SETTING: A sample of 1419 Malaysian community pharmacies with resident pharmacists.
METHOD: A cross-sectional nationwide survey using a self-completed mailing questionnaire.
MAIN OUTCOME MEASURE: Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence.
RESULTS: Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia.
CONCLUSION: The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.
Methods: The cross-sectional study was conducted from August 2019 to November 2019. The community pharmacies, clinical and academic settings in Karachi were approached for gathering the responses of pharmacists towards BSMs and interchangeable products using a 30-item survey form. Pearson correlation and independent sample t-test were used to identify the relationship among independent variables and the responses, considering p values <0.05 as statistically significant.
Results: Overall, there were 305 survey forms used with a response rate of 87.14%. More than 80% of the respondents have good knowledge about the definition, characteristics, safety and efficacy, compatibility, cost issues, and utilization of BSMs. Around half of the respondents (48.9%, [95% CI 46.6-51.2]) were confident in using BSMs in clinical practice. However, they were concerned about the BSM's safety profile (45.2%, [95% CI 42.1-48.3]), quality (30.2%, [95% CI 28.3-32.1]), and efficacy issues (32.3%, [95% CI 31.2-37.5]).
Conclusion: The findings revealed that pharmacists were well informed about the BSMs. However, some of the responses to the attitude demonstrated a lack of understanding of the application of that knowledge. The respondents persuaded that advanced patterns of diseases, product marketing stipulations, and need for better patient care drives higher demand for developing BSMs and were enthusiastic about gaining more insight to integrate BSMs into routine clinical practice.
MATERIALS AND METHODS: This qualitative, explanatory case study evaluated PhIS in ambulatory pharmacies in a hospital and a clinic. Data were collected through observations, interviews, and document analysis. We applied the socio-technical interactive analysis (ISTA) framework to investigate the socio-technical interactions of pharmacy information systems that lead to unintended consequences. We then adopted the human-organization-process-technology-fit (HOPT-fit) framework to identify their contributing and dominant factors, misfits, and mitigation measures.
RESULTS: We identified 28 unintended consequences of PhIS, their key contributing factors, and their interrelations with the systems. The primary causes of unintended consequences include system rigidity and complexity, unclear knowledge, understanding, skills, and purpose of using the system, use of hybrid paper and electronic documentation, unclear and confusing transitions, additions and duplication of tasks and roles in the workflow, and time pressure, causing cognitive overload and workarounds. Recommended mitigating mechanisms include human factor principles in system design, data quality improvement for PhIS in terms of effective use of workspace, training, PhIS master data management, and communication by standardizing workarounds.
CONCLUSION: Threats to information quality emerge in PhIS because of its poor design, a failure to coordinate its functions and clinical tasks, and pharmacists' lack of understanding of the system use. Therefore, safe system design, fostering awareness in maintaining the information quality of PhIS and cultivating its safe use in organizations is essential to ensure patient safety. The proposed evaluation approach facilitates the evaluator to identify complex socio-technical interactions and unintended consequences factors, impact, and mitigation mechanisms.
OBJECTIVE: The aim of this study was to determine the positioning and roles of ICT in community pharmacies in the state of Selangor, Malaysia.
METHODS: A cross-sectional study was conducted from November 2018 to January 2019 across 9 different subdistricts in the state of Selangor, including Subang Jaya, Cheras, Puchong, Port Klang, Kota Kemuning, Selayang, Chow Kit, Ampang, and Seri Kembangan. A total of 90 community pharmacists were approached from the 9 subdistricts and invited to participate in the study.
RESULTS: Of the 90 community pharmacies approached, 60 agreed to participate in the study, representing a response rate of 67%. The majority (36/60, 60%) of the respondents were women, and more than half (32/60, 53%) of the community pharmacies were run by young adults (ie, 30 years old and younger). More than three-quarters of the community pharmacies (46/60, 77%) used electronic health records. Half of the community pharmacies used online social media platforms for advertising and promoting their pharmacies. The vast majority of the community pharmacies (55/60, 92%) were using modern electronic payment systems, and some were also using other new electronic payment methods. Moreover, most of the community pharmacies (41/60, 68%) were using software and programs for accounting and logistics purposes. In addition, 47/60 (78%) of the community pharmacies used a barcode reading system for medicines/health products, and 16/60 (27%) of the pharmacies had online stores, and consumers could buy medicines and health products from these pharmacies via their online portal. In addition, 20/60 (33%) of the community pharmacies used at least one of the common online business platforms available in Southeast Asia to sell products/medicines. The telephone was the most commonly used means of communication with patients, although some pharmacies also used email, WhatsApp, SMS text messaging, and other communication platforms.
CONCLUSIONS: This study showed that the majority of community pharmacies in Selangor, Malaysia are using ICT for different purposes. However, there is still limited use of mobile apps to provide health services. Overall, community pharmacies have been adopting ICT apps for pharmacy services but the rate of adoption is relatively slower than that in other sectors of Malaysia.
METHOD: According to the reported practice address in 2018, the spatial distribution of health care facilities was mapped and explored using the GIS mapping techniques. The density of health care facilities was analyzed using thematic maps with hot spot analysis. Population to facility ratio was calculated using the projection of the population growth based on 2010 census data, which was the latest available in the year of analysis.
RESULTS: The study included geographical mapping of 7051 general practitioner clinics (GPC), 3084 community pharmacies (CP), 139 public general hospitals (GHs) and 990 public primary health clinics (PHC). The health care facilities were found to be highly dense in urban areas than in the rural ones. There were six districts that had no CP, 2 had no GPC, and 11 did not have both. The overall ratio of GPC, CP, GH, and PHC to the population was 1:4228, 1:10,200, 1:223,619 and 1:31,397, respectively. Should the coverage for minor ailment services in public health care clinics be extended to community pharmacies, the ratio of facilities to population for each district would be better with 1:4000-8000.
CONCLUSIONS: The distribution of health care facilities for minor ailment management in Malaysia is relatively good. However, if the scheme for minor ailments were available to community pharmacies, then the patients' access to minor ailments services would be further improved.
Aims: Assess the extent of current antibiotic sales without a prescription in urban areas of Pakistan.
Methodology: A multicenter cross-sectional study was conducted in different areas of Punjab, Pakistan using Simulated Client technique. The investigators demanded different predefined antibiotics from WHO AWaRe groups without prescription. Three levels of demand were used to convince the pharmacy staff in order to dispense the antibiotic without a prescription. A data collection form was completed by simulated clients within 15 min of each visit.
Results: Overall 353 pharmacies and medical stores were visited out of which 96.9% pharmacies and medical stores dispensed antibiotics without demanding a prescription (82.7% at demand level 1 and 14.2% at demand level 2), with only 3.1% of pharmacies refusing to dispense antibiotics. The most frequently dispensed antibiotic was ciprofloxacin (22.1%). Surprisingly, even the reserve group antibiotics were also dispensed without a prescription. In only 25.2% visits, pharmacy staff guided patients about the use of antibiotics, and in only 11.0% pharmacists enquired about other medication history.
Conclusion: Currently, antibiotics are easily acquired without a legitimate prescription in Pakistan. There is a need for strict adherence to regulations combined with a multi-dimensional approach to enhance appropriate dispensing of antibiotics and limit any dispensing of WHO restricted antibiotics without a prescription.