Displaying publications 1 - 20 of 23 in total

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  1. Cha, Xin Xuan, Tan, Ching Siang, Shashidharan Menon, H. Jaasminerjiit Kaur1, Lee, Kah Seng, Mohamed Mansor Manan, et al.
    MyJurnal
    Introduction: Lipid-modifying drugs have been used to treat dyslipidemia as well as for the primary
    and secondary prevention of CVDs and stroke. Objectives: This study aims to describe the drug
    utilization pattern of lipid-modifying drugs in a private hospital. Method: A retrospective study was
    carried out in outpatient of the selected hospital. Patients were selected based on inclusion and
    exclusion criteria by using convenience sampling. Data were collected through KCIS by retrieving
    patients’ registration number. Defined daily dose (DDD) was calculated and compared to World
    Health Organization DDD. Medicine prices were also analysed. Results: A total of 180 patients’
    record were analysed, 70% of them were male; 40.6% of the patients were from the age range of 50
    to 59 years old; ethnicity breakdown was Malay (69.4%), Indian (18.3%) and Chinese (12.2%).
    Among all lipid-modifying drugs, utilization of statins was the highest as statins are the preferred
    line in the treatment of dyslipidemia. Innovator brands were more preferred where most of the lipidmodifying
    drugs used in the selected hospital are innovator brand drugs. In terms of cost, lipidmodifying
    drugs contributes to about 27% of the total cost of prescription in average. Conclusion:
    The utilization of all lipid-modifying drugs in the selected hospital was lower as compared to WHO
    DDD. As compared to combination therapy, monotherapy with atorvastatin was generally preferred
    in the selected hospital. The utilization of atorvastatin was found to be the highest in the OPD of the
    selected hospital.
  2. Teo, Carolyn Ai Li, Mohd Idzham Zainal, Francis, Jessica Olivia, Lee, Kah Seng, Lee, Kristine Sheh Fuen, Liew, Jerry Ee Siung
    MyJurnal
    Widespread over-prescription of proton pump inhibitors (PPIs) without an appropriate indication has financial and potentially adverse clinical consequences.
  3. Lee, Kah Seng, Muthu Kumar Murugiah, Mohammad Aswady Adenan, Tahir Mehmood Khan, Neoh , Chin Fen, Yaman Walid Kassab, et al.
    MyJurnal
    Dikir Farmasi (DF) is a new effort to expand and intensify the dissemination of information about
    the regulation of the legitimate use of drugs and cosmetics. This study was aimed to explore the
    opinions of Pharmacy Enforcement Division staff and the general public regarding the quality and
    impact of DF program as a health promotion tool in Malaysia. A qualitative study using semistructured
    interviews and focus group discussions (FGDs) were conducted at the Pharmacy
    Enforcement Department and three health clinics located at the city of Kota Bharu, Malaysia. The
    interviews were audio recorded, translated and transcribed. Thematic analysis was performed to
    identify the themes and sub-themes of the transcripts. Ethical approval was obtained from Ministry
    of Health Malaysia. All respondents provided a written consent for participation. Nine pharmacy
    officers and 23 general public participated in this study. Five main themes emerged from the
    information gathered and analyzed: 1) language; 2) design; 3) content and delivery 4) costs and
    benefits and 5) prospect of DF. Certain weaknesses of DF have been raised and the health authorities
    could utilize this information for an improvement. Significant effort must be made to improve the
    publicity and dissemination of DF to ensure that it reaches the target population. Certain weaknesses
    of DF have been raised and the health authorities could utilize this information for an improvement.
    Significant effort must be made to improve the publicity and dissemination of DF to ensure that it
    reaches the target population.
  4. Puvithra Ravi Sundram, Tan, Ching Siang, Shashidharan Menon, H. Jaasminerjiit Kaur, Abdullah Khan, Anandarajagopal Kalusalingam, et al.
    MyJurnal
    Anti-peptic ulcer drugs (APUDs) such as proton pump inhibitors (PPI), H2 receptor antagonists (H2A), antacids are widely prescribed. This study is aimed to describe the utilisation pattern of APUDs based on WHO Defined Daily Dose (DDD) and identify most commonly used APUD in the selected hospital. A retrospective study was carried out in outpatient of the selected hospital for year 2017. Sample size was calculated using Raosoft. DDD of APUDs and direct drug cost were calculated. Data were collected through electronic medical record by retrieving patients’ registration number. Inclusion criteria were patients above 18 years old and APUDs prescribed for gastrointestinal related indications. A total of 160 prescriptions were randomly selected for data analysis. Based on the DDD calculated, Rabeprazole 20mg was most prescribed drug among PPI (n=33), while Maalox is most prescribed drug among the antacids (n=23). Based on the DDD calculated, Pantoprazole 20mg recorded highest rates per user per day about 1.26 DDD / user / day while antacids, Actal reported highest usage rate with 7.11 DDD / user / day. Besides, there are 5.4 days supplied per user for this drug. Dexlansoprazole 60mg is the most expensive drug among all the PPI listed in hospital formulary. It has 18.5 days supplied/user, which is the second shortest duration of treatment among all the other PPIs. In contrast, omeprazole 20mg is the lowest cost PPI but the duration supplied per user is longer resulting in higher total cost of therapy. In conclusion, PPIs were the most commonly prescribed.
