Displaying publications 41 - 60 of 115 in total

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  1. Narimah, A.H.H., Shahril Rizwan, O., N Nadhrah, N.R., Adlina, S., Hakimi, Z.A., Nuraliza, A.S.
    MyJurnal
    This descriptive cross sectional study was conducted to assess patient's satisfaction by evaluating the waiting time experienced by 27 (54%) inpatients and 23 (46%) outpatients who sought treatment at a private hospital in Selangor from 15th of May 2006 until 3rd of]une 2006. Majority of the patients (78%) were in the range between Z 1 - 40 years old and well»educated. Almost half (48%) were in the human resources employment category, 20% were in administration and marketing and 10% were professionals. Majority of them earned from RM1000-1999 (34%) and RMZ000-3999 (32%). Almost all of them (96%) agreed that the medical care that they had been receiving in the hospital was just about perfect. 98% agreed that the doctors treated them in a very friendly and courteous manner and 96% rated the care given by nurses as g0od/ excellent. 88% to 92% said that their communication with the doctors, nurses and other staff were good/ excellent. 80% waited less than 15 minutes at the registration counter, 52% waited less than 15 minutes to see the doctor and 44% waited less than 15 minutes at other places such as pharmacy and x-ray. Overall, 94% rated the level of services in the hospital as good/ excellent, Almost all (90%) would like to recommend the hospital to their friends and relatives. Our study demonstrated that the majority of the patients were satisfied with the doctors, nurses and environment of the private hospital. The average waiting time of patient before being attended to by a doctor was less than 30 minutes.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Pharmacies
  2. Mathews A, Azad AK, Abbas SA, Bin Che Rose FZ, Helal Uddin ABM
    J Pharm Bioallied Sci, 2018 12 21;10(4):226-231.
    PMID: 30568380 DOI: 10.4103/JPBS.JPBS_80_18
    Background: In Malaysia, community pharmacies play an important and vital role in both urban and rural areas with approximately 30% of 12,000 registered pharmacists with annual retention certificate practicing in community pharmacies. The main objective of this study was to find the perception of respondents on the value and necessity of pharmacists.

    Materials and Methods: The questionnaire was divided into two sections: the first section assessed the visits to community pharmacies, purpose, interaction with pharmacy staffs, professional fee, and improvements to pharmacy practices; the second section evaluated the characteristics of respondents including an e-consent form. Data were analyzed using the Statistical Package for the Social Sciences software (version 11.5).

    Results: The highest number of respondents (66.1%) consulted with the pharmacists for cough and cold, 33.1% for gastric and stomach ailments, and 28.9% for diarrhea and constipation. Only 34% of cases were handled by the pharmacists, whereas 52.1% by the sales assistant. Approximately 88.5% showed satisfaction with the counseling provided. A total of 46.3% did not know whom they dealt with, whereas 51.2% wanted personal attention of the pharmacists instead of the sales assistants. However, 66.9% of respondents preferred to a private consultation room. Records of only 32.2% of respondents were secured by the pharmacies, whereas 42.1% showed interest to pay a professional fee. Moreover, 83.3% agreed the fee of RM5 only, whereas 20.8% agreed to RM10. Among the respondents, majority agreed to pay a fee willingly, but approximately 30% stayed neutral.

    Conclusion: There is a need for the community pharmacists to play vital roles firsthand at the front desk to serve the patients professionally instead of handing over the responsibilities to the sales assistant.

