Displaying publications 81 - 100 of 286 in total

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  1. Saleh MS, Hong YH, Muda MR, Dali AF, Hassali MA, Khan TM, et al.
    Eur J Hosp Pharm, 2020 05;27(3):173-177.
    PMID: 32419939 DOI: 10.1136/ejhpharm-2018-001679
    Objective: The increase in antimicrobial resistance and the lack of new antimicrobial agents in drug discovery pipelines have called for global attention to mitigate the problem of antimicrobial misuse. While an antimicrobial stewardship (AMS) programme has been implemented in Malaysia, the perception and practices of public hospital pharmacists remain unknown. The aim of this study was to determine the perception and practices of Malaysian public hospital pharmacists towards the AMS programme in the state of Selangor, Malaysia.

    Methods: A cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.

    Results: Of the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).

    Conclusions: Overall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.

    Matched MeSH terms: Pharmacy Service, Hospital/organization & administration*
  2. Selvaraj A, Redzuan AM, Hatah E
    Int J Clin Pharm, 2020 Apr;42(2):777-785.
    PMID: 32006142 DOI: 10.1007/s11096-020-00973-x
    Background Community pharmacists are increasingly recognized to have an important role in providing a convenient and accessible alternative support for patients with minor ailments. In view of the abilities of community pharmacists in managing minor ailments, some countries have started the pharmacy-based minor ailment schemes that offers public access to treatment and advice of minor ailments from their local pharmacist. Nevertheless, there is limited study in Malaysia that explore the current practice of community pharmacists in managing minor ailment. Objective This study aims to evaluate community pharmacists' perceptions, attitudes and barriers of pharmacist-led minor ailment services. Setting Community pharmacists in Malaysia. Methods A cross-sectional survey among community pharmacists practicing in Malaysia was conducted between December 2017 until March 2018. The self-administered survey was distributed online via email, Facebook and WhatsApp's group. Main outcome measure Community pharmacists' perceptions, attitude and barriers towards minor-ailment service in community pharmacy settings. Results A total of 305 community pharmacists had completed the survey. The majority of community pharmacists in Malaysia had positive perceptions and attitudes towards pharmacist-led minor ailment services. The most common perceived barriers were lack of patient's medical information, absence of dispensing separation and lack of support from other healthcare professionals. Ethnicity, position and years of working experience were found to have significant associations with community pharmacists' score of attitudes and barriers related to minor ailment treatment in community pharmacy settings. Conclusion Community pharmacists in Malaysia have positive perceptions and attitudes over benefits of minor ailment services to public, however the barriers towards the service must be overcome to ensure service is sustainable for public's benefits.
    Matched MeSH terms: Community Pharmacy Services/trends*
  3. Abubakar U, Tangiisuran B
    Int J Clin Pharm, 2020 Apr;42(2):756-764.
    PMID: 32270378 DOI: 10.1007/s11096-020-01019-y
    Background Non-prescription dispensing of antibiotics is common in Nigeria and this could contribute to the emergence of microbial resistance. Objectives To evaluate knowledge, perception and practices of community pharmacists towards dispensing antibiotics without prescription. Setting Community pharmacies in two cities in Northern Nigeria. Methods A prospective cross-sectional study was conducted among community pharmacists in two cities in Northern Nigeria, using a validated and pilot-tested questionnaire. The questionnaire was self-administered and data was collected between 06th April and 31st May 2019. The data was analyzed using descriptive and inferential analyses. Main outcome measure Knowledge, perception and practices towards dispensing antibiotics without prescription. Results A total of 98 out of 130 community pharmacists completed and returned the questionnaire (response rate: 75.3%). About two-third (64.3%) of the community pharmacists were aware that dispensing antibiotics without prescription is illegal. However, this malpractice was common as 39.7% of the respondents indicated that they dispensed antibiotics without prescription five times or more in a day. Antibiotics dispensed without prescription were used for the treatment of urinary tract infections (83.7%), typhoid fever (83.7%) and sexually transmitted infections (66.3%). Pharmacist's confidence in knowledge of antibiotic therapy was the most common reason for non-prescription dispensing of antibiotics. Respondents with less than 5 years of working experience (66.7%) were significantly more likely to dispense antibiotics without prescription 5 times or more in a day compared to those with more than 5 years community pharmacy experience (33.3%), P = 0.031. Conclusion Non-prescription dispensing of antibiotics was common among community pharmacists despite awareness about its prohibition and implications. The malpractice was associated with number of years of community pharmacy experience. Confidence in knowledge of antibiotic therapy was the main reason community pharmacists dispensed antibiotics without prescription. Continuous pharmacy education and training on handling of antibiotics may help to reduce inappropriate practices among community pharmacists.
    Matched MeSH terms: Community Pharmacy Services/standards*
  4. Lee JL
    Int J Clin Pharm, 2020 Apr;42(2):604-609.
    PMID: 32095976 DOI: 10.1007/s11096-020-00996-4
    Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysian pediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing error and 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of a prescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers is an important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.
    Matched MeSH terms: Pharmacy Service, Hospital/standards*
  5. Griffiths AW, Cheong WL, Saw PS, Parveen S
    BMC Med Educ, 2020 Mar 20;20(1):82.
    PMID: 32192471 DOI: 10.1186/s12909-020-1972-5
    BACKGROUND: One of the major challenges worldwide is the stigma associated with dementia. There is limited dementia awareness within Malaysian communities, including levels of confusion regarding the differences between dementia and the usual ageing progress, which can lead to delays in support seeking. The need for additional training and education for healthcare professionals has been highlighted. The present study aimed to evaluate the benefits of a one-hour dementia education session (Dementia Detectives workshop) for pharmacy and medicine undergraduate students at a Malaysian university.

