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  1. Fulltext Analgesic Dosing Behaviours in Patients with Chronic, Non-Cancer Pain: Does it Affect the Pain Control?
    Mohamad Akmal Bin Harun, Nurul Fateeha Binti Ahmad, Cheah, Huey Miin
    Malaysian Journal of Pharmacy, 2021;7(1):28-33.
    MyJurnal
    Chronic pain has a significant impact on sufferers’ quality of life. Furthermore, treatment inadequacies are often reported in the literatures. This study aims to investigate the prevalence of the different dosing behaviors in analgesics use in chronic, non-cancer pain and their correlation to pain control. This is a cross-sectional study and a convenience sampling method was applied. Brief Pain Inventory- Short Form and Pain Management Index was computed to assess pain control. Statistical analysis was performed with Pearson chi-square test and alpha value was set at 0.05. A total of 127 patients were analyzed. 70.9% of the patients reported inadequate pain control with their prescribed analgesic(s). 88.2% patients only took oral analgesics whenever they felt the pain while 11.8% patients took around-the-clock despite the absence of pain. Among them, 11.8-34.7% of patients did not follow their prescriber’s instruction for oral and topical analgesic use respectively. However, no statistically significant result was found between the dosing behaviors and pain control (p>0.95). It was also reported that 98% of patients were not aware of the maximum daily dose of their prescribed analgesic(s). The prevalence of ‘as needed’ dosing is higher than around-the-clock dosing in the management of chronic, non-cancer pain, with deviation from the prescribed instructions between 11.8-34.7%. However, those differences were not significantly associated with the pain control.
  2. Power of 1 Malaysian Ringgit: A Low-Cost Prescription Cost-Sharing Model in Malaysia
    Kwong KS, Choo YW, Cheah HM
    Value Health Reg Issues, 2020 May;21:245-251.
    PMID: 32353759 DOI: 10.1016/j.vhri.2019.12.002
    OBJECTIVES: To calculate the total revenue under a hypothetical 1 Malaysian Ringgit (MYR) prescription cost sharing model in government healthcare facilities in Pahang, Malaysia.

    METHODS: A cross-sectional study was conducted at outpatient pharmacy in all government healthcare facilities in Pahang from year 2013 to 2017. Each dispensed medication was calculated as 1 MYR and contributed to the total revenue.

    RESULTS: A total of 11 hospitals and 81 health clinics were recruited into the study. A hospital could generate 0.311 million MYR per year, and a district health department could generate 0.623 million MYR per year, giving a total of 10.268 million MYR revenue every year in Pahang, Malaysia. Under the prescription medicines cost sharing scheme, it was shown that an average of 9.4% of the total pharmaceutical spending could be recovered. The recovery percentage was approximately fourfold higher in health clinics (16.5%-21.7%) when compared with that in hospitals (4.3%-5.2%).

    CONCLUSION: An estimated 10 million MYR or 10% from the total Ministry of Health pharmaceutical spending could be collected under the proposed 1 MYR prescription cost sharing model.

  3. Multidisciplinary education approach to optimize phosphate control among hemodialysis patients
    Chan MW, Cheah HM, Mohd Padzil MB
    Int J Clin Pharm, 2019 Oct;41(5):1282-1289.
    PMID: 31302884 DOI: 10.1007/s11096-019-00878-4
    Background Hyperphosphatemia is a common consequence in end stage renal disease. It is associated with increased cardiovascular risk and mortality, also development of hyperparathyroidism and mineral bone disease. A patient educational program involving physician, pharmacist and dietician was developed to manage hyperphosphatemia among hemodialysis patients. Objective To investigate the efficacy of the program in optimal phosphate control among hemodialysis patients. Setting Kuala Lipis Hospital, Malaysia. Method This was a non-randomized, single-arm community trial running for a period of 6 months. The program consisted of a small group seminar and individual counseling sessions. Two individual counseling sessions were conducted for each patient, focusing on diet and medication adherence, by an accredited dietician and pharmacist respectively. The group seminar was delivered by a multidisciplinary team involving a physician, pharmacist and dietician. Topics included basic knowledge of hyperphosphatemia, phosphate binder and dietary phosphate control. Eligible and consented patients had knowledge and medication adherence assessment, measurement of pre-dialysis serum calcium, albumin, phosphate, haemoglobin and alkaline phosphatase before and after the educational program. Main outcome measure Phosphate level, knowledge and medication adherence assessment. Results Fifty-seven patients completed the program and were included into final data analysis. The median (IQR) phosphate level (mmol/L) was 1.86 (1.45-2.24) before and decreased to 1.47 (1.21-1.91) and 1.49 (1.28-1.81) 3 months and 6 months after PEP (p 
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