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Clinical pharmacist interventions on pain management in cancer patients (PharmaCAP) in low resource settings: a multicenter feasibility-pilot randomized controlled trial

Shrestha S, Sapkota S, Teoh SL, Kc B, Paudyal V, Lee SWH, et al.

Support Care Cancer, 2024 Nov 27;32(12):828.
PMID: 39601933 DOI: 10.1007/s00520-024-08989-z

INTRODUCTION: Cancer pain management is frequently insufficient worldwide, especially in low- and middle-income countries where significant challenges related to workforce resources persist. Clinical pharmacists could potentially enhance outcomes in this context, yet their role remains largely unexplored.
OBJECTIVES: This study aimed to assess the feasibility and acceptability of integrating clinical pharmacists into the multidisciplinary team (MDT) to manage cancer pain and assess preliminary outcomes in cancer patients receiving pain treatment. This pilot study was undertaken to inform a future definitive randomized controlled trial (RCT).
METHODS: The protocol was registered with ClinicalTrials.gov (NCT05021393). The PharmaCAP trial was conducted in two oncology centers in Nepal, where patients were randomly enrolled into usual care (UC) or an intervention group (PharmaCAP). The latter received a clinical pharmacist-led medication review, which involved a comprehensive assessment of the patient's current medications, identification of potential drug-related problems, and personalized recommendations for optimizing pain management. This was accompanied by pain assessment, education and counseling on pain management strategies. Baseline and 4-weeks post-intervention assessments measured primary outcomes, i.e., feasibility metrics (recruitment of the patients, retention of patients, patient satisfaction). Secondary outcomes included pain intensity, health-related QoL, anxiety, depression, barriers to pain management, and medication adherence at 4 weeks.
RESULTS: Out of 140 screened patients, 108 were evaluated for eligibility, with 16 opting out primarily due to lack of interest (n = 11) and communication barriers (n = 5). A total of ninety-two participants with cancer pain were randomized into two groups, with 91 patients successfully recruited and 85 (93.4%) completing 4 weeks post-intervention assessment). Completion rates for the UC and PharmaCAP groups were 91.3% and 93.4%, respectively. The primary feasibility outcomes were positive: 100% of patients found random allocation acceptable. Retention rates were high, with 91.3% in the UC group and 93.4% in the PharmaCAP group, despite a few dropouts due to being unreachable, COVID-related issues, and changes in treatment centers. No evidence of contamination between groups was found, as participants did not discuss interventions or influence each other's attitudes, ensuring effective isolation of interventions The PharmaCAP intervention showed significant improvement in QoL (P patients. These findings support the feasibility of conducting a full-scale RCT. Enabling clinical pharmacists to assist with cancer pain management in low-resource settings can benefit patients, healthcare teams, and health systems.
TRIAL REGISTRATION: ClinicalTrials.gov NCT05021393. Registered on 25th August 2022.

Matched MeSH terms: Patient Care Team/organization & administration
Multidisciplinary treatment approach to restore deep horizontally fractured maxillary central incisor

Patil PG, Nimbalkar-Patil SP, Karandikar AB

J Contemp Dent Pract, 2014 Jan 1;15(1):112-5.
PMID: 24939276

This case report demonstrates sequential periodontic, orthodontic and prosthodontic treatment modalities to save and restore deep horizontally fractured maxillary central incisor. The location of fracture was deep in the mucosa which reveals less than 2 mm of tooth structure to receive the crown. The procedures like surgical crown lengthening, endodontic post placement, orthodontic forced eruption, core build-up and metal-ceramic crown restoration were sequentially performed to conserve the fractured tooth. Forced eruption is preferred to surgical removal of supporting alveolar bone, since forced eruption preserves the biologic width, maintains esthetics, and at the same time exposes sound tooth structure for the placement of restorative margins.

Matched MeSH terms: Patient Care Planning; Patient Care Team*
Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014

Distelhorst SR, Cleary JF, Ganz PA, Bese N, Camacho-Rodriguez R, Cardoso F, et al.