  5. Lee KS, Lim YW, Ming LC
    PMID: 27688885 DOI: 10.1186/s40545-016-0081-7
    The proposed Pharmacy Bill of Malaysia which served to consolidate and harmonise the existing pharmacy legislation which has been used for more than 60 years. This new Pharmacy Bill contains 17 parts and a total of 170 legislative sections covering laws governing pharmacy practice, medicinal products classification, registration, sale, supply, licensing etc. Our article could serve as a case study on pharmacy jurisprudence and drug regulation as well as the governance for medicines.
  6. Ong SG, Ming LC, Lee KS, Yuen KH
    Pharmaceutics, 2016;8(3).
    PMID: 27571096 DOI: 10.3390/pharmaceutics8030025
    The objective of the present study was to investigate the influence of the encapsulation efficiency and size of liposome on the oral bioavailability of griseofulvin-loaded liposomes. Griseofulvin-loaded liposomes with desired characteristics were prepared from pro-liposome using various techniques. To study the effect of encapsulation efficiency, three preparations of griseofulvin, namely, griseofulvin aqueous suspension and two griseofulvin-loaded liposomes with different amounts of griseofulvin encapsulated [i.e., F1 (32%) and F2(98%)], were administered to rats. On the other hand, to study the effect of liposome size, the rats were given three different griseofulvin-loaded liposomes of various sizes, generated via different mechanical dispersion techniques [i.e., FTS (142 nm), MS (357 nm) and NS (813 nm)], but with essentially similar encapsulation efficiencies (about 93%). Results indicated that the extent of bioavailability of griseofulvin was improved 1.7-2.0 times when given in the form of liposomes (F1) compared to griseofulvin suspension. Besides that, there was an approximately two-fold enhancement of the extent of bioavailability following administration of griseofulvin-loaded liposomes with higher encapsulation efficiency (F2), compared to those of F1. Also, the results showed that the extent of bioavailability of liposomal formulations with smaller sizes were higher by approximately three times compared to liposomal formulation of a larger size. Nevertheless, a further size reduction of griseofulvin-loaded liposome (≤400 nm) did not promote the uptake or bioavailability of griseofulvin. In conclusion, high drug encapsulation efficiency and small liposome size could enhance the oral bioavailability of griseofulvin-loaded liposomes and therefore these two parameters deserve careful consideration during formulation.
  7. Ming LC, Hussain Z, Yeoh SF, Koh D, Lee KS
    Global Health, 2020 07 16;16(1):63.
    PMID: 32677974 DOI: 10.1186/s12992-020-00594-z
    The World Health Organisation Western Pacific Region countries were declared free of polio in 2000 until a polio outbreak involving 305 cases occurred in Indonesia in 2006. It was not until 2014 that the World Health Organisation South East Asia region was officially declared polio-free again. However, in February 2019, the Global Polio Eradication Initiative announced a new circulating vaccine-derived poliovirus outbreak in the Papua province of Indonesia. To make matter worse, the outbreak responses were tardy and led to transmission among migrating communities to other cities. The pressing regional issues of polio outbreak caused by circulating vaccine-derived poliovirus and use of oral polio vaccine have not been well presented. Our letter highlighted the suboptimal outbreak responses as well as the necessity of cross-border vaccination to curb continued poliovirus transmission.
  8. Ting CY, Abd Wahab MS, Lee KS, Tan RT, Ming LC
    Ther Innov Regul Sci, 2017 Mar;51(2):212-220.
    PMID: 30231729 DOI: 10.1177/2168479016674041
    BACKGROUND: Because of the large size of Sarawak and the high proportion of people residing in rural areas in this Malaysian state, disseminating drug-related information there can be challenging. It is, therefore, important to recognize the type of mass media for drug-related information that are salient to the people of Sarawak. This study was aimed at identifying the use of and the preferences for mass media to obtain drug-related information among the public in Sarawak. We also aimed to recognize the media perceived as the most reliable for drug-related information.