    Matched MeSH terms: Pharmacies
  3. Mathews A, Ming LC, Che Rose FZ, Abbas SA
    Cureus, 2020 Aug 20;12(8):e9903.
    PMID: 32839684 DOI: 10.7759/cureus.9903
    Background Without stipulated legislation, a free pricing policy can lead to a disparity in prices among private healthcare setups. Competition is especially rampant among community pharmacies, especially in the Sabah state of Malaysia, where the recent years have witnessed the steady growth of pharmacy players from Peninsular Malaysia. Thus, this study aimed to examine the impact of price competition and discount pricing on the practice of community pharmacy in Sabah, Malaysia. Methods This was a cross-sectional study using an online questionnaire. Survey participants included community pharmacists practicing in Sabah. The validated and pilot-tested questionnaire consisted of three parts: background information of the pharmacy, attitudes and perception toward medicine prices, and practice of discount pricing. All required data were collected from community pharmacists practicing only in Sabah. Data were then analyzed by using descriptive, Chi-Square, and Kendall's tau-b tests. Results Of the 150 community pharmacists contacted, only 70 responded, providing a response rate of 47%. In terms of pharmacy type, 71% of the respondents were pharmacist-owned independent pharmacies, while 19% were pharmacy chains owned by community pharmacists. The remaining were pharmacies owned by non-pharmacists (10%). Sixty percent of the community pharmacies had been in existence for more than 10 years, with 12% in existence for less than two years, and 28% in existence for three to 10 years. More than 80% of the respondents stated that the business aspect of community pharmacy had overwhelmed the professional practice aspects and that community pharmacists have become providers of products instead of providers of care. In terms of professionalism, 87% also noted that they are being perceived as profiteering in the medicine business at the expense of patients. Conclusions The free market situation in Malaysia for medicine pricing has brought a detrimental consequence for community pharmacists with each one trying to undercut prices. Differing pricing mechanisms of medicines based on the quantity ordered contribute to the problem of discount pricing and price competition. Most community pharmacists, as indicated by this study, want the problem to be addressed.
    Matched MeSH terms: Pharmacies
  4. Maimunah, W., Kwong, CS, Siti Rozana, M.S., Shahariah, A.
    MyJurnal
    Objective : This scientific writing is meant for describing the problems faced by pharmacy staffs during heavy flood situations in Johore and the actions to be taken for solving these problems.
    Methodology : This finding is in accordance to the observations, experiences and interview of staffs (through questionnaires), who are involved directly and indirectly in preparations of emergency during flood. Efficiency of pharmaceutical services provided during flood is evaluated.
    Result : Several problems were identified when providing pharmaceutical services, such as purchasing and supplying of items, pre-packing, preparing drug charts, visit to relief centers, post-flood health campaign, and doctors from NGOs prescibing medicines out of MOH drug formulary. During the period of flood, usage of drug and non-drug items increases drastically resulting in the current stock in store were not sufficient to compensate for the high demand. Moreover, inaccessibility of certain roads in districts such as Segamat and Kota Tinggi, aggravated and worsen the problems of obtaining goods from suppliers. Workload of pharmacy staffs increased especially in activities such as pre-packing and preparing drug charts due to shortage of manpower.
    Conclusion : Even though workload increased drastically during flood, pharmaceutical services provided by the state pharmacy are still able to maintain good quality services to cater for the need of healthcare professionals and patients. Throughout the flood period, all the difficulties and hurdles faced by us had been solved; due to the cooperation from other agencies. Besides, by writing this article, a disaster preparedness guideline is produced for the purpose of improving management of future disasters.
    Matched MeSH terms: Pharmacies
  5. 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: Pharmacies
  6. 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.

    Matched MeSH terms: Pharmacies
  7. Lukman Nul Hakim Md Khairi, Farah Syakirah Ahmad, Nur Liyana Mohd Fozi, Aimi Shazana Muhammad Anuar, Wan Najiah W. Mokhtar @ W. Moxtor, Maznuraini Zainuddin
    Q Bulletin, 2020;1(29):36-44.
    MyJurnal
    Bedside dispensing (BD) is one of the clinical services offered by the Pharmacy Department to patients prior to their hospital discharge. Increment in number of BD may improve the patients’ discharge process, patients’ satisfaction and their medication knowledge. This project aimed at increasing the percentage of BD in adult medical wards of Hospital Sultanah Nur Zahirah (HSNZ). The proposed standard of BD percentage was at least 30% within four months of intervention. The project was conducted from November 2016 to December 2019. The monthly report of pharmacy BD record was analysed to assess the achievement of BD. A pre-interventional retrospective BD data review of discharge prescriptions received throughout 2016 showed that only 8.1% of discharge prescriptions were dispensed at the bedside. A closed-ended questionnaire to evaluate knowledge, experience and perceived contributing factors to the low percentage of BD was distributed to nurses, inpatient pharmacists and ward pharmacists. The main contributing factors identified included time constraint, poor understanding of BD workflow, inadequate staff awareness and lack of cooperation among healthcare providers. Institutional BD workflow was implemented involving the introduction of discharge prescriptions pick-up points at medical wards, and a scheduled timing for prescriptions collection and dispensing during office hours. Three face-to-face educational sessions on overview of BD and its latest workflow were given to staff nurses, inpatient pharmacists at discharge pharmacy unit and ward pharmacists. In 2017, the percentage of BD increased from 8.1% to 28.0% after the implementation of interventions, and subsequently to 60.0% in the latest maintenance phase of January until December 2019. The sustainable implementation of this BD program could be shared and implemented at other facilities with inpatient discharge services to improve healthcare delivery.
    Matched MeSH terms: Pharmacies
  8. Loh BC, Wah KF, Teo CA, Khairuddin NM, Fairuz FB, Liew JE
    Pharm Pract (Granada), 2017 Jan-Mar;15(1):846.
    PMID: 28503218 DOI: 10.18549/PharmPract.2017.01.846
    BACKGROUND: Value added services (VAS) are an innovative dispensing system created to provide an alternative means of collecting partial drug supply from our hospital. This in turn was projected to reduce the necessity for patient to visit pharmacy counter and thus reduce the burden of prescription handling.