Lancet Oncol, 2015 Mar;16(3):e137-47.
PMID: 25752564 DOI: 10.1016/S1470-2045(14)70457-7

Supportive care and palliative care are now recognised as critical components of global cancer control programmes. Many aspects of supportive and palliative care services are already available in some low-income and middle-income countries. Full integration of supportive and palliative care into breast cancer programmes requires a systematic, resource-stratified approach. The Breast Health Global Initiative convened three expert panels to develop resource allocation recommendations for supportive and palliative care programmes in low-income and middle-income countries. Each panel focused on a specific phase of breast cancer care: during treatment, after treatment with curative intent (survivorship), and after diagnosis with metastatic disease. The panel consensus statements were published in October, 2013. This Executive Summary combines the three panels' recommendations into a single comprehensive document covering breast cancer care from diagnosis through curative treatment into survivorship, and metastatic disease and end-of-life care. The recommendations cover physical symptom management, pain management, monitoring and documentation, psychosocial and spiritual aspects of care, health professional education, and patient, family, and caregiver education.

Matched MeSH terms: Patient Care Team/economics; Patient Care Team/standards
Fulltext Optimizing Glycemic Control Through Titration of Insulin Glargine 100 U/mL: A Review of Current and Future Approaches with a Focus on Asian Populations

Deerochanawong C, Bajpai S, Dwipayana IMP, Hussein Z, Mabunay MA, Rosales R, et al.

Diabetes Ther, 2017 Dec;8(6):1197-1214.
PMID: 29094298 DOI: 10.1007/s13300-017-0322-z

Various data have demonstrated inadequate glycemic control amongst Asians with type 2 diabetes mellitus (T2DM), possibly on account of suboptimal titration of basal insulin-an issue which needs to be further examined. Here we review the available global and Asia-specific data on titration of basal insulin, with a focus on the use of insulin glargine 100 U/mL (Gla-100). We also discuss clinical evidence on the efficacy and safety of titrating Gla-100, different approaches to titration, including some of the latest technological advancements, and guidance on the titration of basal insulin from international and local Asian guidelines. The authors also provide their recommendations for the initiation and titration of basal insulin for Asian populations. Discussion of the data included in this review and in relation to the authors' clinical experience with treating T2DM in Asian patients is also included. Briefly, clinical studies demonstrate the achievement of adequate glycemic control in adults with T2DM through titration of Gla-100. However, studies investigating approaches to titration, specifically in Asian populations, are lacking and need to be conducted. Given that the management of insulin therapy is a multidisciplinary team effort involving endocrinologists, primary care physicians, nurse educators, and patients, greater resources and education targeted at these groups are needed regarding the optimal titration of basal insulin. Technological advancements in the form of mobile or web-based applications for automated dose adjustment can aid different stakeholders in optimizing the dose of basal insulin, enabling a larger number of patients in Asia to reach their target glycemic goals with improved outcomes.

Matched MeSH terms: Patient Care Team
Fulltext Influenza A Viral Infection with Septic Shock in Pregnancy

Lwin S, San Yi M, Shi Leong M, Suharjono H, Moe Nwe T

Case Rep Obstet Gynecol, 2019;2019:2470352.
PMID: 31139480 DOI: 10.1155/2019/2470352

The influenza virus is RNA virus and is classified into four subtypes, influenza A, influenza B, influenza C, and influenza D. One of the subtypes of influenza A, the H1N1 strain, also known as swine flu, is especially of high risk for development of complications in pregnant women. The influenza A virus infection is difficult to diagnose clinically because its presenting symptoms are similar to those of the common cold but are more severe, last longer, and can be potentially life-threatening. This case also presented with common cold symptoms but her condition worsened later. Fortunately, obstetric health providers were vigilant enough to address the developing infection and its related complications. It was the cooperative effort of multidisciplinary team care which resulted in a favourable outcome in both mother and baby.

