Displaying publications 81 - 100 of 2096 in total

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  1. Sereda M, McFerran D, Axon E, Baguley DM, Hall DA, Potgieter I, et al.
    Int J Audiol, 2020 08;59(8):640-646.
    PMID: 32134348 DOI: 10.1080/14992027.2020.1733677
    Objective: To develop an innovative prioritisation process to identify topics for new or updated systematic reviews of tinnitus research.Design: A two-stage prioritisation process was devised. First, a scoping review assessed the amount of randomized controlled trial-level evidence available. This enabled development of selection criteria for future reviews, aided the design of template protocol and suggested the scale of work that would be required to conduct these reviews. Second, using the pre-defined primary and secondary criteria, interventions were prioritised for systematic review.Study sample: Searches identified 1080 records. After removal of duplicates and out of scope works, 437 records remained for full data charting.Results: The process was tested, using subjective tinnitus as the clinical condition and using Cochrane as the systematic review platform. The criteria produced by this process identified three high priority reviews: (1) Sound therapy using amplification devices and/or sound generators; (2) Betahistine and (3) Cognitive behaviour therapy. Further secondary priorities were: (4) Gingko biloba, (5) Anxiolytics, (6) Hypnotics, (7) Antiepileptics and (8) Neuromodulation.Conclusions: A process was developed which successfully identified priority areas for Cochrane systematic reviews of interventions for subjective tinnitus. This technique could easily be transferred to other conditions and other types of systematic reviews.
    Matched MeSH terms: Research*; Research Design*
  2. Chin WK, Thuraisingam AS, Kanagasabapathy S
    Account Res, 2021 May 05.
    PMID: 33857400 DOI: 10.1080/08989621.2021.1917397
    Clinical trials play a critical role in the development of life-enhancing and life-sustaining biomedical advances. It is costly and, regardless of how well-designed and ethically conducted, there are always inherent uncertainties which subsequently expose human participants to the risk of injuries or even death. In Malaysia, compensation for clinical trial-related injury has not been incorporated into standard national regulations or policies. Therefore, when clinical trial-related injuries do occur, such participants cannot be compensated by researchers, and with the absence of specific statutory laws governing trial-related injury within the local legal framework, aggrieved parties need to seek legal redress and can only depend on the existing tort laws. To propose a viable compensation framework, the existing compensation regulations and policies implemented in India and South Africa are analyzed, and their best principles have been recommended. This study proposes the implementation of a no-fault compensation framework in Malaysia which should be disbursed efficiently at minimum administrative cost. This proposed approach should be mandated by the amendment of current laws governing biomedical research and, in the interim, should be adopted voluntarily by research sponsors, institutions and investigators conducting clinical trials in Malaysia.
    Matched MeSH terms: Research Personnel; Biomedical Research
  3. Ismail MT
    Malays J Reprod Health, 1994 Jun;12(1):43-8.
    PMID: 12320338
    PIP: Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.
    Matched MeSH terms: Research
  4. Shah B, Kirpalani A, Sunder S, Gupta A, Khanna U, Chafekar D, et al.
    BMC Nephrol, 2015;16:215.
    PMID: 26696239 DOI: 10.1186/s12882-015-0191-5
    The objective of this article is to describe the organisation of an international, clinical registry, the Chronic Kidney Disease Observational Database (CKDOD), the processes of enrolling patients and entering data and preliminary results to date.
    Matched MeSH terms: Research Design
  5. Nagendrababu V, Murray PE, Ordinola-Zapata R, Peters OA, Rôças IN, Siqueira JF, et al.
    Int Endod J, 2019 Aug;52(8):1090-1095.
    PMID: 30908638 DOI: 10.1111/iej.13123
    Laboratory-based research studies are the most common form of research endeavour and make up the majority of manuscripts that are submitted for publication in the field of Endodontology. The scientific information derived from laboratory studies can be used to design a wide range of subsequent studies and clinical trials and may have translational potential to benefit clinical practice. Unfortunately, the majority of laboratory-based articles submitted for publication fail the peer-review step, because unacceptable flaws or substantial limitations are identified. Even when apparently well-conducted laboratory-based articles are peer-reviewed, they can often require substantial corrections prior to the publication. It is apparent that some authors and reviewers may lack the training and experience to have developed a systematic approach to evaluate the quality of laboratory studies. Occasionally, even accepted manuscripts contain limitations that may compromise interpretation of data. To help authors avoid manuscript rejection and correction pitfalls, and to aid editors/reviewers to evaluate manuscripts systematically, the purpose of this project is to establish and publish quality guidelines for authors to report laboratory studies in the field of Endodontology so that the highest standards are achieved. The new guidelines will be named-'Preferred Reporting Items for Laboratory studies in Endodontology' (PRILE). A steering committee was assembled by the project leads to develop the guidelines through a five-phase consensus process. The committee will identify new items as well as review and adapt items from existing guidelines. The items forming the draft guidelines will be reviewed and refined by a PRILE Delphi Group (PDG). The items will be evaluated by the PDG on a nine-point Likert scale for relevance and inclusion. The agreed items will then be discussed by a PRILE face-to-face consensus meeting group (PFCMG) formed by 20 individuals to further refine the guidelines. This will be subject to final approval by the steering committee. The approved PRILE guidelines will be disseminated through publication in relevant journals, presented at congresses/meetings, and be freely available on a dedicated website. Feedback and comments will be solicited from researchers, editors and peer reviewers, who are invited to contact the steering committee with comments to help them update the guidelines periodically.
    Matched MeSH terms: Research Design*; Research Report
  6. Gan Kim Soon P, Lim SK, Rampal S, Su TT
    PLoS One, 2019;14(8):e0220411.
    PMID: 31404075 DOI: 10.1371/journal.pone.0220411
    INTRODUCTION: End-stage renal disease (ESRD) is increasing globally, and renal transplantation (RT) is the preferred renal replacement therapy to treat ESRD. Internationally, there are only a few countries with RT rates above 50 per million population (pmp), while most of the countries have RT rates between 30-40 pmp. The low- and middle-income countries (LMIC) makes up the majority for the RT rates below 20 pmp in which Malaysia belongs to despite its increasing ESRD rates. There is a need to explore the barriers to access RT with targeted solutions to improve the RT rates and service in LMIC. Thus, a qualitative study was undertaken in Malaysia to address this issue.