    METHODS: This was a cross-sectional study using a self-administered questionnaire carried out from September to October 2013. Survey respondents were recruited from 4 divisions in Sarawak: Kuching, Sibu, Miri, and Bintulu.

    RESULTS: A total of 433 completed questionnaires were obtained at the end of the study period. All respondents had access to common mass media such as television (89.8%, 389/433), radio (68.6%, 297/433), and the Internet (66.1%, 286/433). Among all respondents, television (71.4%, 309/433) was noted as the most preferred media for drug-related information. Compared with rural respondents, urban respondents were significantly more likely to have access to and prefer the Internet to obtain drug-related information. On the other hand, rural respondents were more likely to have access to and prefer radio for such information compared to their urban counterparts.

    CONCLUSIONS: Television can be an important and attractive choice of mass media in a quality use of medicines (QUM) campaign. The Internet can be used to disseminate drug-related information in urban areas, whereas radio can be used in a QUM campaign targeting the rural public.

  9. Yap YY, Wong CP, Lee KS, Ming LC, Khan TM
    Ther Innov Regul Sci, 2017 Jul;51(4):446-459.
    PMID: 30227055 DOI: 10.1177/2168479017697253
    This article aims to discuss the main consequences of the implementation of the Trans-Pacific Partnership Agreement (TTPA) in the pharmaceutical sector in regard to public health, focusing on the accessibility and affordability of medicines. This paper also looks at the likely impact of the TPP agreement on access to affordable medicines. The potential effects of provisions in the final text are explored based on the context of developed and developing countries. A meta-synthesis study design was used. The thematic analysis technique was used to generate themes and a decision tree of the TTPA meta-synthesis. PubMed, EBSCOhost, Ovid, and Scopus databases from inception until the first week of January 2016 were used. Only peer-reviewed journals that discussed TPPA's impact on the pharmaceutical sector were included. Data were extracted by 2 reviewers and then verified by 3 senior researchers. The extracted data were imported into Excel spreadsheets and coded line by line. Codes were organized into descriptive themes. The identified themes were cross-checked against original articles to ensure consistency. A total of 85 full articles and reports were reviewed and, finally, 32 of them were used in the meta-synthesis. Two central themes to the TTPA emerged: intellectual property rights and transparency. Five subthemes were identified under intellectual property rights: patent subject matter (representing scope of patentability), patent term adjustment for patent office delays (representing patent term extension), protection of undisclosed test or other data (representing data exclusivity), protection of undisclosed test or other data (representing patent linkage), and compulsory licensing. Meanwhile, transparency and anti-corruption-procedural fairness, which presents restriction of coverage program and reimbursement, were identified as the subthemes of transparency. Findings indicate that the TPPA could potentially hinder the affordability and accessibility of medicine, which could increase risks to public health.
  10. Juperi RNAA, Goh HP, Rehman IU, Lee KS, Ming LC, Hermansyah A
    J Pharm Policy Pract, 2023 Aug 24;16(1):101.
    PMID: 37620839 DOI: 10.1186/s40545-023-00594-5
    BACKGROUND: Pharmacy medicine (P) is obtained exclusively from a pharmacy under the supervision of a pharmacist. This study aims to understand the perception of healthcare professionals towards the dispensing separation, as well as the dispensing of pharmacy medicine by community pharmacies to enhance patient health outcomes in Brunei Darussalam.