Matched MeSH terms: Patient Care Team
Fulltext Knowledge, attitudes, and barriers towards evidence-based practice among physiotherapists in Malaysia

Yahui HC, Swaminathan N

Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao, 2017 Dec;37:10-18.
PMID: 30931041 DOI: 10.1016/j.hkpj.2016.12.002

Background: Recently, there has been an increased need for all healthcare disciplines to provide interventions that are effective and evidence based. This has led to more implementation of evidence-based practice (EBP) in clinical settings. Following this, research regarding EBP gained attention to determine its uptake into the physiotherapy profession. Although there are numerous studies to determine the attitudes and barriers of physiotherapists towards EBP, most of them were done in developed nations. As for Malaysia, little research has been carried out, much less among physiotherapists.
Purpose: The purpose of this study was to identify the knowledge, attitude, and barriers towards the implementation of EBP among physiotherapists in Malaysia.
Methods: A survey was conducted among the members of the Malaysian Physiotherapy Association and other practicing therapists in Malaysia. One hundred and two responses were collected throughout a span of 2 months.
Results: Respondents agreed that EBP is necessary to practice and that it helps in decision making as well as improving patient care. Eighty-one percent of the respondents either agreed or strongly agreed that they had received formal training in EBP. However, 61% of the respondents reported that strong evidence is lacking to support their interventions. Thirty percent of the respondents reported reading <2 articles per month, with 57% stating that they read two to five articles in a typical month. This study also found time constraints, limited access to search engines, and lack of generalizability of research evidence as the top three barriers to implementing EBP.
Conclusion: Physiotherapists in Malaysia had a positive attitude towards EBP and are inclined towards implementing evidence into their clinical practice. They are interested in attending courses to improve their knowledge and skills in EBP.

Matched MeSH terms: Patient Care
Cardiopulmonary exercise testing: utility in research and patient care

Elina RA, Husain R, Lang CC

JUMMEC, 2005;8:9-22.

Cardiopulmonary exercise testing is a non-invasive physiological test which incorporates the conventional method of exercise stress test with a more advanced breath-to-breath ventilatory analysis. The physiological parameters obtained from the test help to illustrate the cardiovascular, respiratory and metabolic responses to physical exertion. Individual's functional capacity and aerobic fitness is reflected by the value of maximal oxygen consumption (VO2 max) obtained from the cardiopulmonary exercise test. This non-invasive and sophisticated test is regarded as a valuable assessment tool in research and clinical practice. Cardiopulmonary exercise test has been extensively utilized to define the mechanisms of exercise intolerance in various clinical disorders, to evaluate responses to therapy and indicate disease prognosis. Emerging data obtained from the use of the cardiopulmonary exercise testing in the research field, has led to its extensive clinical usage. It is now utilized as an integral part of the patients' clinical evaluation in the field of respiratory and cardiovascular medicine, sports medicine, surgery as well as occupational and rehabilitative medicine. It has a clinical role in assessing patient's functional capacity, monitoring disease progression and response to therapy, predicting prognosis, and perioperative morbidity and mortality, as well as constructing and monitoring training and rehabilitative programs. This article aims to give an overview of the physiological profiles obtained from cardiopulmonary exercise testing, its methodological aspects, as well as its utility in research and clinical practice. KEYWORDS: Cardiopulmonary, exercise, physiology, respiratory medicine, oxygen consumption

Matched MeSH terms: Patient Care
Comparison of stress levels between physicians working in public and private hospitals in Johor, Malaysia

Hafiz A, Ima-Nirwana S, Chin KY

J Taibah Univ Med Sci, 2018 Oct;13(5):491-495.
PMID: 31435368 DOI: 10.1016/j.jtumed.2018.01.004

