METHODS: All pharmacists attending the Malaysian Community Pharmacy Guild event held in-person were invited to self-administer a web-based survey.
KEY FINDINGS: The response rate was 61% (168/276). Overall, community pharmacists have mixed knowledge (mean ± SD: 5.89 ± 1.38) and positive attitude (mean ± SD: 9.58 ± 0.81) towards household pharmaceutical waste disposal. However, few community pharmacists (18/168, 10.7%) have promotional materials encouraging safe medication disposal in their pharmacies.
CONCLUSIONS: Community pharmacists do not proactively promote safe household pharmaceutical waste disposal to mitigate pharmaceutical pollutants entering the environment although they have satisfactory knowledge and attitude.
BACKGROUND: Tuberculosis (TB) eradication is one of the top priorities in the public health agenda in Malaysia. While public-private mix (PPM) initiatives have been launched, community pharmacists remain undervalued assets in TB management.
METHODS: A two-phase mixed-methods study targeting community pharmacists was conducted in Malaysia between March and October 2021. The first phase was an online self-administered survey developed according to the Consolidated Framework for Implementation Research (CFIR). The second phase was a semi-structured interview to allow deeper understanding on the quantitative results. Quantitative data were analysed using descriptive analysis while qualitative data were analysed using thematic analysis with a semi-inductive approach. The data were triangulated to enhance comprehensiveness and credibility of the findings.
FINDINGS: The survey was completed by 388 community pharmacists, and 23 pharmacists participated in the interview. Most community pharmacists indicated their willingness to serve as TB-DOT supervisors (70.1%). Qualitative results supported the findings. Community pharmacy-based TB-DOT service was perceived as an avenue to improve TB management and outcomes and to enhance the professional role of pharmacists in TB service at primary care settings. This was also perceived as a feasible intervention with the potential to strengthen the National TB Control programme. This initiative needs be reinforced with adequate support from the public healthcare sector for a strong partnership in ensuring success.
METHODS: We conducted five semi-structured focus groups with 18 pharmacy students from years one to four of the bachelor of pharmacy program at Monash University Malaysia where students came from different pre-university backgrounds. Focus group recordings were transcribed verbatim and thematically analysed. Interrater reliability was performed to ascertain reliability of themes.
RESULTS: Three major themes were identified. Firstly, students cited issues moving past the initial barrier when starting flipped classrooms in terms of education background impacting adaptability and how/why they eventually adapted. Another theme was how flipped classrooms helped development of life skills such as adaptability, communication, teamwork, self-reflection, and time management. The final theme was on requiring a sufficient safety net and support system in flipped classrooms that included well designed pre-classroom materials and well-implemented feedback mechanisms.
CONCLUSIONS: We have identified students' perspectives on the benefits and challenges associated with a predominantly flipped classroom pharmacy curriculum in a low to middle income country setting. We suggest using scaffolding and effective feedback approaches to guide the implementation of flipped classrooms successfully. This work can aid future educational designers in preparation and supporting a more equitable learning experience regardless of student background.
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.
METHODS: A cross-sectional study was conducted from March to April 2021. An online survey, consisting of socio-demographic characteristics, Internet use, eHealth Literacy Scale and mobile health application utilisation, was distributed amongst pharmacy undergraduates in public and private universities in Malaysia. Data analysis included descriptive statistics, one-way analysis of variance test, Mann-Whitney U test and Kruskal-Wallis test.
RESULTS: A total of 415 participants completed the survey (response rate = 82.5%). The median eHealth Literacy Scale score (out of 40) was 31.0 ± 3.0 (interquartile range). More than one-third of participants (34.7%) were found to have low eHealth literacy. Many lacked confidence in making health decisions from online information (42.4%) and skills in distinguishing between high-quality and low-quality health resources (35.2%). Only 70.4% of the participants had mobile health applications installed on their smartphones and/or tablets. Some students felt that they were neither knowledgeable nor skilful enough to utilise mobile health applications (24.8%), whereas 23.9% were unaware of the mobile health applications available.
CONCLUSION: In summary, the eHealth literacy of Malaysian pharmacy students can be further enhanced by incorporating eHealth literacy-focused programmes into the curriculum. Moreover, pharmacy students' mobile health application utilisation can be improved through increased awareness and support from universities.
METHODS: The study is completed in two phases. In phase I a cross-sectional study is performed using two quantitative research designs, i.e., exploratory and descriptive, to evaluate the knowledge of private pharmacy staff. The sample of 218 pharmacies was selected. While in phase II cross sectional survey is conducted in 10 facilities from where FDC anti TB drugs were sampled for analyzing their quality.