    OBJECTIVE: To evaluate the impact of increased VAS uptake following promotional campaign towards patient waiting time and to explore factors that may affect patient waiting time at the Ambulatory Pharmacy, Queen Elizabeth Hospital.

    METHODS: A quasi experimental study design was conducted from September 2014 till June 2015 at the Ambulatory Pharmacy. During pre-intervention phase, baseline parameters were collected retrospectively. Then, VAS promotional campaign was carried out for six months and whilst this was done, the primary outcome of patient waiting time was measured by percentage of prescription served less than 30 minutes. A linear regression analysis was used to determine the impact of increased VAS uptake towards patient waiting time.

    RESULTS: An increased in percentage of VAS registration (20.9% vs 35.7%, p<0.001) was observed after the promotional campaign. The mean percentage of prescription served less than 30 minutes increased from 83.2% SD=15.9 to 90.3% SD=11.5, p=0.001. After controlling for covariates, it was found that patient waiting time was affected by number of pharmacy technicians (b=-0.0349, 95%CI-0.0548 : -0.0150, p=0.001), number of pharmacy counters (b=0.1125, 95%CI 0.0631 : 0.1620, p<0.001), number of prescriptions (b=0.0008, 95%CI 0.0004 : 0.0011, p<0.001), and number of refill prescriptions (b=0.0004, 95%CI 0.0002 : 0.0007, p<0.001). The increased in percentage of VAS registration was associated with reduction in number of refill prescription (b=-2.9838, 95%CI -4.2289 : -1.7388, p<0.001).

    CONCLUSIONS: Patient waiting time at the Ambulatory Pharmacy improved with the increased in VAS registration. The impact of increased VAS uptake on patient waiting time resulted from reduction in refill prescriptions. Patient waiting time is influenced by number of pharmacy technicians, number of pharmacy counters, number of prescriptions and number of refill prescriptions.
    Matched MeSH terms: Pharmacies
  9. Lim MT, Ab Rahman N, Teh XR, Chan CL, Thevendran S, Ahmad Hamdi N, et al.
    Ther Adv Chronic Dis, 2021;12:2040622321990264.
    PMID: 33643600 DOI: 10.1177/2040622321990264
    Background: Medication adherence measures are often dichotomized to classify patients into those with good or poor adherence using a cut-off value ⩾80%, but this cut-off may not be universal across diseases or medication classes. This study aimed to examine the cut-off value that optimally distinguish good and poor adherence by using the medication possession ratio (MPR) and proportion of days covered (PDC) as adherence measures and glycated hemoglobin (HbA1c) as outcome measure among type 2 diabetes mellitus (T2DM) patients.

    Method: We used pharmacy dispensing data of 1461 eligible T2DM patients from public primary care clinics in Malaysia treated with oral antidiabetic drugs between January 2018 and May 2019. Adherence rates were calculated during the period preceding the HbA1c measurement. Adherence cut-off values for the following conditions were compared: adherence measure (MPR versus PDC), assessment period (90-day versus 180-day), and HbA1c target (⩽7.0% versus ⩽8.0%).

    Results: The optimal adherence cut-offs for MPR and PDC in predicting HbA1c ⩽7.0% ranged between 86.1% and 98.3% across the two assessment periods. In predicting HbA1c ⩽8.0%, the optimal adherence cut-offs ranged from 86.1% to 92.8%. The cut-off value was notably higher with PDC as the adherence measure, shorter assessment period, and a stricter HbA1c target (⩽7.0%) as outcome.

    Conclusion: We found that optimal adherence cut-off appeared to be slightly higher than the conventional value of 80%. The adherence thresholds may vary depending on the length of assessment period and outcome definition but a reasonably wise cut-off to distinguish good versus poor medication adherence to be clinically meaningful should be at 90%.

