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The influence of consumers' preferences and perceptions of oral solid dosage forms on their treatment

Ibrahim IR, Ibrahim MI, Al-Haddad MS

Int J Clin Pharm, 2012 Oct;34(5):728-32.
PMID: 22744843 DOI: 10.1007/s11096-012-9667-6

BACKGROUND: Beyond the direct pharmacological effect of medicines, preferences and perceptions toward a particular oral solid dosage form (OSDF) play a crucial role in recovery and may reduce adherence to the prescribed treatment.
OBJECTIVES: This study conducted to investigate the most preferred OSDF and the degree to which swallowing solid medication is an issue, to assess perceptions of the therapeutic benefits of the OSDF, and to find predictors of the most preferred OSDF.
METHOD: A cross-sectional study, through convenience sample method, was conducted to survey consumers visiting community pharmacies in Baghdad, Iraq. Data was collected by self-administered and pre-piloted questionnaires, and analyzed using Statistical Package for Social Science. Multiple logistic regression analysis and Chi-square tests were used at alpha level = 0.05.
RESULTS: A total of 1,000 questionnaire were included in the analysis. Of all respondents, 52.9 % preferred capsule among other OSDF and this preference varied significantly with a number of socio-demographic factors. Ease of swallowing solid medication was the main issue which resulted in preferences for a particular form. A negative perception of the therapeutic benefits of the OSDF was found among 89.1 % of the consumers. Multiple logistic regression analysis indicated that gender, ease of swallowing, and perceptions of the therapeutic benefits of the OSDF were significant predictors of capsule preferences.
CONCLUSIONS: Given the fact that consumers are the end users of medicines and their preferences may influence response to the treatment, efforts are worthwhile by the prescribers and medicines' manufactures to understand consumers' preferences of a particular dosage form in order to achieve successful therapy outcomes.
Fulltext Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia

Oh AL, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A

J Infect Dev Ctries, 2011 May;5(5):338-47.
PMID: 21628809

INTRODUCTION: Public knowledge and attitudes towards antibiotics play a vital role in the success of the treatment process. This study aimed to assess public knowledge and attitudes toward antibiotic usage which could serve as baseline data for future studies within a government hospital setting in Malaysia.
METHODOLOGY: A self-administered cross-sectional survey involving 408 respondents was conducted using a validated questionnaire at an outpatient pharmacy department in Penang Hospital, Malaysia, from February to March 2009.
RESULTS: Nearly 55% of the respondents had a moderate level of knowledge. Three quarters of the respondents (76.7%) could correctly identify that antibiotics are indicated for the treatment of bacterial infections. However, 67.2% incorrectly thought that antibiotics are also used to treat viral infections. About 59.1% of the respondents were aware of antibiotic resistance phenomena in relation to overuse of antibiotics. With regard to attitudes, 38% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 47.3% expected antibiotics to be prescribed for common cold symptoms. Age, race and educational level were among the demographic characteristics significantly associated with knowledge and attitudes toward antibiotic use. Poor level of knowledge was found in less than one-third of the respondents whereas more than one-third of the respondents wrongly self-medicate themselves with antibiotics once they have a cold.
CONCLUSION: Educational interventions are needed to promote prudent use of antibiotics among the public.
Study site: outpatient pharmacy, Hospital Pulau Pinang, Malaysia
Case series of buprenorphine injectors in Kuala Lumpur, Malaysia

Bruce RD, Govindasamy S, Sylla L, Haddad MS, Kamarulzaman A, Altice FL

Am J Drug Alcohol Abuse, 2008;34(4):511-7.
PMID: 18584580 DOI: 10.1080/00952990802122259

Diversion of buprenorphine has been described in settings where it is legally prescribed and has become an increasing concern in Malaysia; it resulted in banning of buprenorphine in Singapore where unsubstantiated case reports suggested that buprenorphine injection was associated with particularly poor outcomes. We therefore conducted a case series of qualitative interviews with buprenorphine injectors in Kuala Lumpur, Malaysia to examine further the issues surrounding buprenorphine injection as well as the abuse of midazolam in combination with buprenorphine. Interviews with 19 men do not suggest significant adverse health consequences from buprenorphine injection alone and injectors have adapted diverted buprenorphine as a treatment modality. A subset of these injectors, however, combined buprenorphine and midazolam for euphoric effects with resultant symptoms of a possible pharmacological interaction. Prospective cohort studies, rather than hospital-derived samples, are needed to better understand the safety of buprenorphine injection.
Social pharmacy as a field of study: the needs and challenges in global pharmacy education

Hassali MA, Shafie AA, Al-Haddad MS, Abduelkarem AR, Ibrahim MI, Palaian S, et al.