RESULT: Results revealed the presence of pharmacists only at 11.5% of pharmacies. Approximately 81% of staff at pharmacies had no awareness of MDR-TB, while 89% of pharmacies had no TB-related informative materials. The staff identified that most of the patients with TB (70%) were of poor socio-economic class, which restricted their purchase of four FDCs only up to 2-3 months. Only 23% were acquainted with the Pakistan National TB Program (NTP). Except for MDR-TB, the results showed a significant correlation between the experiences of staff with TB awareness. Findings from the quality evaluation of four FDC-TB drugs indicated that the dissolution and content assay of rifampicin were not according to the specifications, and overall, 30% of samples failed to comply with specifications. However, the other quality attributes were within the limits.
CONCLUSION: In light of the data, it can be concluded that private pharmacies could be crucial to the effective management of NTP through the timely identification of patients with TB, appropriate disease and therapy-related education and counseling, and proper storage and stock maintenance.
METHOD: This cross-sectional survey was conducted among community pharmacists in all 14 states of Malaysia between November 2021 and July 2022. The self-administered survey was shared to relevant groups through various social media platforms.
RESULTS: A total of 312 community pharmacists were involved in the survey. Majority of the respondents were females (66%), with a mean age (SD) of 32.9 (8.4) years. Most of the respondents showed satisfactory practice for patient counselling, but improvements are needed particularly in risk assessment and collaborative care aspect. Most of them expressed their interest for dyslipidemia management training (89.4%). Lack of access to medical records (71.2%) and lack of CVD-related educational materials (70.8%) were the two main perceived barriers identified.
CONCLUSION: Community pharmacists in Malaysia provide a satisfactory role in the provision of cardiovascular disease-related health promotion activities, especially in providing patient counselling. Strengthening collaborative care is essential for providing comprehensive and patient-centered intervention in dyslipidemia management. This requires ongoing efforts to address and overcome existing barriers for effective teamwork and coordination among healthcare professionals.
METHODS: A cross-sectional study was conducted using a self-administrated, web-based survey (Google form) among the public in Malaysia between May and June 2022. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the use of drive-thru community pharmacy services were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with perceptions towards drive-thru community pharmacy services.
RESULTS: A total of 565 (70.6%) of the general public completed the survey instrument. The median age of study participants was 40.0 (IQR = 36.0) and about half of them were males (50.6%, n = 286). Although 18.6% (n = 105) of the participants reported the presence of DTCPS in their cities, only 9.0% (n = 51) reported having used this service. Most of the participants were supportive to establish drive-thru services at community pharmacies in the country. Most of the believed advantages among participants were that DTCPS are helpful during COVID-19 and quarantine time 48.0% (n = 271) by enhancing social distancing and reducing the spread of the COVID-19 virus 48.5% (n = 274). Among sociodemographic factors, non-Malaysian nationality (p<0.001), and age above 55 years (p = 0.01) were found to negatively affect participants' perceptions towards drive-thru community pharmacy services.
CONCLUSION: This study showed positive awareness, attitudes, and perceptions toward drive-thru community pharmacy services during COVID-19 in Malaysia among the public. The participants believed that those services were helpful during COVID-19 to enhance social distancing and to reduce the spread of the COVID-19 virus.
AIM: Our aim is to develop and validate a pharmaceutical assessment screening tool (PAST) to guide medical ward pharmacists in our local hospitals to effectively prioritise patient care.
METHOD: This study involved 2 major phases; (1) development of PAST through literature review and group discussion, (2) validation of PAST using a three-round Delphi survey. Twenty-four experts were invited by email to participate in the Delphi survey. In each round, experts were required to rate the relevance and completeness of PAST criteria and were given chance for open feedback. The 75% consensus benchmark was set and criteria with achieved consensus were retained in PAST. Experts' suggestions were considered and added into PAST for rating. After each round, experts were provided with anonymised feedback and results from the previous round.
RESULTS: Three Delphi rounds resulted in the final tool (rearranged as mnemonic 'STORIMAP'). STORIMAP consists of 8 main criteria with 29 subcomponents. Marks are allocated for each criteria in STORIMAP which can be combined to a total of 15 marks. Patient acuity level is determined based on the final score and clerking priority is assigned accordingly.
CONCLUSION: STORIMAP potentially serves as a useful tool to guide medical ward pharmacists to prioritise patients effectively, hence establishing acuity-based pharmaceutical care.
METHODS: A cross-sectional study was conducted. The developed tool consists of 28 items to evaluate believed advantages toward drive-thru community pharmacy services, believed disadvantages toward drive-thru community pharmacy services, differences between drive-thru community pharmacy services and instore drug refill services, perceptions toward drive-thru community pharmacy services and feelings regarding how the introduction of drive-thru pharmacy services may affect the image of community pharmacists. Exploratory factor analysis (EFA) was performed to identify the factors of the developed tool, and confirmatory factor analysis (CFA) evaluated the model fitness.