    METHODS: Participants attended the workshop and completed pre- (Time 1) and post-workshop (Time 2) questionnaires consisting of validated measures exploring attitudes towards dementia and older people more broadly.

    RESULTS: A total of 97 students were recruited. Attitudes towards people with dementia showed significant positive changes between Time 1 and Time 2, whereas no differences were found for attitudes towards older people.

    CONCLUSIONS: As medical and pharmacy students develop theoretical knowledge, practical skills and professional attitudes during their undergraduate studies, it is important for students to also learn about the humanistic side of diseases and conditions through workshops such as the one presented here. Further research should now be conducted to consider how Dementia Detectives can be delivered to non-healthcare students and what the barriers and facilitators to wider delivery are.

    Matched MeSH terms: Students, Pharmacy/psychology*
  6. Abubakar U, Muhammad HT, Sulaiman SAS, Ramatillah DL, Amir O
    Curr Pharm Teach Learn, 2020 03;12(3):265-273.
    PMID: 32273061 DOI: 10.1016/j.cptl.2019.12.002
    BACKGROUND AND PURPOSE: Training pharmacy students in infectious diseases (ID) is important to enable them to participate in antibiotic stewardship programs. This study evaluated knowledge and self-confidence regarding antibiotic resistance, appropriate antibiotic therapy, and antibiotic stewardship among final year pharmacy undergraduate students.

    METHODS: A cross-sectional electronic survey was conducted at universities in Indonesia, Malaysia, and Pakistan. A 59-item survey was administered between October 2017 and December 2017.

    FINDINGS: The survey was completed by 211 students (response rate 77.8%). The mean knowledge score for antibiotic resistance, appropriate antibiotic therapy, and antibiotic stewardship was 5.6 ± 1.5, 4.7 ± 1.8 (maximum scores 10.0) and 3.1 ± 1.4 (maximum score 5.0), respectively. Significant variations were noted among the schools. There was poor awareness about the consequences of antibiotic resistance and cases with no need for an antibiotic. The knowledge of antibiotic resistance was higher among male respondents (6.1 vs. 5.4) and those who had attended antibiotic resistance (5.7 vs. 5.2) and antibiotic therapy (5.8 vs. 4.9) courses (p 

