review suggests that pictorial aids might be potential interventions, but more high-quality studies are needed to support the routine use of any pictogram-based materials with liquid medications in the clinical settings.
    KEYWORDS: caregivers; graphics; health literacy; medication adherence; medication errors; paediatrics
  8. Fulltext Disposal practices of unused and expired pharmaceuticals among general public in Kabul
    Bashaar M, Thawani V, Hassali MA, Saleem F
    BMC Public Health, 2017 01 07;17(1):45.
    PMID: 28061902 DOI: 10.1186/s12889-016-3975-z
    BACKGROUND: Most of the medicine users remain unaware about the disposal of unused or expired medicines. The aim of this study was to know the disposal practices of unused and expired medicines among the general public in Kabul.

    METHODS: This was a descriptive, cross-sectional survey, conducted through face-to-face interviews using prevalidated structured questionnaire. Returned questionnaires were double-checked for accuracy. Statistical Package for Social Science (SPSS) version 23 was used for statistical analysis.

    RESULTS: Total of 301 valid questionnaires were returned with a response rate of 100% in which 73.4% men and 26.6% women participated. More than half of the respondents were university graduates. Interestingly, 83.4% of the interviewees purchased medicines on the prescription of which 47.2% were university graduates, while 14.6% purchased medicine over the counter. Among the respondents, 46.5/100 purchased antibiotics and the remaining purchased NSAIDs, anti-hypertensive and anti-diabetic medicines. Significantly, 97/100 checked the expiry date of medicine before buying. Majority (95.3%) of the respondents' stored medicines at home. 77.7% of the respondents discarded the expired medicines in household trash. Majority of respondents held government responsible for creation of awareness for proper medicine disposal. Almost entire sample (98%) felt that improper disposal of unused and expired medicines can affect the environment and health.

    CONCLUSION: Gaps exist in practices, therefore robust, safe and cost-effective pharmaceutical waste management program supported with media campaign is needed. Healthcare practitioners and community pharmacists should offer training to educate customers on standard medicine disposal practices.

  9. Fulltext Erratum to: Disposal practices of unused and expired pharmaceuticals among general public in Kabul
    Bashaar M, Thawani V, Hassali MA, Saleem F
    BMC Public Health, 2017 03 06;17(1):231.
    PMID: 28264706 DOI: 10.1186/s12889-017-4139-5
  10. Fulltext Cultural adaptation and linguistic validation of the Beliefs about Medicines Questionnaire in Malaysia
    Tan CS, Hassali MA, Neoh CF, Saleem F, Horne R
    Value Health Reg Issues, 2018 May;15:161-168.
    PMID: 29730249 DOI: 10.1016/j.vhri.2017.12.010
    BACKGROUND: Low rate of adherence was found strongly associated with patients' beliefs across the studies about chronic diseases with hypertension. A crucial move is needed to bridge the gap between appropriate assessment tools and local hypertensive patients' medication adherence.

    OBJECTIVE: To produce a translated version in Malay language of Beliefs about Medicines Questionnaire (BMQ) that was "conceptually equivalent" to the original English version for use in local clinical practice and research.

    METHODS: The forward translation process was conducted by two independent professional translators and back translation was done by two other independent translators. A reliability analysis was conducted on 238 conveniently selected hypertensive patients. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability for the randomly selected 40 patients in a period of 2 weeks. Discriminant validity was tested through Necessity-Concerns differential, BMQ subscales, and other parameters.

    RESULTS: The overall Cronbach alpha for the internal consistency was good (0.860). The subscales of the BMQ demonstrated adequate internal consistency, with Cronbach alpha value of 0.759 for Specific-Necessity, 0.762 for Specific Concern, 0.624 for General-Overuse, and 0.756 for General-Harm. The ICC was excellent (0.922). Discriminant validity revealed that BMQ Specific-Necessity score was significantly inversely correlated with the systolic blood pressure level. Systolic and diastolic blood pressure levels (P = 0.038; P = 0.05) were reported to be significantly correlated with the Necessity-Concerns differential, with Necessity score equal or exceeding Concerns score.