    Matched MeSH terms: Pharmacies
  10. Lim MT
    MyJurnal
    There is a growing concern of unintended consequences of inappropriate medications disposal on the environment and public health. Objective: The aims of this study are to determine patients’ medications disposal methods and their awareness of the pharmacy medications take back program.
    Method: A cross sectional survey using a self-administered closed-ended questionnaire on information, medications disposal and views, awareness of medications take back program and reasons for their unwillingness to return the unused and unwanted medication to pharmacy or doctor. A convenient sample of 438 patients at Out Patient Pharmacy and Patient Registration areas in the hospital was collected and completed within three months.
    Results: Only 44.5% had ever received information about medications disposal and were significantly more likely to return to pharmacy or doctor (29.2% versus 6.0%, p < 0.001). There were significant differences between tertiary and nontertiary with regard to not returning to pharmacy or doctor (22.8% versus 42.0 %, p = 0.004). Some common medications disposal methods were throwing medications away with household garbage, 38.3% (n = 168), returning to pharmacy or doctor, 35.1% (n = 154) and flushing medications down the toilet or sink 11.0% (n = 48). About 50.2% (n = 220) knew about medications take back program and were significantly more willing to return the medication to the assigned location (34.7 % versus 20.1%, p < 0.001). The main reasons for unwillingness were availability of time, not convenient or a bother and out-of-vicinity location.
    Conclusion: There is a clear need to create public awareness about issues on safe medication disposal and medications take back program,
    Study site: Outpatient pharmacy, and patient registration area in Sultanah Aminah Hospital, Johor, Malaysia
    Matched MeSH terms: Pharmacies
  11. Lim KK, Teh CC
    South Med Rev, 2012 Dec;5(2):26-33.
    PMID: 23532680
    OBJECTIVE: The objective of the study was to assess public knowledge and attitudes regarding antibiotic utilization in Putrajaya, Malaysia.
    METHODS: A self-administered questionnaire survey was conducted among public attending a local hospital. The four-part questionnaire collected responses on demographic characteristics, recent use of antibiotics, knowledge and attitude statements. Cronbach's alpha for knowledge and attitude statements were 0.68 and 0.74 respectively. Only questionnaires with complete responses were analysed. General linear modelling was used to identify demographic characteristics which contributed significantly to knowledge and attitude. Multiple logistic regression was used to determine the adjusted odds ratios of obtaining an inappropriate response for each knowledge and attitude statement. The relationship between antibiotic knowledge and attitude was examined using Pearson's correlation and correlation between related statements was performed using the Chi-square test. In all statistical analyses, a p-value of < 0.05 was considered statistically significant.
    RESULTS: There was positive correlation (p<0.001) between mean knowledge (6.07±2.52) and attitude scores (5.59±1.67). Highest education level (p<0.001) and healthcare-related occupation (p=0.001) contributed significantly to knowledge. Gender (p=0.010), race (p=0.005), highest education level (p<0.001), employment status (p=0.016) and healthcare-related occupation (p=0.005) contributed significantly to attitude. The differences in score between demographic groups were small. Misconceptions that antibiotics would work on both bacterial and viral infections were reported. Approximately three quarters of respondents expected antibiotics for treatment of coughs and colds. Close to two thirds (60%) believed that taking antibiotics would improve recovery. Several demographic groups were identified as 'high risk' with respect to gaps in knowledge and attitude.
    CONCLUSIONS: This study has identified important knowledge and attitude gaps as well as people 'at risk'. These findings would be useful in strategizing targeted antibiotic awareness campaigns and patient counselling.
    KEYWORDS: Malaysia; antibiotic; attitude; knowledge; public; survey
    Study site: outpatient pharmacy department of Putrajaya Hospital, Malaysia
    Matched MeSH terms: Pharmacies
  12. Liew JES, Abdul Gapar AAB, Shim LT
    PMID: 32537169 DOI: 10.1186/s40545-020-00221-7
    Background: In 2015, the drive-through pharmacy was first introduced in Queen Elizabeth Hospital (QEH), Malaysia as one of the pharmacy value-added services. Therefore, it is imperative to review the service for further amelioration to fulfil patients' needs and expectations.

    Objective: The aim of this study is to evaluate the drive-through pharmacy service in Queen Elizabeth Hospital, Malaysia.