    Matched MeSH terms: Education, Pharmacy/methods; Education, Pharmacy/standards*; Education, Pharmacy/statistics & numerical data; Students, Pharmacy/psychology*; Students, Pharmacy/statistics & numerical data
  7. Kubas MA, Halboup AM
    Int J Clin Pharm, 2020 Feb;42(1):51-56.
    PMID: 31713107 DOI: 10.1007/s11096-019-00936-x
    Background Studies have revealed that the inclusion of a clinical pharmacist as a member in multidisciplinary medical team has been associated with improved medication use, reduced adverse drug reaction, reduced cost of treatment, and improved health outcomes. Objective The objectives of this study were to evaluate the implementation of clinical pharmacy recommendations and services, the acceptance rate by the physicians, and the anticipated outcomes of the recommendations at a hospital in Yemen. Methods Different units of the University of Science and Technology Hospital, Sana'a were included in this study. All the recommendations and services provided by the clinical pharmacist during daily activities were documented between June 2013 and November 2015. The provided recommendations were classified based on the type, acceptance rate, and the anticipated outcomes. Main outcome measure Type and quality of clinical pharmacists' recommendations, anticipated impact of the recommendations on health outcomes, and their acceptance rate. Results Throughout the study period, a total of 957 patients in different hospital units were visited and provided with a total of 3307 interventions and services. The most frequent types of clinical pharmacist's interventions were drug discontinuation (23.6%, n = 782), inappropriate dose interval or time (n = 735, 22.2%), and add medication (18.9%, n = 626). Overall, 61.8% (n = 2044) of the provided recommendations were accepted by the physicians. The most anticipated outcomes were improved the effectiveness of therapy (45.1%, n = 1909), avoid adverse drug reactions (29%, n = 1228), and decrease the cost of medications (18.8%, n = 797). Conclusion Clinical pharmacist's recommendations resulted in improving drug therapy and decreasing adverse effects for inpatients at the University of Science and Technology Hospital. This suggests that the implementation of clinical pharmacy services is essential and has a positive outcome on patient care.
    Matched MeSH terms: Pharmacy Service, Hospital/standards; Pharmacy Service, Hospital/trends*
  8. Blebil A, Dujaili J, Elkalmi R, Tan HLK, Tai MS, Khan TM
    J Pharm Bioallied Sci, 2020 01 29;12(1):64-71.
    PMID: 32801602 DOI: 10.4103/jpbs.JPBS_152_19
    Introduction: Pharmacists have been well recognized as an active and have a more integrated role in the preventive services within the National Health Services. This study assessed the community pharmacists' attitudes, beliefs, and practices toward oral health in the Malaysian setting.

    Materials and Methods: A cross-sectional survey-based study was used to conduct this project. An anonymous self-administered questionnaire was developed and distributed among community pharmacists within Kuala Lumpur and Selangor states areas, Malaysia. The data collection was carried out from the beginning of November to the end of December 2018.

    Results: Of the 255 pharmacists, 206 agreed to participate in the study, yielding a response rate of 80.8%. Overall, approximately half of the pharmacists provided two to five oral health consultations per week and two to five over the counter (OTC) oral health products recommendations per week. The main services provided by community pharmacists in were the provision of OTC treatments (93.7%), referral of consumers to dental or medical practitioners when appropriate (82.5%), and identify signs and symptoms of oral health problems in patients (77.2%). In addition, more than 80% of the pharmacists viewed positively and supported integrating oral health promotion and preventive measures into their practices. The most commonly reported barriers to extending the roles of pharmacists in oral health care include lack of knowledge or training in this field, lack of training resources, and lack of oral health educational promotion materials.

    Conclusion: The study shows that community pharmacists had been providing a certain level of oral health services and play an important role in oral health. The findings highlighted the need of an interprofessional partnership between the pharmacy professional bodies with Malaysian dental associations to develop, and evaluate evidence-based resources, guidelines, the scope of oral health in pharmacy curricula and services to deliver improved oral health care within Malaysian communities.

    Matched MeSH terms: Pharmacy
  9. Alrasheedy AA, Alsalloum MA, Almuqbil FA, Almuzaini MA, Aba Alkhayl BS, Albishri AS, et al.
    Expert Rev Anti Infect Ther, 2020 01;18(1):87-97.
    PMID: 31834825 DOI: 10.1080/14787210.2020.1705156
    Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes.Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios.Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively.Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.
    Matched MeSH terms: Community Pharmacy Services/legislation & jurisprudence*; Legislation, Pharmacy
  10. Nouri AI, Hassali MA, Hashmi FK
    Perspect Public Health, 2020 Jan;140(1):62-66.
    PMID: 31165671 DOI: 10.1177/1757913919832927
    AIMS: This article examines the outputs of pharmaceutical education with the development of the pharmacy profession and how that affects pharmaceutical innovation. It also discusses different models of collaboration between the academic and pharmaceutical industry in order to achieve a healthy collaboration between the stakeholders.

    METHODS: The perspective, experiences and insights of educators from various backgrounds, origin and educational levels were sought regarding the role of pharmacy education in providing pharmaceutical research and development workforce.

    RESULTS: Many countries around the world are currently undertaking major reforms in pharmacy education due to the changing landscape of health and healthcare delivery. These reforms must be accompanied by robust systems to assure that the quality of educational structures, processes and outcomes will produce competent pharmacy graduates in the future. It is also considered imperative that pharmacy academic institutions should establish collaboration with the drug development units, the pharmaceutical industry and government agencies for sustainability and positive research outcomes.