Objectives: Physicians are known to experience a high level of stress due to the profession itself, as well as due to factors related to the workplace, patient care, and work-life balance. Owing to the nature of public and private hospitals in Malaysia, physicians working in different settings are expected to have different levels of stress. However, there is no study to validate this assumption. The present study aimed to compare stress levels between physicians working in public and private hospitals in the state of Johor, Malaysia.
Methods: Participants were selected via stratified sampling. Participants completed an online questionnaire comprising demographic details and the Health Professional Stress Inventory. Scores on each domain and the aggregate scores were compared between physicians in public and private hospitals using a univariate analysis adjusted for potential confounders.
Results: The overall stress level between physicians in public and private hospitals was similar. However, physicians in private hospitals experienced a higher stress level related to patient care responsibilities and professional uncertainty as compared to those in public hospitals.
Conclusion: Physicians from private hospitals experience stress in different aspects of their profession as compared to physicians in public hospitals, especially with reference to patient care and career uncertainty. Measures should be taken to relieve the stress of physicians and thus improve their wellbeing.

Matched MeSH terms: Patient Care
Nurturing professional identity through a community based education program: medical students experience

Ahmad A, Bahri Yusoff MS, Zahiruddin Wan Mohammad WM, Mat Nor MZ

J Taibah Univ Med Sci, 2018 Apr;13(2):113-122.
PMID: 31435313 DOI: 10.1016/j.jtumed.2017.12.001

Objectives: Community-based education (CBE) has an impact on the types of medical students produced at the end of medical training. However, its impact on professional identity development (PID) has not been clearly understood. This study thus explores the effect of the CBE program on PID.
Methods: A qualitative phenomenological study was conducted on a group of Universiti Sains Malaysia medical students who had finished the Community and Family Case Study (CFCS) program. Data were gathered through focused group discussions and student reflective journals. Participants were sampled using the maximal variation technique of purposive sampling. Three steps of thematic analysis using the Atlasti software were employed to identify categories, subthemes, and themes.
Results: Personal, role, social, and research identities were generated that contribute to the PID of medical students through the CFCS program. The results indicate that the CFCS program nurtured personal identity through the development of professional skills, soft skills, and personal values. Pertaining to role identity, this is related to patient care in terms of primary care and interprofessional awareness. Pertaining to social identity, the obvious feature was community awareness related to culture, society, and politics. A positive outcome of the CFCS program was found to be its fostering of research skills, which is related to the use of epidemiology and research methods.
Conclusion: The findings indicate that the CFCS program promotes PID among medical students. The current data highlight and provide insights into the importance of integrating CBE into medical curricula to prepare future doctors for their entry into the profession.

Matched MeSH terms: Patient Care
Mental Health Status and Its Associated Factors Among Caregivers of Psychiatric Patients in Kuching, Sarawak

Ivan Vun JS, Cheah WL, Helmy H

Malays Fam Physician, 2019;14(2):18-25.
PMID: 31827731

Introduction: Caregivers have a high risk of mental health disorders. The quality of patient care is inseparable from the mental health status of caregivers. The objective of this research was to study the mental health status among caregivers of psychiatric patients and its associated factors.
Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014. The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0.
Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively. The caregiver's age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety. A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337), and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression.
Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary.

Matched MeSH terms: Patient Care
Fulltext Continuity of care of diabetic patients in a family practice clinic: How important is it?

Hanafi NS, Teng CL, Yasin S

Asia Pac Fam Med, 2003;2(1):10-15.

Aim: To assess the importance of continuity of care among diabetic patients attending a primary care clinic and to correlate degree of continuity of care with diabetic control. Methods: A cross sectional survey was carried out among diabetic patients (n = 166) attending follow-up consultations in a family practice clinic of a teaching hospital. Face-to-face interviews were carried out on patients' perception of continuity of care and various aspects related to diabetes. Diabetic control was assessed by glycosylated hemoglobin. Retrospective chart audits of each patient over the previous 28 months were done to assess the degree of continuity of care, measured with the Usual Provider Continuity Index (UPCI). Results: The UPCI ranged from 0.18 to 1.00 with a mean value of 0.60. The average number of visits per patient over the 28-month period was 11.7 visits. The majority of patients saw five different doctors for all their visits. There were no statistically significant associations between the degree of provider continuity with diabetic control (r = 0.054) and diabetic self-care behavior (r = 0.065). The majority of patients (89%) felt that it was important to have a regular doctor. The main reason given was that a regular doctor would know the patient's problems. Conclusions: Continuity of care was highly valued by diabetic patients attending a hospital-based family practice clinic. Even though the degree of continuity was not associated with the degree of diabetic control, patients felt that it was important to have doctors who are aware of their problems.