    Methods: A cross-sectional observational study was conducted from July to December 2018. The questionnaire was developed and underwent thorough validation process which yielded a Cronbach's alpha reliability score of 0.9130. Satisfaction was calculated by mean percentage score (0% (dissatisfied) to 100% (satisfied). All data were analysed descriptively and thematic analysis was used in analysing open-ended question.

    Results: Compliance in obtaining medication was at 96.3% with a given two-week grace collection period. Insufficient quantity of medications (33.3%) was the highest near-missed medication errors occurred at the drive-through pharmacy. The mean satisfaction percentage score for all patients were 76.6% ± 8.1. A total of 69.2% (n = 83) were "very satisfied" while 30.8% (n = 37) were "satisfied" with the service. Among the reasons for satisfaction are convenience in getting medication refills (n = 74, 62%), short waiting time (n = 75, 63%) and knowledgeable dispensers (n = 87, 73%). A handful of patients were "dissatisfied" with the opening hours (n = 14, 11.7%) and the location of the drive-through pharmacy service (n = 19, 15.8%).

    Conclusion: Compliance in medication collection is acceptable within stipulated grace period. Despite low occurrence, identification of near-missed medication errors provides useful insights for future improvement of the service. Generally, our patients are satisfied with the service. However, we need to re-evaluate on the opening hours and location of the service.