    CONCLUSION: Shortcomings in pharmacy curricula need to be addressed and the authors have proposed the 'TARGET' approach for the development of integrated pharmacy curriculum to substantially contribute to pharmaceutical research and development.

    Matched MeSH terms: Education, Pharmacy/methods*
  11. Goswami N, Dahal P, Shrestha S, Kc B, Mallik SK
    Risk Manag Healthc Policy, 2020;13:1513-1522.
    PMID: 32982509 DOI: 10.2147/RMHP.S264192
    Background: Community pharmacies are easily accessible outlets providing medicines to the general public in Nepal, but it is known that irrational dispensing of antibiotics from such outlets contributes to antimicrobial resistance.

    Objective: To assess the understanding of community pharmacy personnel around antibiotic-dispensing in Eastern Nepal and the relationship between this understanding and their personal characteristics.

    Methods: A cross-sectional survey was conducted on 312 pharmacy personnel working in community pharmacies of three districts within Eastern Nepal using a self-administered questionnaire. Descriptive statistics were used to analyze participants' characteristics and their understanding of antibiotic dispensing. The relationships between their understanding of antibiotic dispensing and their characteristics were determined using Chi-square tests.

    Results: Most of the pharmacy personnel considered that dispensing antibiotics without a valid prescription is a problem (76.9%), and that it would not be legal to do so (86.9%). In the survey, 34.9% of participants agreed that they had dispensed antibiotics without prescription, and 26.9% disagreed with the assertion that inappropriate dispensing of antibiotics could promote antimicrobial resistance. Most (94.5%) reported that they would advise patients to follow their antibiotic dosage regimen, but 34.3% reported that they believed antibiotics to reduce pain and inflammation. Bivariate analysis showed that the level of understanding about antibiotic indication was significantly associated with age (p<0.001), work experience (p<0.001) and qualifications (p=0.017) of the pharmacy personnel. Work experience and qualifications also had significant but independent relationships with the level of understanding that irrational dispensing of antibiotics promotes antimicrobial resistance (p=0.018 and p=0.004) and is on the need for patient follow-up after dispensing antibiotics (p<0.001 and p=0.042).

    Conclusion: The understanding of community pharmacy personnel about antibiotic dispensing in Eastern Nepal requires significant improvement. Degree of understanding of some aspects of antibiotic dispensing was influenced by age, work experience and qualifications.

    Matched MeSH terms: Pharmacy
  12. Mohd Shaiful Ehsan Shalihin, Iskandar Firzada Osman, Muhammad Hapizie Bin Din
    MyJurnal
    Introduction: Long waiting time is a common issue complained by diabetic patients that came for an
    early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in
    a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for
    improvement. Methods: This audit was conducted for four weeks using a universal sampling method in
    November 2017. All diabetic patients who attended the clinic during this period were included except those
    who required longer period such as critically ill patients or those who came for repeat medication or
    procedures. The arrival and departure time for each station was captured using the modified waiting time
    slip, which is manually filled at every station. The waiting and consultation time for registration, screening,
    laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into
    the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered
    within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was
    20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other
    stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58
    minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor
    tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file
    tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.
    Matched MeSH terms: Pharmacy
  13. 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: Pharmacy
  14. Ching, Melissa Lim Ven, Chin, Ling Hui, Yin, Ng Wai
    MyJurnal
    Comfort and acceptance by healthcare professionals are crucial for effective operation of clinical pharmacy services. To date, there is no published report on the perceptions towards clinical pharmacy services from Tawau, Sabah or anywhere else in Malaysia. The objective of this study is to evaluate the comfort, perceptions and expectations of healthcare professionals towards the clinical pharmacy services in Tawau Hospital. This crosssectional, questionnaire-based study was carried out in 10 wards of Tawau Hospital with clinical pharmacy services, from June to July 2014. Validated questionnaires with consent were anonymously distributed to doctors and nurses. The self-administered questionnaires consisted of four sections: demographic, comfort level, expectations, and experiences dealing with clinical pharmacists. A 4-point Likert scale, where 1 = strongly disagree, while 4 = strongly agree, was used to indicate the level of agreement. Of 292 questionnaires administered, 269 were completed, giving a response rate of 92.1%. Compared to nurses, higher percentage of doctors were less comfortable with clinical pharmacists providing drugrelated education, suggesting the use of drugs to prescribers, designing pharmacotherapy regimes, and monitoring safety and outcomes of the designed regimens. The participants have great expectations, perceptions and experiences with clinical pharmacists of Tawau Hospital. Majority of the healthcare professionals who have direct contact with clinical pharmacists in their work were generally receptive and have high expectations towards patient-oriented clinical pharmacy services.
    Matched MeSH terms: Pharmacy Service, Hospital
  15. Shrestha S, Jha N, Palaian S, Shankar PR
    SAGE Open Med, 2020;8:2050312120974513.
    PMID: 33282309 DOI: 10.1177/2050312120974513
    Good knowledge, awareness and preparedness regarding coronavirus disease 2019, among community pharmacy practitioners (CPPs), will enable them to provide correct information and support to patients, convey instructions from the public health authorities and protect their own health.