Matched MeSH terms: Continuity of Patient Care
Fulltext Remission of recalcitrant dermatomyositis following a chiropractic adjustment

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.

Matched MeSH terms: Patient Care Team
Fulltext Programmed cell death-ligand, thymidylate synthase and deleted in colorectal carcinoma biomarkers in colorectal carcinoma

Fauzah Abd Ghani, Reena Rehavu Zin, Maha Abdullah, Norhafizah Mohtarrudin, Ebenyi Emeka Onwe

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):16-16.
MyJurnal

Introduction: It is well known that cancer cells evade the immune system with the help of programmed cell death protein 1 (PD-L1) molecule to remain undetected, causing abnormal proliferation of T-cells. PD-L1 expression on the surface of neoplastic cells inhibits cytotoxic T-cell responses which lead to negative regulation of cytokines and proliferation of T-cells. The deleted in colorectal cancer (DCC) gene belongs to the immunoglobulin superfamily. It is a candidate of the tumour suppressor gene by regulating apoptosis. DCC assessment gives an insight into progno-sis in patients with advanced stages of CRC. Thymidylate synthase (TYMS) is a highly conserved enzyme involved in DNA synthesis. TYMS has been an important target for cancer chemotherapy because of its central, rate-limiting role in de novo synthesis of thymidylate. Expression of PD-L1, TYMS and DCC has been demonstrated to confer a prognostic value in CRC but none have been completely validated for patient care. This study aimed to determine the prognostic and predictive potential of PD-L1, TYMS, and DCC biomarkers in CRC. Methods: The expression of these biomarkers was evaluated immunohistochemically in 91 formalin-fixed paraffin-embedded (FFPE) archival tumour samples from patients that underwent surgical resection. Results: There was high expression of DCC in most cases; 84.6% (77/91). TYMS expression at a high level score was 46.2% (42/91) and at low level was 53.8% (49/91). Majority of cases had low PD-L1 expression in 93.4% (86/91) cases and high expression was detected in 6.6% (6/94) of cases. In addition, there was a significant association between TYMS expression with gender (P < 0.05) with distribution of TYMS expression detected at high level was 76.2% in male and 23.8% in female. The Kaplan-Meier survival plot showed mean overall survival in patients with PD-L1 with high expression to be 22 months, which pre-dicts better survival. TYMS low expression showed mean overall survival of 90 which also indicated better survival. DCC high expression showed mean overall survival of 90 which indicated better survival. The correlation between the biomarkers and overall survival were not statistically significant. Conclusion: The results from this study suggest that PD-L1, TYMS and DCC expression could be used as biomarkers to predict treatment outcome in CRC. PD-L1 overexpression predicts patients who could benefit from anti-PD-1 and anti-PD-L1 immunotherapy whilst TYMS low expression predicts patients who could benefit from 5-fluorouracil therapy. DCC high expression tumours predicts a better prognosis and overall survival compared to DCC-negative tumours in advanced CRC.

Matched MeSH terms: Patient Care
Fulltext Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Sahathevan S, Khor BH, Ng HM, Gafor AHA, Mat Daud ZA, Mafra D, et al.

Nutrients, 2020 Oct 15;12(10).
PMID: 33076282 DOI: 10.3390/nu12103147

Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

Matched MeSH terms: Patient Care
Fulltext Factors associated with strain among informal care providers of patients with traumatic brain injury in Malaysia

Bamatraf AA, AlAmodi AA, Ali MA, Chan CM, Mazlan M, Shareef MA

J Family Med Prim Care, 2020 Jun;9(6):2990-2994.
PMID: 32984161 DOI: 10.4103/jfmpc.jfmpc_247_20

Purpose: This study aims to investigate the level of strain and various influencing factors among informal care providers of traumatic brain injury (TBI) patients.
Methods: A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample t-test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.
Results: A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.
Conclusion: Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.

