Displaying publications 61 - 80 of 322 in total

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  1. Saleem Z, Godman B, Azhar F, Kalungia AC, Fadare J, Opanga S, et al.
    Expert Rev Anti Infect Ther, 2022 Jan;20(1):71-93.
    PMID: 34038294 DOI: 10.1080/14787210.2021.1935238
    INTRODUCTION: The emergence of antimicrobial resistance (AMR) is a threat to public health. In 2015, the World Health Organization (WHO) introduced a global action plan to tackle AMR in the World Health Assembly. Pakistan's national action plan (NAP) for AMR was released in May 2017 by the Ministry of National Health Services. Based on the NAP, strategies have been initiated on a national and provincial scale in Pakistan.

    AREAS COVERED: This narrative review of the five components of the Pakistan NAP has been undertaken to discuss some of the challenges in implementation of the NAP for AMR in Pakistan including different opinions and views of key stakeholders, combined with suggestions on potential ways to reduce the burden of the AMR.

    EXPERT OPINION: Going forward, healthcare authorities should focus on screening and monitoring of all the objectives of the NAP by establishing proper policies as well as promoting antimicrobial stewardship interventions and Infection prevention and control (IPC) practices. Overall, the comprehensive strengthening of the healthcare system is required to adequately implement the NAP, tackle continued inappropriate antimicrobial use and high AMR rates in Pakistan.