Res Social Adm Pharm, 2011 Dec;7(4):415-20.
PMID: 21272536 DOI: 10.1016/j.sapharm.2010.10.003

The practice of pharmacy and, consequently, pharmacy curricula have undergone significant changes over the past years in response to a rapidly changing economic, political, and social environment. Within this context, the pharmacist's role had expanded to include more direct interaction with the public in terms of the provision of health information and advice on the safe and rational use of medications. To carry out these roles effectively, pharmacists need to be well prepared on how to deal with patients' behavior and psychology. The understanding of patient sociobehavioral aspects in the medication use process is paramount to achieving optimal clinical and humanistic outcomes from therapy. The concept of behavioral sciences and health psychology are embedded as the fundamental concepts in the field of social pharmacy, and thus it is imperative that this should be taught and nurtured to future pharmacy practitioners. Based on the growing needs for future pharmacists to be exposed to issues in social pharmacy, many pharmacy schools around the world have adopted this subject to be part of their standard curriculum. In this commentary, a discussion of the needs of social pharmacy courses in pharmacy curriculum will be addressed in the context of both developed and developing countries.
Fulltext Barriers and Facilitators to Implementing Project ECHO in Malaysia During the COVID-19 Pandemic

Walters SM, Li WP, Saifi R, Azwa I, Syed Omar SF, Collier ZK, et al.

J Int Assoc Provid AIDS Care, 2022;21:23259582221128512.
PMID: 36177542 DOI: 10.1177/23259582221128512

Objective: In Malaysia, HIV is concentrated among key populations who experience barriers to care due to stigma and healthcare discrimination. The COVID-19 pandemic has increased barriers to healthcare. Project ECHO (Extension for Community Healthcare Outcomes) is a transformative tele-education strategy that could improve HIV prevention and treatment. Methods: Practicing physicians who were aged 18 years or older and had internet access participated in asynchronous online focus groups. Results: Barriers to Project ECHO were conflicting priorities, time constraints, and technology. Facilitators included content and format, dedicated time, asynchronized flexible programming, incentives, and ensuring technology was available. Conclusion: Project ECHO is a promising intervention that can increase physicians' knowledge and skill set in specialty medicine during the COVID-19 pandemic. Interventionists in Malaysia in particular, but also in general, should consider these barriers and facilitators when developing Project ECHO as they may aid in developing a more robust program and increase participation.
Fulltext "I want the doctors to know that I am as bright as a candle": : Experiences with and Hopes for Doctor Interactions Among Malaysian Key Populations and People Living with HIV

Earnshaw VA, Cox J, Wong PL, Saifi R, Walters S, Azwa I, et al.

AIDS Behav, 2023 Jul;27(7):2103-2112.
PMID: 36472685 DOI: 10.1007/s10461-022-03942-9

Stigma in healthcare settings is a pernicious barrier to HIV prevention and treatment in contexts with strong HIV-related structural stigma. Previous work has documented substantial stigma towards key populations and people living with HIV (PLWH) among Malaysian doctors. The perspectives of Malaysian key populations and PLWH, however, remain understudied. In 2021, 34 Malaysian participants representing key populations and PLWH engaged in a photovoice study designed to qualitatively explore their experiences with and hopes for doctor interactions. Many participants reported stigma from their doctors, perceiving that doctors view them as not normal, sinful, misguided, and incapable. Several emphasized that they wear figurative masks to conceal aspects of themselves from doctors. Yet, many also remain hopeful for constructive relationships with doctors. They want their doctors to know that they are bright, capable, kind, and valuable. Interventions are needed to address stigma among doctors working in contexts with strong structural stigma.
Fulltext Acceptability and Feasibility of Online, Asynchronous Photovoice with Key Populations and People Living with HIV

Earnshaw VA, Cox J, Wong PL, Saifi R, Walters S, Azwa I, et al.

AIDS Behav, 2023 Jul;27(7):2055-2069.
PMID: 36463390 DOI: 10.1007/s10461-022-03938-5

Photovoice is an action-oriented qualitative method involving photography and story-telling. Although photovoice yields a powerful form of data that can be leveraged for research, intervention, and advocacy, it has arguably been underutilized within HIV research. Online, asynchronous photovoice methods represent a promising alternative to traditional in-person methods, yet their acceptability and feasibility with key populations and people living with HIV (PLWH) have yet to be explored. The current study describes the methods and evaluation of an online, asynchronous photovoice project conducted with 34 members of key populations and PLWH in Malaysia in 2021. A HIPAA-compliant website incorporating a series of instructional videos was created to facilitate participant engagement and data collection. Quantitative and qualitative indicators suggest that participants found the project to be highly acceptable and feasible. Online, asynchronous photovoice methods hold potential for increasing the scale of this powerful and versatile qualitative research method with key populations and PLWH.