Matched MeSH terms: Patient Care
Preconception care in adolescents

Sainafat A, Asmawati, Ikhlasiah M, Mat SB, Hassan HC

Enferm Clin, 2020 06;30 Suppl 5:73-76.
PMID: 32713589 DOI: 10.1016/j.enfcli.2019.11.024

Preconception Care is an intervention starting from adolescence until near conception. Preconception Care refers to biomedical interventions and social preventive behaviors which can improve healthy babies and healthy mothers. Interventions carried out during adolescence are more effective in reducing the occurrence of pregnancies untimely, unplanned pregnancies. Preconception Care program has not run optimally so far. The purpose of this literature study is to present the research findings on how Preconception Care interventions in adolescents. The method used is the study of the research findings on Preconception Care published in the last ten years (2009-2019) in national and international reputable literature sources indexed by Scopus, Elsiver, Proquest, Plos One, and Google Scholar database. The keywords of Preconception Care, Adolescent, AKI, and AKB are used to facilitate the search for literature. The results of the study show that Preconception Care has a powerful impact on women's health and is part of Continuum Care, including Preconception Care, Antenatal Care, Intranatal, and Post Natal. Preconception Care in adolescents has a good impact on the preconception period and can reduce maternal mortality (AKI) and infant mortality (AKB), thus, it is necessary to optimize Preconception Care on adolescents.

Matched MeSH terms: Continuity of Patient Care
Fulltext Development and Psychometric Validation of a Questionnaire to Evaluate Knowledge and Attitude Towards Medication Error Reporting Among Pharmacists

Mamat R, Awang SA, Ab Rahman AF

Drug Healthc Patient Saf, 2020;12:95-101.
PMID: 32523381 DOI: 10.2147/DHPS.S249104

Purpose: Assessment of medication errors (ME) is crucial to improving the quality of health care. A questionnaire that can be used to explore pharmacists' perspectives regarding ME would be very useful as part of an ongoing process of quality improvement in patient care. The aim of this study was to develop and validate a questionnaire to measure perceived causes of ME and attitude towards ME reporting among pharmacists.
Methods: The questionnaire was developed from the literature together with outcomes from focus group discussions. It was divided into two domains which are knowledge on ME and attitude towards ME reporting. Content validity index (I-CVI), exploratory factor analysis (EFA), Cronbach alpha and intraclass correlation coefficient (ICC) to assess test-retest reliability were obtained during the validation process.
Results: Overall Cronbach alpha for internal consistency was good (0.742), where subscale of the questionnaire demonstrated adequate internal consistency, with Cronbach alpha value 0.83 for knowledge and 0.70 for reporting behaviour attitude. The I-CVI showed good scores (knowledge=0.88) and (attitude=0.81), while ICC was moderately accepted with a value of 0.77. Two factors were extracted from the 16 items in EFA.
Conclusion: The questionnaire to assess knowledge on ME and attitude towards ME reporting among pharmacists is valid and reliable. It demonstrates good psychometric properties.

Matched MeSH terms: Patient Care
Fulltext 'To be or not to be in the ward': The Impact of Covid-19 on the Role of Hospital-Based Clinical Pharmacists - A Qualitative Study

Cheong MWL

Journal of the American College of Clinical Pharmacy : JACCP, 2020 Aug 12.
PMID: 32838225 DOI: 10.1002/jac5.1315