    CONCLUSIONS: The Malay-translated version of BMQ is a reliable and valid tool to assess patient belief about medication, especially medication adherence among the hypertensive patients in Malaysia.
  11. Uncontrollable medicine prices in Pakistan
    Saleem F, Hassali MA, Iqbal Q, Baloch M, Shanker PR
    Lancet, 2016 11 26;388(10060):2602.
    PMID: 27832869 DOI: 10.1016/S0140-6736(16)32120-1
  12. Fulltext Challenges in the management of community pharmacies in Malaysia
    Kho BP, Hassali MA, Lim CJ, Saleem F
    Pharm Pract (Granada), 2017 Apr-Jun;15(2):933.
    PMID: 28690697 DOI: 10.18549/PharmPract.2017.02.933
    BACKGROUND: The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation.

    OBJECTIVE: The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges.

    METHODS: Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation.

    RESULTS: Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers' knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced.

    CONCLUSION: Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials.
  13. 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.
  14. Goods and Services Tax on Pharmaceuticals in Malaysia
    Wong ZY, Alrasheedy AA, Hassali MA, Saleem F
    Ther Innov Regul Sci, 2017 Mar;51(2):221-223.
    PMID: 30231714 DOI: 10.1177/2168479016680256
    In Malaysia, the goods and services tax (GST) was implemented in 2015. Within this context, medicines are subjected to GST. However, essential medicines are exempted. In fact, exempting essential medicines from tax is in line with the Malaysian National Medicines Policy which aims to promote equitable access to affordable essential medicines of good quality to improve health outcomes of the people. The implementation of GST on medicines can generate a stable source of revenue for the nation. However, there are some ways/actions that could be considered to ensure the affordability and accessibility of all medicines post-implementation of GST in Malaysia.
  15. A multicenter point prevalence survey of healthcare-associated infections in Pakistan: Findings and implications
    Saleem Z, Hassali MA, Godman B, Hashmi FK, Saleem F
    Am J Infect Control, 2019 04;47(4):421-424.
    PMID: 30471976 DOI: 10.1016/j.ajic.2018.09.025
    BACKGROUND: Healthcare-associated infections (HAIs) are seen as a global public health threat, leading to increased mortality and morbidity as well as costs. However, little is currently known about the prevalence of HAIs in Pakistan. Consequently, this multicenter prevalence survey of HAIs was conducted to assess the prevalence of HAIs in Pakistan.

    METHODS: We used the methodology employed by the European Centre for Disease Prevention and Control to assess the prevalence of HAIs in Punjab Province, Pakistan. Data were collected from 13 hospitals using a structured data collection tool.

    RESULTS: Out of 1,553 hospitalized patients, 130 (8.4%) had symptoms of HAIs. The most common HAI was surgical site infection (40.0%), followed by bloodstream infection (21.5%), and lower respiratory tract infection (14.6%). The prevalence of HAI was higher in private sector hospitals (25.0%) and among neonates (23.8%) and patients admitted to intensive care units (33.3%). Patients without HAIs were admitted mainly to public sector hospitals and adult medical and surgical wards.

    CONCLUSIONS: The study found a high rate of HAIs among hospitals in Pakistan, especially surgical site infections, bloodstream infections, and lower respiratory tract infections. This needs to be addressed to reduce morbidity, mortality, and costs in the future, and further research is planned.

  16. Fulltext Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
    Saleem Z, Hassali MA, Hashmi FK, Godman B, Saleem F
    Fam Med Community Health, 2019;7(3):e000138.
    PMID: 32148717 DOI: 10.1136/fmch-2019-000138
    Background: There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.

    Objective: To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.

    Design: In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.

    Setting: Interviews were conducted among community pharmacists in Lahore, Pakistan.

    Participants: In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.

    Results: A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.

    Conclusion: The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.