    METHOD: A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly.

    RESULTS: Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration.

    CONCLUSION: The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.

    Matched MeSH terms: Qualitative Research
  7. Farooqui M, Hassali MA, Knight A, Shafie AA, Farooqui MA, Saleem F, et al.
    BMC Public Health, 2013;13:48.
    PMID: 23331785 DOI: 10.1186/1471-2458-13-48
    Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients' perceptions of cancer screening and early diagnosis.
    Matched MeSH terms: Qualitative Research
  8. Farooqui M, Othman CN, Hassali AA, Saleem F, Ul Haq N, Sadeeqa S
    Value Health, 2014 Nov;17(7):A789.
    PMID: 27202944 DOI: 10.1016/j.jval.2014.08.425
    Objectives: The study aims to assess doctors’ perceptions towards Complementary and Alternative Medicines (CAM) in their medical practice, factors that affect the referral of CAM and suggestions to improve CAM in medical practice.
    Methods: A qualitative research approach was adopted to gain a better understanding of the current perceptions and practice held by doctors’ within their medical professions. In order to gain a wide perspective of the issue, eleven doctors were purposively selected who were working in academics, hospitals and in the community health clinics. Participants were interviewed using a semi-structured interview guide. A saturation point was reached after the 10th interview, and no new information emerged with the subsequent interviews. All interviews were transcribed verbatim and analyzed by means of a standard content analysis framework.
    Results: The doctors expressed a range of views on CAM that can be divided into two major themes: doctors’ knowledge and understanding towards CAM and doctors’ viewpoint on CAM in their professional practice. A key factor which affected doctor’s perspectives on CAM was the lack of scientific evidences. The attitudes on CAM were basically shaped based on their personal CAM use rather than knowledge gained during an academic course. Lack of knowledge on CAM was also attributing to the doctors’ reluctance in CAM discussion with their patients. Though addition of CAM courses into the medical curriculum was proposed by some of the doctors; the practical implication was criticized as some found medical curriculum heavily packed with the biomedical courses.
    Conclusions: Majority of the doctors in this study were skeptical and uncertain about CAM due to lack of scientific evidence. Doctor-patient communication on CAM can only be improved when doctors’ knowledge on CAM can be improved by providing necessary training on CAM.
    Matched MeSH terms: Qualitative Research
  9. Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R
    Asia Pac J Public Health, 2014 Sep;26(5):536-45.
    PMID: 24368749 DOI: 10.1177/1010539513514434
    This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.
    Matched MeSH terms: Qualitative Research
  10. Tan CS, Hassali MA, Neoh CF, Saleem F
    Pharm Pract (Granada), 2017 12 18;15(4):1074.
    PMID: 29317924 DOI: 10.18549/PharmPract.2017.04.1074
    Objective: This study aimed to explore hypertensive patients' perspectives on quality use of medication and issues related to hypertension management at the community level in Malaysia.