Introduction: The Coronavirus disease 2019 (COVID-19) pandemic has significantly affected health care systems around the world. In many hospitals and health care facilities, services and health care workers have been reorganized and restructured to meet the demands of the pandemic. The impact of the pandemic on hospital-based clinical pharmacists and their ability to deliver pharmaceutical care is currently unknown.
Objective: This study aimed to explore the impact of the COVID-19 pandemic on hospital-based clinical pharmacists working in Malaysia and the implications on how clinical pharmacy is perceived as a health care service.
Methods: A qualitative study was designed to meet the research objectives. Nineteen hospital-based clinical pharmacists consented and participated in one-on-one, semi-structured interviews. The interviews were transcribed and analyzed using an iterative thematic analysis approach.
Results: The experiences and views of the participants were reported. Three main themes were developed: 'Reassignment and other changes in clinical pharmacist roles', 'Adapting clinical pharmacy services to COVID-19', and 'The need for clinical pharmacists in the ward'. The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment. Despite this, clinical pharmacists continued to support patient care in hospitals through the use of technology. The withdrawal of clinical pharmacy services, however, raises concern that the role of clinical pharmacists is still poorly recognized.
Conclusion: Clinical pharmacists in hospitals continue to support patient care despite the disruption caused by the COVID-19 pandemic. Greater support and recognition of their role is required in order to empower and enhance their ability to deliver pharmaceutical care.This article is protected by copyright. All rights reserved.

Matched MeSH terms: Patient Care
Fulltext The correlation between Environment of Care, patient satisfaction and willingness to recommend in a teaching hospital setting

Ahmad Badruridzwanullah Zun, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Ahmad Sukari Halim

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):7-7.
MyJurnal

Introduction: The Environment of Care (EoC) is less being the highlight as one of the important components in hospi-tal administration. The EoC is the interface between the patient and the organisation and it provides both a practical and safe area in which to provide patient care. The study aims to determine the correlation between the environment of care, patient satisfaction and willingness to recommend. Methods: This was a cross-sectional study conducted in one of the teaching hospitals in Malaysia. A Malay validated Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS) questionnaire was used. The multistage sampling was applied. 13 wards represent medical, surgical and O&G based wards were selected randomly. Systematic random sampling method was used for pa-tient selection. Number of samples for each ward was calculated proportionately based on the average number of discharge patient monthly. The global rating item in HCAHPS was used to determine satisfaction level. Data was collected and analysed using SPSS version 22.0. Results: 547 respondents were involved in the study with 61.6% of them were female. Majority of respondents were young adult less than 60 years old. 36.9% of the respondents had positive experience with cleanliness of the ward meanwhile 26.7% had positive experience with quietness of the ward. 57.6% of the respondents were satisfied with the services and 64.5% were willing to recommend the hos-pital to others. There was a significant correlation between environment of care, satisfaction level and willingness to recommend. Conclusion: The healthcare facility needs to concentrate on creating a positive experience on EoC component as this can influence satisfaction level and willingness to recommend the hospital.

Matched MeSH terms: Patient Care
Fulltext Pharmacist role in global health: a review of literature

Allayla, Tuqa Haitham, Nouri, Ahmed Ibrahim, Hassal, Mohamed Azmi

Malaysian Journal of Pharmaceutical Science, 2018;16(1):45-54.
MyJurnal

Emergence of various global health problems has widened the pharmacist’s job scope. An accessible resource for health and medication information as the pharmacist strengthen the existing public health system. Achievement of optimal patient outcomes involves community and clinical pharmacist safe and effective medication use. However, the public is still unaware of the pharmacist’s role in public and global health. This essay aims to identify pharmacist’s role in overcoming global health problems with a literature review. Pharmacists’ role change from public care provider to public care profession. The roles of pharmacists in health care team as primary care practitioners can be seen in their management of tropical and chronic diseases. With their evaluation skills and extensive knowledge of drugs. Pharmacists can provide the best medical advice to the patients besides promoting selftreatment on minor ailments. Furthermore, they also help in reducing the medical costs and optimising medications for the patients. The faith of the public in pharmacists on vaccination proves that they accept the involvement of pharmacists in healthcare provision. However, the public awareness towards pharmacists’ role should be improved.

Matched MeSH terms: Patient Care Team

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