RESULTS: The EFA identified five elements and 25 items for the tool, and through CFA results, the observed model of the 25 items structure of the tool was verified as an excellent fit for the data [χ2 (265, N = 565) = 819.586, p < 0.001, IFI = 0.931, CFI = 0.93, RMSEA = 0.064]. The results of the CFA indicated a good model fit between the observed model and the proposed model. The internal reliability of the entire tool and each factor was very satisfactory as Cronbach's Alpha for the whole structured tool was 0.843 and for each factor was as follows, first factor (believed advantages) = 0.909, second factor (believed disadvantages) = 0.921, third factor (differences between drive-thru and instore refill) = 0.647, fourth factor (perceptions) = 0.926, and fifth factor (feelings) = 0.681.
CONCLUSION: The developed and validated tool would be valuable for assessing the public's perceptions of the drive-thru community pharmacy service during COVID-19 and future pandemics.
METHODS: A qualitative research design was used. In-depth interviews with structured questions following the Context, Input, Process, and Product/Outcomes model framework were conducted with four academic staff, three alumni, and three alumni supervisors from six study sites in six countries. Interview questions were constructed in Thai and translated to English by using forward and backward translation. Verbatim transcriptions were used to perform thematic analysis with investigator triangulation.
RESULTS: Sixty participants were included. The context showed three main themes related to Burden of NCDs, Pharmacist Roles in NCDs, and Goals. The input showed three main themes of Teaching Methods, Development Plans for Academic Staff, and Budgets and Infrastructure. The process showed one main theme of Struggles in Teaching Methods. The outcomes/outputs showed three main themes of Individual, Organizational, and Professional Levels. Schools need curricula that focus on NCDs, pharmacist competency and skills, and academic preparation of students for practice. Gaps limiting achievement of goals included lack of well-trained academic staff, limited learning facilities, self-learning opportunities, acceptance from other health professionals, and career ladders.
CONCLUSIONS: The preparation of pharmacy students varied in six ASEAN countries. Pharmacy education programs must address existing gaps that limit achievement of goals related to NCDs.
METHODS: All fourth-year pharmacy students enrolled in Monash University in 2017 were provided access to MOVE. Cost-minimization analyses were performed to evaluate the cost of introducing MOVE in the pharmacy course using the smallest cohort size (Malaysia campus) of 40 students as the base case. We also determined under what circumstances MOVE would be more cost-effective, considering the different operational situations such as when student numbers increased or when the number of simulation modules created were increased.
RESULTS: The overall cost of setup and implementation of MOVE in the first year of implementation among 40 students was US $94.38 per student. In comparison, the face-to-face workshop cost was US $64.14 per student. On the second year of implementation, the ongoing cost of operation of MOVE was US $32.86 per student compared with US $58.97 per student using face-to-face workshop. A net benefit using MOVE was observed after the third year of implementation. Larger savings were noted when the cohort size extends larger than 100 students.
CONCLUSIONS: Monash OSCE Virtual Experience was a flexible and cost-effective approach to aid students in preparation for an OSCE and enhanced students' learning experience. The wider applicability of these findings will need to be explored in other settings.
METHODS: A cross-sectional study was conducted among undergraduate pharmacy students in 14 countries in Asia and the Middle East. The validated Warwick-Edinburgh Mental Wellbeing Scale (the 14-item WEMWBS) was adopted to assess mental wellbeing. Data collection was performed online between February and April 2022. Descriptive and inferential statistics were used as appropriate.
RESULTS: A total of 2,665 responses were received, mainly from females (68.7%) with a higher presence of private universities (59.1%). About 34.9% had low mental wellbeing levels, while 57 and 8.1% had medium, and high levels, respectively. Binary logistic regression showed that males (AOR: 1.34; CI 95%: 1.11-1.61; p < 0.01) and students with no chronic illnesses (AOR: 2.01; CI 95%: 1.45-2.80; p < 0.001) were more likely to have higher mental wellbeing. Also, participants who did not engage in any exercise (AOR: 0.71; CI 95%: 0.52-0.98; p = 0.04) and those in public universities (AOR: 0.82; CI 95%: 0.69-0.97; p = 0.02) were less likely to have higher mental wellbeing. Additionally, students who had interest/passion for pharmacy (AOR: 1.69; CI 95%: 1.07-2.68; p = 0.02), and those who known pharmacists inspired (AOR: 1.81; CI 95%: 1.06-3.12; p = 0.03), were more likely to have higher mental wellbeing compared with those who had no specific reason for their choice to study pharmacy. The participants with excellent (AOR: 1.87; CI 95%: 1.29-2.70; p = 0.001) or very good self-reported academic performance (AOR: 1.57; CI 95%: 1.12-2.22; p = 0.01) were more likely to have higher mental wellbeing compared to those with fair academic performance.
CONCLUSION: More than a third of the participants had low mental wellbeing. Various demographic, lifestyle, medical and academic factors appeared to affect students' mental wellbeing. Careful consideration of these factors and their integration into the pharmacy schools' plans for student support services and academic advising would be essential to improve students' mental wellbeing.
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.