  2. Saleem Z, Godman B, Hassali MA, Hashmi FK, Azhar F, Rehman IU
    Pathog Glob Health, 2019 Jun;113(4):191-205.
    PMID: 31215326 DOI: 10.1080/20477724.2019.1632070
    Health-care-associated infections (HAIs) are considered a serious public health issues that contribute substantially to the global burden of mortality and morbidity with respect to infectious diseases. The aim is to assess the burden of health-care-associated infections by collation of available data from published point prevalence surveys (PPS) on HAIs to give future guidance. Study protocol and methodology were designed according to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Published research papers that conducted a point prevalence survey of HAIs in hospital settings by following the structured survey methodology employed by European Centre of Disease Prevention and Control (ECDC) were included. Of 1212 articles, 67 studies were included in the final analysis conducted across different countries. Overall, 35 studies were conducted in Europe, 21 in Asia, 9 in America, and 2 in Africa. The highest prevalence of HAIs was recorded in a study conducted in adult ICU settings of 75 regions of Europe (51.3%). The majority of the studies included HAI data on urinary tract infections, respiratory tract infections, and bloodstream infections. Klebsiella pneumonia, Pseudomonas aeruginosa and E. coli were the most frequent pathogens responsible for HAIs. PPS is an useful tool to quantify HAIs and provides a robust baseline data for policymakers. However, a standardize surveillance method is required. In order to minimize the burden of HAIs, infection prevention and control programs and antibiotic stewardship may be effective strategies to minimize the risk of HAIs.
  3. Saleem F, Hassali MA, Ibrahim ZS, Rasheedy AA, Aljadhey H
    J Community Health, 2015 Apr;40(2):285-90.
    PMID: 25115271 DOI: 10.1007/s10900-014-9930-y
    The present study aims to explore the perceptions and understanding of future pharmacists towards volunteerism in health promotional activities. The study was designed as a cross sectional, descriptive survey. All pharmacy undergraduates (n = 293) from the first, second and third professional years enrolled at the School of Pharmaceutical Sciences, Universiti Sains Malaysia were targeted for the study. A pre validated, 15-itemed questionnaire was used for data collection and was analysed by using SPSS. Dichotomous groups were compared with Mann-Whitney U test. The Jonckheere-Terpstra test was used to evaluate the trend of association. Where significant associations were reported, effect size was calculated by using Kendall tau correlation coefficient. p value of <0.05 was considered to be of statistical significance. Out of 200 respondents, 185 completed the study with a response rate of 92.5 %. Agreement with mandatory status of volunteerism at community services was significant with gender (p = 0.003) and year of study (p = 0.045). Confidence in performing health promotional activities (p = 0.001, τ = 0.155) and needed communication skills during health promotional activities (p = 0.022, τ = 0.322) were also significantly associated with year of study with a moderate positive trend from junior to senior classes. Although pharmacy undergraduates showed positive interest and will to volunteer at the health promotional programs, certain issues were also highlighted. Therefore, in order to address these challenges, pharmacy curriculum needs to include a greater emphasis on role of pharmacists in public health. This can be achieved by having a dedicated core course as part of pharmacy curriculum.
  4. Saleem F, Hassali MA, Shafie AA, Ul Haq N, Farooqui M, Aljadhay H, et al.
    Health Expect, 2015 Oct;18(5):1270-81.
    PMID: 23786500 DOI: 10.1111/hex.12101
    The study evaluated whether a pharmaceutical care intervention can result in better understanding about hypertension, increase medication adherence to antihypertensive therapy and improve overall health-related quality of life.
  5. Saleem F, Hassali MA, Shafie AA, Atif M, Ul Haq N, Aljadhey H
    South Med Rev, 2012 Jul;5(1):47-52.
    PMID: 23093899
    This study aims to evaluate association between Health related quality of lifeand disease state knowledge among hypertensive population of Pakistan.
  6. Saleem F, Hassali MA, Shafie AA
    Health Expect, 2014 Jun;17(3):388-95.
    PMID: 22390260 DOI: 10.1111/j.1369-7625.2012.00765.x
    OBJECTIVE: To describe the health-related quality of life (HRQoL) profile of hypertensive population in Pakistan.
    METHODS: A cross-sectional descriptive study was undertaken with a cohort of 385 hypertensive patients attending two public hospitals in Quetta city, Pakistan. The EuroQoL EQ-5D scale was used for the assessment of HRQoL. EQ-5D is a standardized instrument for use as a measure of health outcome and is used in the clinical and economic evaluation of health care as well as population health surveys. The HRQoL was scored using values derived from the UK general population survey. P ≤ 0.05 was taken as significant.
    RESULTS: Two hundred and sixty-five (68.85%) respondents were men with 3.01 ± 0.939 years of history of hypertension. Majority (n = 186, 48.3%) were categorized in age group of 28-37 years with mean age of 39.02 ± 6.596. Education, income and locality had significant relation with HRQoL score. HRQoL was measured poor in our study patients (0.4674 ± 0.2844).
    CONCLUSION: Hypertension has an adverse effect on patients' well-being and HRQoL. Results from this study could be useful in clinical practice, particularly in early treatment of hypertension, at point where improving HRQoL is still possible.
    KEYWORDS: educational level; health-related quality of life; hypertension
  7. 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
  8. Saleem F, Hassali M, Shafie A, Atif M
    J Young Pharm, 2012 Apr;4(2):101-7.
    PMID: 22754262 DOI: 10.4103/0975-1483.96624