    Matched MeSH terms: Pharmacies
  13. Lee, Soik Fun, Chew, Wei Yee, Malar, Louise Santana, Nor Azrizan Hashim
    Q Bulletin, 2019;1(28):4-16.
    MyJurnal
    Medication Stockpiling (MS), in the Ministry of Health, Malaysia, resulted in the disposal of MYR 2 million worth of expired or spoilt medicines between 2014 and 2016. MS is an alarming issue that causes healthcare resources wastage and potentially harmful and toxic to patients. This study aimed to reduce MS in Hospital Selama, beginning with the medical wards within one year.
    A situational analysis from the year 2013 to 2014 showed a 9.4% increase in MS. A four-month pre-intervention study from November 2014 to February 2015 revealed a 28% MS. The standard of the study was set based on the team members’ consensus. The aim was to reduce 50% of MS after four-month of intervention. The cause-effect analysis identified the main contributing factors of MS. The questionnaire was distributed to nurses in the wards and pharmacists to pinpoint the MS antecedent. The results indicated a lack of routine ward audit by the clinical pharmacists, over-indent by ward nurses and oversupply by the pharmacy unit. A flow-chart of the good care process comprises the steps of medications indent and supply was developed. It involved assigning the nightshift nurses for checking and indenting the wards’ medication stock, developing the ward stock indent (WSI) form, ensuring the pharmacy staff supply sufficient medication and enforcing a monthly ward audit by the clinical pharmacists and cross-audit by other pharmacists. Each indicator in the model of good care was then measured.
    The post-intervention period successfully achieved a 3.5% MS; an 87.5% reduction (exceeded the target). Additionally, a cost reduction in the medication wastage from MYR 1,273.97 to MYR 654.44 was noted. The study successfully achieved less than 6% of MS from 2015 to 2018.
    In conclusion, the study facilitated a successful collaboration among the hospital different units towards MS reduction.
    Matched MeSH terms: Pharmacies
  14. Lee KS, Lim YW, Ming LC
    PMID: 27688885 DOI: 10.1186/s40545-016-0081-7
    The proposed Pharmacy Bill of Malaysia which served to consolidate and harmonise the existing pharmacy legislation which has been used for more than 60 years. This new Pharmacy Bill contains 17 parts and a total of 170 legislative sections covering laws governing pharmacy practice, medicinal products classification, registration, sale, supply, licensing etc. Our article could serve as a case study on pharmacy jurisprudence and drug regulation as well as the governance for medicines.
    Matched MeSH terms: Pharmacies
  15. Lee HL, Chua SS, Mahadeva S
    J Dig Dis, 2018 Jun;19(6):342-349.
    PMID: 29732728 DOI: 10.1111/1751-2980.12607
    OBJECTIVE: To evaluate regular non-steroidal anti-inflammatory drug (NSAID) users for dyspepsia, as well as to assess the effect of preventive measures, and the reasons for non-adherence to gastroprotective agents (GPA) from a real-world perspective.
    METHODS: A prospective longitudinal study was conducted among outpatients with regular NSAID usage. The presence of dyspepsia was assessed by locally validated versions of the Leeds dyspepsia questionnaire (LDQ), GPA and the participants' adherence to the drugs were assessed at recruitment and 2 weeks later. GPA was defined as the use of antisecretory medications or cyclooxygenase-2 inhibitors.
    RESULTS: Initially, 409 participants (mean age 52.3 ± 14.6 years, 60.6% females, 48.4% treated for musculoskeletal pain) were recruited. At recruitment, 50.9% of the participants had at least one upper gastrointestinal symptom. Complete data for follow-up analysis were collected from 158 participants who were naive NSAID users, had no prior gastrointestinal medication and who could be contacted. At 2-week follow-up there was no significant difference in the LDQ score change between NSAID users treated with GPA and those did not. However, there was a greater reduction in abdominal pain/discomfort (8.8% vs 5.0%, P 
    Matched MeSH terms: Pharmacies
  16. Lee EL, Wong PS, Tan MY, Sheridan J
    Int J Pharm Pract, 2018 Apr;26(2):138-147.
    PMID: 28574154 DOI: 10.1111/ijpp.12374
    OBJECTIVES: This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia.
    METHODS: A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively.
    KEY FINDINGS: Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services.
    CONCLUSION: This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia.
    Study site: primary care health clinic (klinik kesihatan), Kuala Lumpur, Malaysia
    Matched MeSH terms: Pharmacies/organization & administration
  17. Lau BT, Nurul-Nadiah-Auni AR, Ng SY, Shuen-Wong N
    Pharm Pract (Granada), 2018 03 23;16(1):1075.
    PMID: 29619135 DOI: 10.18549/PharmPract.2018.01.1075
    Background: Patients' satisfaction is the key parameter to measure the quality of healthcare services. Value added-services (VAS) were introduced to improve the quality of medication deliveries and to reduce the waiting time at outpatient pharmacy.
    Objective: This study aimed to compare the satisfaction levels of patients receiving VAS and traditional counter service (TCS) for prescription refills in Port Dickson Hospital.
    Methods: A single-center, cross-sectional study was conducted in the outpatient pharmacy department of Port Dickson Hospital from 1 March to 30 June 2017. Systematic sampling method was utilized to recruit subjects into the study, except mail pharmacy in which universal sampling method was used. Data collection was done via telephone interviews for both groups.
    Results: There was 104 and 105 in TCS and VAS group respectively. The response rate was 99.5%. Overall, a significant higher total mean satisfaction score in VAS group was observed as compared to TCS group (43.39 versus 40.49, p=0.002). The same finding was observed after confounding factors were controlled (VAS=44.66, 95% CI 43.07:46.24 versus TCS=39.88, 95% CI 38.29:41.46; p<0.001). VAS respondents reported more satisfaction than TCS respondents for both general and technical aspects. Among the VAS offered, mail pharmacy service respondents showed highest total mean satisfaction score, but no significant different was seen between groups (p=0.064).
    Conclusion: VAS respondents were generally more satisfied than TCS respondents for prescription refills. A longitudinal study is necessary to examine the impact of other dimensions and other types of VAS on patients' satisfaction levels.
    Study site: outpatient clinic, Hospital Port Dickson, Negeri Sembilan, Malaysia
    Matched MeSH terms: Pharmacies
  18. Lai PS, Wong YY, Low YC, Lau HL, Chin KF, Mahadeva S
    PeerJ, 2014;2:e451.
    PMID: 25024919 DOI: 10.7717/peerj.451
    Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25-75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hospital in Malaysia. Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients' demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI. Main Outcome Measure. Proportion of appropriate IV PPI prescriptions. Results. Data for 106 patients were collected. Most patients were male [65(61.3%)], Chinese [50(47.2%)], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%)] and medical [42(39.6%)] departments. Only 50/106(47.2%) patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%)] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9%) were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8%) patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%), followed by clinical pharmacists (50%), and inpatient pharmacists (37.5%, p = 0.027). Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence-based prescribing through education of medical staff could result in more judicious use of intravenous PPI and dose-optimization.
    Matched MeSH terms: Pharmacies
  19. 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.
    Matched MeSH terms: Pharmacies
  20. Kho BP, Hassali MA, Lim CJ, Saleem F
    Int J Pharm Pract, 2018 Dec;26(6):494-500.
    PMID: 29542834 DOI: 10.1111/ijpp.12438
    OBJECTIVES: The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges.

    METHODS: Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues.

    KEY FINDINGS: High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%).

    CONCLUSIONS: Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change.

    Matched MeSH terms: Pharmacies
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