    Methods: Focus groups discussion was employed in this qualitative study. A total of 17 hypertensive patients were purposively recruited. Three focus group discussions with semi-structured interview were carried out at Flat Desa Wawasan, Penang. All the conversations were audio recorded, transcribed verbatim and thematically analysed.

    Results: Three major themes were developed, including medication adherence among hypertensive patients, self-management of hypertension and patients' knowledge towards hypertension. Poor medication adherence was found and different strategies were taken to overcome the barriers towards adherence. Use of herbal and traditional therapies was perceived as alternative method in controlling blood pressure instead of taking antihypertensive medication. The participants were found to have poor knowledge on side effect and mechanism of action of hypertensive medication.

    Conclusions: The misconception about the side effect of antihypertensive medication has led to poor adherence among the participants. Lack of knowledge on targeted blood pressure level has led to poor blood pressure monitoring among the participants. Health awareness program and counselling from health care professional should be advocated among the hypertensive patients in addressing the above gaps.

    Matched MeSH terms: Qualitative Research
  11. Sukeri S, Idris Z, Zahiruddin WM, Shafei MN, Idris N, Hamat RA, et al.
    PLoS One, 2018;13(7):e0200871.
    PMID: 30021013 DOI: 10.1371/journal.pone.0200871
    This qualitative study aimed to explore the misconceptions, knowledge gaps and constructs of leptospirosis among 72 respondents from rural and urban districts in two states of Malaysia. We conducted focus group discussions and data were examined using thematic analyses. The layman term of 'rat urine disease' contributed the most to the misconceptions regarding leptospirosis. There were gaps in the knowledge among urban and rural respondents in the two states, with the majority of subjects demonstrating a poor understanding of the disease. Construction of knowledge about leptospirosis relied mostly on the information provided by mass and social media; reading materials; word-of-mouth publicity; observations; experiences; and knowledge sharing among families, friends, and communities. The study findings may provide the foundation for the development of educational materials that may reduce the gaps in knowledge, and thereby improve health literacy and enhance preventive health behaviours for avoiding leptospirosis.
    Matched MeSH terms: Qualitative Research
  12. Lee ML, Hassali MA, Shafie AA
    Res Social Adm Pharm, 2013 Jul-Aug;9(4):405-18.
    PMID: 22835711 DOI: 10.1016/j.sapharm.2012.05.010
    BACKGROUND: Treatment default among the smokers hinders the effectiveness of the delivery of cessation services. While many studies have predicted the defaulters' characteristics, the reasons why these smokers dropped out and continued smoking are seldom explored.
    OBJECTIVES: This study examined the barriers encountered by such smokers and their respective health care providers (HCPs) in relation to the discontinuation of cessation treatment.
    METHODS: From May 2010 to March 2011, 15 current adult smokers and 9 HCPs from 2 Quit Smoking Clinics (QSCs) in the Melaka Tengah District, Malacca, Malaysia were interviewed on smoking, cessation, and the QSC. Interviews were audio recorded and transcribed verbatim. The transcripts were subsequently translated into English and analyzed using thematic analysis.
    RESULTS: The barriers encountered were categorized as Individual- and Clinic-level. Both smokers and HCPs acknowledged that the smokers' low intrinsic motivation was the individual-level barrier. The clinic-level barriers were the mismatched perceptions of smokers and HCPs regarding the HCPs' roles, skills, and attitudes, as well as the availability and efficacy of smoking cessation aids (SCAs). While the smokers viewed the program as not helpful, the HCPs cited the lack of organizational support as their main barrier.
    CONCLUSIONS: The reasons for treatment default centered on the overall dissatisfaction with the treatment (due to the program, HCP, and SCA factors) combined with the smokers' low intrinsic motivation. Optimizing the interplay of the extrinsic motivational cues, such as the HCP and SCA factors, would complement the smoker's low intrinsic motivation and thus encourage treatment retention. However, it is necessary to strike a balance between the individual smoker's needs and the availability of organizational support.
    KEYWORDS: Qualitative; Smoking cessation; Treatment discontinuation
    Study site: Quite smoking clinics, Klinik Kesihatan Ayer Keroh, Hospital Melaka, Melaka, Malaysia
    Matched MeSH terms: Qualitative Research
  13. Kiew SJ, Majid HA, Mohd Taib NA
    Eur J Cancer Care (Engl), 2022 Jan;31(1):e13530.
    PMID: 34693588 DOI: 10.1111/ecc.13530
    OBJECTIVE: This study aimed to explore the dietary practices and factors affecting Malaysian breast cancer survivors' dietary behaviours.