  17. Antimicrobial prescribing and determinants of antimicrobial resistance: a qualitative study among physicians in Pakistan
    Saleem Z, Hassali MA, Godman B, Hashmi FK, Saleem F
    Int J Clin Pharm, 2019 Oct;41(5):1348-1358.
    PMID: 31273588 DOI: 10.1007/s11096-019-00875-7
    Background Understanding physicians' perception about antimicrobial use and resistance is essential to ensure that the objectives of the Pakistan national action plan on antimicrobial resistance are met. Little is currently known about physicians' perceptions in Pakistan. Objective Assess physicians' perception surrounding antibiotic use and resistance, factors influencing antibiotic prescribing and potential interventions to improve future antibiotic prescribing. Settings The study was conducted in Lahore, the capital of the province of Punjab, which is the second largest and most populous city of Pakistan. Method Qualitative study was conducted with a semi-structured interview guide involving in-depth face-to-face interviews with purposively selected physicians. Audiorecorded interviews were transcribed verbatim and transcripts analyzed by thematic content analysis. Main outcome measures Themes surrounding the perspectives of physicians on issues of antimicrobial use and resistance. Results Five major themes emerged: (1) knowledge and perception of physicians about antimicrobials, (2) antimicrobial prescribing behaviors of physicians, (3) factors influencing prescribing, (4) determinants of antimicrobial resistance, (5) and potential interventions to reduce antimicrobial resistance. The main challenges and issues associated with antibiotic prescribing were the improvement of knowledge, implementation of hygienic measures, access to and clarity of treatment recommendations and minimizing external factors influencing prescribing including pharmaceutical company activities. Suggestions for the future included stricter regulations for prescribing, improved diagnosis, availability of local guidelines and monitoring of prescribing and resistance patterns. Conclusion Identification of concerns regarding inappropriate antimicrobial prescribing will enable specific initiatives and approaches to improve future antimicrobial use and reduce antimicrobial resistance in Pakistan.
  18. Crimean-Congo haemorrhagic fever in Pakistan
    Haider S, Hassali MA, Iqbal Q, Anwer M, Saleem F
    Lancet Infect Dis, 2016 12;16(12):1333.
    PMID: 27998597 DOI: 10.1016/S1473-3099(16)30452-2
  19. Does adherence to the therapeutic regimen associate with health related quality of life: Findings from an observational study of type 2 diabetes mellitus patients in Pakistan
    Nazir SR, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Pak J Pharm Sci, 2017 Nov;30(6):2159-2165.
    PMID: 29175785
    Patient adherence with a therapeutic regimen predicts successful treatment and reduces the severity of negative complications. The purpose of this work was to find the relationship between general Health Related Quality of Life (HRQoL) and compliance to the treatment among type 2 diabetes mellitus patients (T2DM) in Sargodha, Pakistan. The research was planned as a cross-sectional survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The Urdu version of the Morisky Medication Adherence Scale (MMAS-Urdu) and EuroQol Quality of Life Scale were employed to evaluate adherence to treatment regimen and HRQoL correspondingly. Descriptive statistics were used for the elaboration of socio-demographic characteristics. The Spearman rank order test was employed to determine the relationship between medicine adherence and HRQoL. P<0.05 was considered statistically significant. A total of 392 patients were selected for the survey. Most participants were males (n=222, 56.6%) with 5.58±4.09 years of history of T2DM. Majority of respondents (n=137, 34.9%) were categorized in age group of 51 to 60 years with mean age of 50.77±9.671 years. The present study highlighted that individuals with type 2 diabetes mellitus had decreased HRQoL (0.4715±0.3360) and poor medication adherence (4.44±1.8). Significant, yet weak positive correlations were observed between medication adherence and HRQoL (r=0.217 and 0.136 for EQ-5D and EQVAS respectively). Although the association between adherence to therapeutic regimen and HRQoL in the present study cohort was significant, it was rated as weak, hence failed in producing an overall impression on quality of life. The study highlights the need of identifying other individual factors affecting HRQoL among T2DM patients in Pakistan.
  20. 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 

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