    Objective: The aim of this study was to determine knowledge, awareness and preparedness regarding coronavirus disease 2019 among CPPs working in Kathmandu, Nepal.

    Methods: A cross-sectional study was conducted using a convenience sampling method from 10 February to 25 March 2020. Data were analysed descriptively, and one-sample independent t-test and one-way analysis of variance were used to compare scores among different subgroups of respondents (p 

    Matched MeSH terms: Pharmacy
  16. Saleem Z, Hassali MA, Godman B, Fatima M, Ahmad Z, Sajid A, et al.
    PMID: 32774870 DOI: 10.1186/s40545-020-00233-3
    Introduction: Resistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. There is a particular issue in countries such as Pakistan. Consequently, there is a need to assess current rates of self-purchasing especially for reserve antibiotics to guide future policies.

    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.

    Matched MeSH terms: Pharmacy
  17. Greta Miranda Goh, Awg Khairul Bin Awang Mohammad
    MyJurnal
    Introduction: Increase in antibiotic resistance (ABR) worldwide, specifically in developing countries, requires the need to pay attention to self-medicated antibiotics, perception and attitude of ABR. Self-medication on antibiotics practices have a major pitfall, which is that users do not follow a prescribed course of drug and may usually stop the drug regimen once they feeling better. The spread of ABR is known to be associated with inadequate dosing, and incomplete courses which increases the actual cost of treating illnesses and social burden. This research is motivated by the alarming spread of ABR in Malaysia, the paucity of data on self-medication with antibiotics, and the alarming rate of pharmacy or drug stores that sell antibiotics and prescription-only medicines that are unauthorized to do so. Thus, the study has been done to observe the pattern of antibiotics usage of undergraduate students in a public uni- versity. Methods: Quantitative study with cross-sectional study have been chosen in this study and the target sample is localUniversiti Malaysia Sarawak(UNIMAS) undergraduate students with use of convenience sampling method. Besides, data collection has been done at main library (Centre for Academic Information Services)of UNIMASand students pavilion, UNIMAS by using the fully English online and hardcopy self-administered questionnaire adapted from previous study. Then, the data collected has been analysed by using SPSS Version 22. Results: In this study, 30.5% out of 403respondents have admitted that have taken antibiotics within 6 months and common reason of taking antibiotics given are fever, respiratory tract infection, and pain. Besides, there are 36% of respondents are not compliance to their antibiotics once prescribed with reason of already felt better and healed from the illness. More than 50% of the respondents are believed that antibiotics can treat the viral infection and work on the cold or coughs. For the attitude’s aspect, more than 60% of the respondents are expecting the doctor to prescribed them antibiotics when they are having cold symptoms and 49.9% will take antibiotics when they get cold to help them recover more quickly. Conclusion: This study has showed that there about a quarter of respondents (36%) still using antibiotics in improper method of consumption. Besides, some of the respondents have misunderstanding perception toward anti- biotics and bad attitudes on compliance toward the antibiotics. Thus, this problem from the young adult population could contributes to the increasing trend of antibiotics resistance in Malaysia.
    Matched MeSH terms: Pharmacy
  18. Fatokun O
    Curr Drug Saf, 2020;15(3):181-189.
    PMID: 32538733 DOI: 10.2174/1573403X16666200615144946
    BACKGROUND: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists' beliefs regarding these measures in Malaysia.

    OBJECTIVES: This study examined community pharmacists' beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures.

    METHODS: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia.

    RESULTS: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002).

    CONCLUSION: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

    Matched MeSH terms: Community Pharmacy Services*
  19. 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: Pharmacy
  20. Ab Rahman AF
    Bull World Health Organ, 2019 Nov 01;97(11):730.
    PMID: 31673185 DOI: 10.2471/BLT.19.245019
    Matched MeSH terms: Community Pharmacy Services
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