    METHODS: We conducted an in-depth qualitative interview on 20 participants from a cohort study. An ecological framework was used to construct the semi-structured topic guide. The interviews were audio-recorded and transcribed verbatim. Thematic analysis with theoretical saturation was used in data analysis.

    RESULTS: The participants were found to have variable dietary practices that either followed or did not follow dietary recommendations. The social environment was critical as most women relied on family and friends for food choices; additionally, individuals in charge of food preparation had to prepare food based on their family member preferences. Furthermore, individuals had difficulty sustaining healthy dietary changes during the acute survivorship phase due to a lack of health consciousness and difficulty in healthy food access. Notably, there was a lack of dietary guidance from health care professionals, especially dietitians, in long-term survivorship care.

    CONCLUSION: This study highlights the lack of breast cancer survivors' healthy diet and lifestyle knowledge. A holistic multidisciplinary approach involving individual, social, physical, and macro-level environmental elements are crucial to influencing healthy eating behaviours.

    Matched MeSH terms: Qualitative Research
  14. Syed IA, Syed Sulaiman SA, Hassali MA, Thiruchelvum K, Lee CK
    Health Expect, 2015 Dec;18(6):2841-52.
    PMID: 25228140 DOI: 10.1111/hex.12268
    BACKGROUND: Understanding patients' knowledge and belief towards disease could play a vital role from an outcome perspective of disease management and HIV/AIDS patients are not exception to that.

    METHODS: Qualitative methodology was used to explore Malaysian HIV/AIDS patients' perspectives on disease and status disclosure. A semi structured interview guide was used to interview the patients and a saturation point was reached after the 13th interview. All interviews were audio-recorded and subjected to a standard content analysis framework.

    RESULTS: Understandings and beliefs towards HIV/AIDS and Perspective on disease disclosures were two main themes derived from patients' data. Beliefs towards causes and cure emerged as sub-themes under disease understandings while reasons for disclosure and non-disclosure were resulted as main sub-themes under disease disclosure. Majority of patients apprehended HIV/AIDS and its causes to acceptable extent, there were elements of spirituality and lack of education involved with such understandings. Though beliefs existed that knowing status is better than being ignorant, fear of stigma and discrimination, social consequences and family emotions were found important elements linked to disease non-disclosure.

    CONCLUSIONS: The outcomes provided basic information about patients' perceptions towards disease and status disclosure among HIV/AIDS patients which can help in the designing and improvising existing strategies to enhance disease awareness and acceptance and will also serve as baseline data for future research further focusing on this subject.
    Matched MeSH terms: Qualitative Research
  15. Ibrahim IR, Hassali MA, Saleem F, Al Tukmagi HF
    J Pharm Bioallied Sci, 2016 Oct-Dec;8(4):284-288.
    PMID: 28216951 DOI: 10.4103/0975-7406.199349
    BACKGROUND: The self-treatment with complementary and alternative medicines (CAMs) in chronic diseases is portraying an expanding trend worldwide. Yet, little is known concerning patients' motives to use CAM in the control of blood pressure.
    OBJECTIVE: This study aims to explore the self-use of CAM in the management of hypertension and explore patients' attitudes, perceived benefits, and disclosure to the physician.
    MATERIALS AND METHODS: A qualitative technique was adopted and face-to-face interviews, using a validated interview guide, were carried out among twenty hypertensive patients. A purposive sampling method was used to recruit patients at Al-Karama Teaching Hospital in Baghdad; the capital of Iraq; from January to April 2015. All the interviews were audio-recorded, then transcribed verbatim and examined for thematic relationships.
    RESULTS: Three major themes were identified through thematic content analysis of the interviews. These encompassed patients' understanding of CAM; experience and perceived benefits; and communication with the doctors. The use of CAM was prevalent among the majority of the respondents. The most commonly used therapies were biological-based practices (herbal remedies, special diet, vitamins, and dietary supplements); traditional therapies (Al-Hijama or cupping); and to a less extent of manipulative body-based therapies (reflexology). Factors influencing the use of CAM were traditions, social relationships, religious beliefs, low-cost therapy, and safety of natural products.
    CONCLUSION: The use of CAM was common as a practice of self-treatment among hypertensive patients in Iraq. This was underpinned by the cultural effects, social relationships, religious beliefs, and the perception that natural products are effective and safe. Understanding patients' usage of CAM is of great importance as long as patient's safety and interaction with the standard prescribed treatment are major concerns.
    Matched MeSH terms: Qualitative Research
  16. Nies YH, Ali AM, Abdullah N, Islahudin F, Shah NM
    Patient Prefer Adherence, 2018;12:1955-1964.
    PMID: 30319245 DOI: 10.2147/PPA.S168638
    Purpose: The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia.
    Participants and methods: Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews.
    Results: Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy.
    Conclusion: Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.