    METHODS: A cross-sectional study was conducted between 1st March 2023 and 20th April 2023 among healthcare professionals. A newly designed and validated questionnaire was used. Its face and content validity, along with internal consistency, was adequately established. Convenient sampling was employed to recruit participants for the study. Statistical analysis using one-way ANOVA was performed, considering a p-value 

  11. Bahri S, Lee KS, Adenan MA, Murugiah MK, Khan TM, Neoh CF, et al.
    Arts Health, 2016 Sep 01;8(3):272-278.
    PMID: 27695527
    In an effort to enhance public awareness, we develop Dikir Farmasi as an innovative approach to deliver health information. Dikir Farmasi combines the elements of dikir barat (a type of traditional folk song rhythm) and traditional sketches which are popular in the state of Kelantan, Malaysia. These sketches and dikir barat rhythmic songs, with lyrics touch on issues such as drug abuse and regulation are presented in an entertaining and humorous way. Health promotion messages are disseminated using Dikir Farmasi in the form of compact disks, video compact disks, stage performance, exhibition, social media, printed media (signboard, brochure and flyer).
  12. Bahrin AA, Moshawih S, Dhaliwal JS, Kanakal MM, Khan A, Lee KS, et al.
    Biomed Pharmacother, 2022 Feb;146:112568.
    PMID: 34963086 DOI: 10.1016/j.biopha.2021.112568
    Plums is one of the most cultivated stone fruits due to its fast growing popularity. It has various traditionally recognized health benefits. There are two main commercial types of plums: the European plum (Prunus domestica) and the Japanese plum (Prunus salicina), each having many varieties. Researchers are gathering further evidence of pharmacological effects for plums by scientifically studying its anti-inflammatory, antioxidant properties. A systematic review analysing the literature related to the effects of plums on prevention and treatment of cancer is warranted. This is the first review examining the cancer-related effects of plums. Antioxidation properties of the active constituents of plum were also compared. Scopus, Google Scholar, PubMed, Medxriv and Cochrane Library databases, from their date of inception until July 2021 were utilized. The risk of bias was assessed using CONSORT checklist. A total of 6639 studies were screened and eventually only 54 studies were included. Full-text review of included studies revealed that plum extracts were rich in antioxidants. Overall, most of the studies that fulfilled the eligibility criteria were in vitro and a few clinical studies involving in vivo work. Therefore, it would be beneficial to perform more studies on animals or humans, to confirm that the result obtained from these in vitro studies are able to be extrapolated in a wider range of applications. Further clinical and in vivo studies are warranted to validate plums as a functional food for treatment and prevention of cancer.
  13. Abdul Nasir HH, Goh HP, Wee DVT, Goh KW, Lee KS, Hermansyah A, et al.
    Int J Environ Res Public Health, 2022 Sep 09;19(18).
    PMID: 36141623 DOI: 10.3390/ijerph191811350
    BACKGROUND: Medication wastage is causing a cost burden to the healthcare system that is worth millions of dollars. An economic and ecological friendly intervention such as using a patient's own medications (POM) has proven to reduce wastage and save the cost spent by the hospital. The potential benefits of using POM in inpatient settings have yet to be explored in a country with universal health coverage. This study aimed to pilot test the POM intervention in an adult ward setting and to perform the economic analysis of using POM and ward stock during hospitalization.

    METHODS: A prospective cross-sectional observational study was conducted among the patients admitted to the medical and surgical wards in a public hospital located in Brunei Darussalam between February 2022 and April 2022. Hospitalized adults above 18 years old with regular medications with a minimum length of stay of 48 h and a maximum length of stay of 21 days were included in the study. These eligible patients were divided into a POM group and a non-POM group. The economic analysis of using POM was performed by calculating the direct cost per unit of medication used during admission (from unit-use, ward stock and POM) and comparing the cost spent for both groups. Expired ward stock deemed as medication wastage was determined. Medical research ethics were approved, and all participating patients had given their written informed consent before enrolling in this study.