    The study is aimed to explore the perceptions and experiences of hypertensive patients toward medication use and adherence. The study was qualitative in nature conducted at Sandamen Provisional Hospital of Quetta city, Pakistan; a public hospital catering to the health needs of about 40% of the population. A qualitative approach was used to gain an in-depth knowledge of the issues. Sixteen patients were interviewed, and the saturation point was achieved after the 14(th) interview. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Perceived benefits and risks of medications, (2) physician's interaction with patients, (3) perception toward traditional remedies, (4) layman concept toward medications, and (5) beliefs toward hypertension and its control. The majority of the patients carried specific unrealistic beliefs regarding the long-term use of medication; yet these beliefs were heavily accepted and practiced by the society. The study indicated a number of key themes that can be used in changing the beliefs and experiences of hypertensive patients. Physician's attitude, patient's past experiences, and knowledge related to hypertension were noted as major contributing factors thus resulting in nonadherence to therapy prescribed.
  9. Saleem F, Hassali MA, Verma AK, Aljadhey H
    Value Health, 2015 Nov;18(7):A614-5.
    PMID: 26533446 DOI: 10.1016/j.jval.2015.09.2138
    Objectives: An adequate disease-related knowledge is important in treatment and management of ailments. Within this context, patients are needed to have correct knowledge and positive attitude especially when they are faced with an emergence of chronic diseases. The aim of this study therefore is to assess the level of type 2 diabetes mellitus (T2DM) awareness and disease related attitude among general population at Bujang Valley, Merbok, Kedah, Malaysia.
    Methods: A questionnaire based, cross sectional study was conducted. The Diabetes Attitude Scale was used to assess the knowledge and attitude of respondents towards T2DM. Data was described descriptively and SPSS v.22 was used for data analysis.
    Results: Out of three hundred and seventy seven respondents, majority of the respondents (n=156, 41.4%) were in age group of more than 40 years old and the cohort was dominated by Malay ethnic group. Females subjugated over males (n=229, 60.7%) and the highest number of respondents were working as businessman (n=115, 30.5%). Corresponding to the marital status, majority of the respondent were married (n=247, 65.5%). Majority of the respondents (n=274, 72.7%) were reported as healthy with no chronic disease. The respondents reported certain misapprehensions where they believed that T2DM have lesser complications, blood glucose control is needed for Type 1 Diabetes Mellitus only and the emotional effects of T2DM are minor.
    Conclusions: The study reported insufficient level of knowledge among the respondents in management of T2DM. General population needs to have good collaboration with healthcare professionals to get more education and knowledge related to T2DM for their empowerment.
  10. Rezal RS, Hassali MA, Alrasheedy AA, Saleem F, Yusof FA, Kamal M, et al.
    Expert Rev Anti Infect Ther, 2015;13(12):1547-56.
    PMID: 26358203 DOI: 10.1586/14787210.2015.1085303
    INTRODUCTION AND AIMS: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among 10 public primary healthcare centers in Kedah, Malaysia, from 1 January to 31 March 2014.
    RESULTS: A total of 123,524 prescriptions were screened and analyzed. Of these, 7129 prescriptions were for URTI, with 31.8% (n = 2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic, constituting 61% (n = 1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p = 0.001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ = 0.122).
    CONCLUSIONS: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use.
    KEYWORDS: Malaysia; antibiotics stewardship programs; guidelines; inappropriate use of antibiotics; primary healthcare centres; upper respiratory tract infections
    Study site: Klinik kesihatan, Kedah, Malaysia
  11. Rayes IK, Hassali MA, Abduelkarem AR
    Saudi Pharm J, 2015 Oct;23(5):470-4.
    PMID: 26594111 DOI: 10.1016/j.jsps.2014.02.004
    Pharmacy practice has passed several rounds of advancements over the past few years. It had changed the traditional positioning criteria of pharmacists as business people into patient-centered healthcare professionals. This worldwide shift is increasingly accumulating pressure on UAE pharmacists to turn up into better level of service providing accompanied with higher demand of inter-personal skills and intellectual capabilities. This can be accomplished through stressing the significance of continuing pharmacy education in basic sciences as well as social and administrative pharmacy techniques and its collaboration in elevating the quality of pharmacy practice in the UAE.
  12. Rayes IK, Hassali MA, Abduelkarem AR
    Pharm Pract (Granada), 2014 Jan;12(1):363.
    PMID: 24644519
    BACKGROUND: The role of community pharmacists is very important due to their access to primary care patients and expertise. For this reason, the interaction level between pharmacists and patients should be optimized to ensure enhanced delivery of pharmacy services.
    OBJECTIVE: To gauge perceptions and expectations of the public on the role of community pharmacists in Dubai, United Arab Emirates (UAE).
    METHODS: Twenty five individuals were invited to participate in 4 separate focus group discussions. Individuals came from different racial groups and socio-economic backgrounds. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers coded all transcripts to identify emerging themes. Appropriate measures were taken to ensure study rigor and validity.
    RESULTS: All facilitators and barriers that were identified were grouped into 5 distinct themes. The pharmacist as a healthcare professional in the public mind was the most prominent theme that was discussed in all 4 focus groups. Other themes identified were, in decreasing order of prevalence, psychological perceptions towards pharmacists, important determinants of a pharmacist, the pharmacy as a unique healthcare provider, and control over pharmacies by health authorities.
    CONCLUSIONS: This study provided insight into the way that the public looks at the role of community pharmacists in Dubai. Determinants that influence their perception are the media, health authorities, pharmacist's knowledge level, attire, nationality, age, and pharmacy location.
    KEYWORDS: Community Pharmacy Services; Consumer Satisfaction; Focus Groups; Pharmacies; Professional Practice; United Arab Emirates
  13. Rayes IK, Hassali MA, Abduelkarem AR
    Pharm Pract (Granada), 2015 06 15;13(2):506.
    PMID: 26131039
    BACKGROUND: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies.