    Study site: two tertiary care hospitals in Malaysia as well as the National Cancer Society Malaysia.

    Matched MeSH terms: Qualitative Research
  17. Hashmi FK, Hassali MA, Khalid A, Saleem F, Aljadhey H, Babar ZUD, et al.
    BMC Health Serv Res, 2017 07 19;17(1):500.
    PMID: 28724411 DOI: 10.1186/s12913-017-2442-6
    BACKGROUND: In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan.

    METHODS: A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework.

    RESULTS: Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings.

    CONCLUSION: Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

    Matched MeSH terms: Qualitative Research
  18. Naqvi AA, Hassali MA, Aftab MT, Nadir MN
    J Pak Med Assoc, 2019 Feb;69(2):216-223.
    PMID: 30804587
    OBJECTIVE: The study aimed to perceived barriers to medication adherence in patients with chronic illnesses..

    METHODS: A qualitative study was conducted in a tertiary care hospital in Karachi in September 2017, using grounded theory and inductive approach. Interviews were conducted using a checklist in Urdu language from patients of chronic illnesses determined based on medicines dispensed from the out-patient pharmacy in hospital. Interviews were recorded, transcribed verbatim, translated in English and validated. The translated quotations were analysed using a qualitative analysis software, and thematic analysis was conducted. Codes were generated and analysed by semantic linkages and network analysis using ATLAS.ti qualitative research software.

    RESULTS: Of the 16 patients interviewed, 8(50%) were males and 8(50%) were females. Barriers to medication adherence identified were patient behaviour (intentional and un-intentional non-adherence), comorbidity and pill burden, cost-related non-adherence, and low patient knowledge. The last barrier was associated with the rest.

    CONCLUSIONS: Counselling has the potential to increase patient knowledge regarding medication use, and active pharmacist-physician collaboration can improve medication adherence..

    Matched MeSH terms: Qualitative Research
  19. Nik J, Lai PS, Ng CJ, Emmerton L
    BMC Health Serv Res, 2016 08 30;16:448.
    PMID: 27577560 DOI: 10.1186/s12913-016-1686-x
    BACKGROUND: Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services.

    METHODS: Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach.

    RESULTS: Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care.

    CONCLUSIONS: The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.
    Matched MeSH terms: Qualitative Research
  20. Manaf RA, Mahmud A, Ntr A, Saad SR
    BMC Public Health, 2021 05 06;21(1):876.
    PMID: 33957870 DOI: 10.1186/s12889-021-10917-3
    BACKGROUND: The challenges faced by healthcare personnel in relation to dengue prevention and control are perennial but noticeably unexplored. It is often difficult to translate policies and decision making by the elite into astute management in consonance with the needs of rank-and-file personnel. In this study, we assess the impact of governance on dengue prevention and control activities in Malaysia as narrated by the elite.

    METHODS: A qualitative study using a case-study approach was conducted between January 2019 and November 2019 in the districts of Gombak and Klang, where the relevant key informants were located. Nineteen interviews were conducted among elite healthcare personnel from different divisions: management, vector, laboratory, inspectorate, health promotion and entomology. Semi-structured interviews were conducted. The sample size was determined through saturation point criteria. Purposive sampling techniques were used to recruit the participants. The interviews were audio recorded, and the transcribed text was analysed with deductive thematic analysis.

    RESULTS: Data analysis led to the development of 5 themes and 13 categories. The major principles of governance were embodied in a milieu of predicament, linked to constraints but also opportunities. The constraints resulted from inherent determinants of dengue outbreaks, the serviceability of governing policies and the macro-economics of budget allocation. The opportunities to sustain governance at the local operating level stem from a prevalent supportive internal management system, collaborative efforts among corresponding external government agencies and willingness to innovate and embrace novel technology.

    CONCLUSION: Elites are influential, often well-informed personnel tasked with making decisions that can reverberate across an organisation, impacting future plans and strategic policies. Political arrangements at higher levels will reflect in advance the tone of how governance in dengue prevention and control is operationalised by entities and individuals at lower levels of the health system. The prevailing centralised structure in the Malaysian health system will continue to entrench the position of the elite and intertwine it with governance and its predicaments.

    Matched MeSH terms: Qualitative Research
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