    RESULTS: A total of 112 patients aged 63.2 ± 15.8 years participated in this study. The average cost of medication supplied by the inpatient pharmacy for the non-POM group was USD 21.60 ± 34.20 per patient, whereas, for the POM group, it was approximately USD 13.00 ± 18.30 per patient, with a mean difference of USD 8.60 ± 5.17 per patient (95% CI: -3.95, 27.47, p ≥ 0.05). The use of POM minimized 54.03% (USD 625.04) of the total cost spent by the hospital for the POM group within the period of the study.

    CONCLUSION: The pilot study showed that the supplied medication cost per patient was not significantly different between the POM and non-POM groups. Nevertheless, the utilization of POM during hospitalization is capable of reducing at least 50% of the total cost spent on inpatient medications by the hospital. The use of POM during hospitalization also helped in reducing the total time spent on the medication process per patient.

  14. Salmasi S, Lee KS, Ming LC, Neoh CF, Elrggal ME, Babar ZD, et al.
    BMC Cancer, 2017 12 28;17(1):903.
    PMID: 29282008 DOI: 10.1186/s12885-017-3888-y
    BACKGROUND: Globally, cancer is one of the leading causes of mortality. High treatment cost, partly owing to higher prices of anti-cancer drugs, presents a significant burden on patients and healthcare systems. The aim of the present study was to survey and compare retail prices of anti-cancer drugs between high, middle and low income countries in the South-East Asia, Western Pacific and Eastern Mediterranean regions.

    METHODS: Cross-sectional survey design was used for the present study. Pricing data from ten counties including one from South-East Asia, two from Western Pacific and seven from Eastern Mediterranean regions were used in this study. Purchasing power parity (PPP)-adjusted mean unit prices for 26 anti-cancer drug presentations (similar pharmaceutical form, strength, and pack size) were used to compare prices of anti-cancer drugs across three regions. A structured form was used to extract relevant data. Data were entered and analysed using Microsoft Excel®.

    RESULTS: Overall, Taiwan had the lowest mean unit prices while Oman had the highest prices. Six (23.1%) and nine (34.6%) drug presentations had a mean unit price below US$100 and between US$100 and US$500 respectively. Eight drug presentations (30.7%) had a mean unit price of more than US$1000 including cabazitaxel with a mean unit price of $17,304.9/vial. There was a direct relationship between income category of the countries and their mean unit price; low-income countries had lower mean unit prices. The average PPP-adjusted unit prices for countries based on their income level were as follows: low middle-income countries (LMICs): US$814.07; high middle income countries (HMICs): US$1150.63; and high income countries (HICs): US$1148.19.

    CONCLUSIONS: There is a great variation in pricing of anticancer drugs in selected countires and within their respective regions. These findings will allow policy makers to compare prices of anti-cancer agents with neighbouring countries and develop policies to ensure accessibility and affordability of anti-cancer drugs.

  15. Izadi E, Afshan G, Patel RP, Rao VM, Liew KB, Meor Mohd Affandi MMR, et al.
    Front Pharmacol, 2019;10:881.
    PMID: 31474853 DOI: 10.3389/fphar.2019.00881
    Counterfeit and substandard medicines are recognized as one of serious threats to public health. The product quality of antibacterial medicine will compromise patients' recovery and increase the chance of antibacterial resistance. The review aims to provide a summary of low quality levofloxacin issues and the risk factors as well as suggesting the aspects of product quality that need to be regulated strictly. Quality of the active ingredient, levofloxacin, has an important role to contribute to successful therapy. The poor quality of raw material, directly and indirectly, causes treatment failure as the presence of insufficient dose, mislabeled content, and poor dissolution characteristics can lead to lower bioavailability. Identifying and reporting these factors can potentially help in improving the quality of drug marketed in various developing countries and may also reduce the incidences of treatment failure. Dissolution test is used for testing the dissolution profiles and the rate of drug release from solid formulation such as oral formulations, thus providing information regarding the in vivo performance of a formulation and its bioequivalence. On the other hand, quality-testing procedures are used for comparing the quality of products.
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