    OBJECTIVE: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey.

    METHODS: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists' current professional role, and barriers to enhanced pharmacy services.

    RESULTS: About half of the respondents (45.4%, n=90) agreed that pharmacy clients under-estimate them and 52.5% (n=104) felt the same by physicians. About 47.5% (n=94) of the respondents felt that they are legally unprotected against profession's malpractice. Moreover, 64.7% (n=128) stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252) found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124) disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134) gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not.

    CONCLUSIONS: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost.

  14. Rayes IK, Hassali MA, Abduelkarem AR
    Saudi Pharm J, 2015 Jul;23(3):235-40.
    PMID: 26106271 DOI: 10.1016/j.jsps.2014.11.016
    The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.
  15. Rasool MF, Rehman AU, Imran I, Abbas S, Shah S, Abbas G, et al.
    Front Public Health, 2020;8:531038.
    PMID: 33330300 DOI: 10.3389/fpubh.2020.531038
    Introduction: Medication error is unintentional and can be reduced by reducing the risk factors. Patients suffering from chronic diseases are at an increased risk of medication errors. Objective: This work aims to assess the risk factors associated with medication errors among patients suffering from chronic disorders in hospitals of South Punjab, Pakistan. Methodology: Multiple logistic regression analysis was used to assess the impact of different risk factors on the prevalence of medication errors in patients suffering from chronic diseases. Results: A greater risk for the occurrence of medication errors was associated with age ≥60 years (odds ratio, OR = 1.9; 95% CI = 1.3-3.1; p = 0.001), overburdened healthcare system (OR = 2.2; 95% CI = 1.64-3.56; p < 0.000), number of prescribed drugs ≥5 (OR = 1.74; 95% CI = 1.02-2.64; p < 0.000), comorbidities (OR = 2.6; 95% CI = 1.72-3.6; p = 0.003), Charlson comorbidity index (OR = 1.31; 95% CI = 0.49-1.84; p = 0.004), and multiple prescribers to one patient (OR = 1.12; 95% CI = 0.64-1.76; p = 0.001). Conclusion: Older age, overburdened healthcare system, number of prescribed drugs, comorbidities, Charlson comorbidity index, and multiple prescribers to one patient are significant risk factors for the occurrence of medication errors.
  16. Rajah R, Hassali MA, Lim CJ
    Front Public Health, 2017;5:281.
    PMID: 29098146 DOI: 10.3389/fpubh.2017.00281
    Introduction: Patients' health literacy (HL) has emerged as a critical determinant of health outcomes and becoming one of the core competencies of health-care providers. Therefore, this study aimed to assess among Malaysian physicians, pharmacists, and nurses, their HL-related knowledge, attitude, and perceived barriers, and also to determine the associated factors.

    Methods: A cross-sectional study design was used to enroll 600 eligible respondents using stratified sampling from 6 public hospitals in Penang, Malaysia. A validated self-administered questionnaire was used for data collection. Descriptive and inferential analysis was performed with statistical significance defined as p 

  17. Rajah R, Hassali MA, Lim CJ
    Ann Pharmacother, 2018 04;52(4):345-351.
    PMID: 29078711 DOI: 10.1177/1060028017739031
    BACKGROUND: Health care practitioners carry a tremendous responsibility to differentiate the varying need of information and customized communication according to a patient's health literacy (HL) level.

    OBJECTIVES: To assess and compare the HL communication practices among physicians, pharmacists, and nurses serving at public hospitals in Penang, Malaysia.

    METHODS: A pretested, self-administered questionnaire was used to collect data from study participants of 6 public hospitals using stratified sampling. Descriptive and inferential statistics used to analyze the data with level of significance was set at P < 0.05.

    RESULTS: Of 600 distributed questionnaires, 526 (87.6%) were adequately filled and returned. Almost 19.0% (n = 98) of the respondents admitted that they did not frequently use simple language and avoid medical jargon during communication with patients. Only about half of the respondents reported frequently using other HL communication practices that include handing out education material to patients (52.2%, n = 275), asking the patient to repeat information (58.9%, n = 310), and asking patients' caregivers to be present during explanation (57.4%, n = 302). Comparatively, drawing pictures to ease patients' understanding (40.1%, n = 211) was the less-frequently practiced HL communication techniques. Health practitioners in the age group >41 years ( P = 0.046), serving 10 years and more ( P = 0.03) and those who have heard the term or concept of HL ( P = 0.004) have statistically significantly higher mean score of HL communication practices than other groups.

    CONCLUSIONS: The gap in the HL communication practices among physicians, pharmacists, and nurses warrants educational intervention, and standardized HL communication techniques guidelines are needed in the near future.

  18. Rajah R, Ahmad Hassali MA, Jou LC, Murugiah MK
    Perspect Public Health, 2018 Mar;138(2):122-132.
    PMID: 28980881 DOI: 10.1177/1757913917733775
    AIM: Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers.

    METHODS: CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality.

    RESULTS: A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients.

    CONCLUSION: Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

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