Methods: A cross-sectional study using a validated 20-item questionnaire was conducted among physicians (n=78) and clinical pharmacists (n=45) working in the medical wards of two tertiary hospitals in Malaysia. Knowledge was assessed by six clinical vignettes which were developed based on Beers criteria and the STOPP/START criteria. Other domains of the study were investigated using a four-point or five-point Likert scale.
Results: Of the 82 participants who completed the questionnaire, 65% were physicians, 90.2% had never received training in geriatric medicine, and 70.8% estimated that 25% or more of their patients were elderly. Only six participants (7.3%) had ever used STOPP/START or Beers criteria when prescribing for elderly patients, and 60% of the respondents had never heard of either one of those criteria. The mean score (SD) for the knowledge part was 3.65 (1.46) points, and only 27 participants (22.9%) scored more than four out of a possible six points. Overall, 34% of the participants rated themselves as confident in prescribing for elderly patients, and this was significantly associated with their knowledge score (P=0.02). The mean number (SD) of barriers cited per participant was 6.88 (2.84), with polypharmacy being the most cited barrier.
Conclusions: The majority of the participants had inadequate knowledge and low confidence regarding recommending medications for elderly patients. Continuing education on geriatric pharmacotherapy may be of value for the hospital physicians and pharmacists.
METHODS: We observed 70 SUs and 148 DUs for 52 weeks and tested their exhaled carbon monoxide and saliva cotinine to confirm their complete nicotine cessation status through cotinine in saliva. Safety issues were to be identified through self-report. Smoking cessation, CCs reduction of ≥ 50%, and relapsed to CCs smoking and safety issues were also documented.
RESULTS: The nicotine cessation rate was higher in SUs then DUs (15.9% vs. 6.8%; P = 0.048; 95% CI (2.328-0.902). A similar result for smoking cessation (34.8% SUs vs. 17.1% DUs; P = 0.005; 95% CI: 2.031-0.787), whereas CCs ≥ 50% reduction was 23.3% DUs vs 21.7% SUs (P = 0.863; 95% CI :1.020-0.964). Relapse to CC smoking was 47.3% in DUs versus 30.4% in SUs (P = 0.026; 95% CI: 1.555-0.757). The adverse effects reported were coughing and breathing problems, whereas craving smoking was documented as a major withdrawal symptom. Smoking-related diseases were also identified, five in DUs and two in SUs, during the one-year study period.
CONCLUSIONS: Study showed SUs achieved higher complete nicotine and smoking cessation rates as compared to DUs. However, the rates of reduced CC use were not different between both the groups. No serious adverse effects related to the sole use of ECs were detected. However, the safety of the sole use of ECs in absolute terms needs to be further validated in different populations.
METHODS: A cross-sectional survey was conducted via a validated 49-item questionnaire, administered immediately after all students completed the examination. The questionnaire comprised of questions to evaluate the content and structure of the examination, perception of OSCE validity and reliability, and rating of OSCE in relation to other assessment methods. Open-ended follow-up questions were included to generate qualitative data.
RESULTS: Over 80% of the students found the OSCE to be helpful in highlighting areas of weaknesses in their clinical competencies. Seventy-eight percent agreed that it was comprehensive and 66% believed it was fair. About 46% felt that the 15 minutes allocated per station was inadequate. Most importantly, about half of the students raised concerns that personality, ethnicity, and/or gender, as well as interpatient and inter-assessor variability were potential sources of bias that could affect their scores. However, an overwhelming proportion of the students (90%) agreed that the OSCE provided a useful and practical learning experience.
CONCLUSIONS: Students' perceptions and acceptance of the new method of assessment were positive. The survey further highlighted for future refinement the strengths and weaknesses associated with the development and implementation of an OSCE in the International Islamic University Malaysia's pharmacy curriculum.
METHODS: As a quasi-experimental design with a control group and pre-tests., we examined 1,598 medical records of T2DM subjects in six healthcare facilities in the state of Pahang, Malaysia. In all study sites, there was a pre and post-intervention assessment of the percentage of appropriate statin therapy prescribing that complied with the clinical guidelines with no potential safety issues. The intervention was an academic detailing program offered to the health care providers in three study sites, while the other three sites served as the control group. A comparison of the overall percentage of appropriate statin therapy prescribing before and after the academic detailing was performed in all intervention and control sites.
RESULTS: Overall, 797 medical records were examined in the pre-intervention phase, and 801 records were evaluated in the post-intervention phase. The academic detailing program was associated with a statistically significant difference in the proportion of appropriate statin therapy prescribing between the post-intervention phase compared to the pre-intervention phase (n = 246, 61.7% versus n = 188, 47.1%), p = 0.001. Whereas, the appropriate statin therapy prescribing in the control study sites experienced a modest change from 53.8% (214/398) to 56.7% (228/402), p = 0.220. The academic detailing showed significant increases in the proportions of appropriate statin therapy prescribing in both hospital and primary care settings.
CONCLUSIONS: The academic detailing program was found to be significantly associated with a positive impact on the overall statin therapy prescribing among patients with T2DM in Malaysian hospital and primary care settings.
METHODS: This is a cross-sectional study that took place in a Malaysian tertiary hospital. Patients ≥ 65 years old with at least one medication on admission were recruited. The patients' prehospitalization medications were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. HRQoL was assessed using the EuroQol-5 dimensions (EQ-5D) and EuroQol-visual analog scale (EQ-VAS). The association between the presence of PIM/PPO and the patients' HRQoL was analyzed using Chi-square and Mann-Whitney U tests. Multiple linear regression models were applied to determine the effect of exposure to PIM/PPO on the patients' HRQoL, adjusting for confounders.
RESULTS: Out of 517 patients who fulfilled the inclusion criteria, 502 patients (97%) accepted to be involved in the study and completed the HRQoL questionnaire. The mean (SD) age was 72.4 (5.9) years. 393 (78.3%) of the patients had problems in at least one EQ-5D dimension with pain/discomfort problem being the most reported complaint. The mean (SD) values of the EQ-5D index and the EQ-VAS were 0.734 (0.214) and 59.6 (14.2), respectively, which are lower than those seen in the general Malaysian population. PIM and PPO were found in 28.5% and 45.6% of the patients, respectively. No significant differences were found in the EQ-5D dimensions, EQ-5D index and EQ-VAS between patients who had PIM/PPO and those who did not. Age, sex, and comorbidities were significantly associated with the patients' HRQoL.
CONCLUSION: PIM and PPO are not uncommon among hospitalized elderly patients; however, it does not significantly affect their HRQoL as measured by the EQ-5D-3L instrument.
Methods: This is a before-and-after study that took place in a tertiary Malaysian hospital. Discharge medications of patients ≥65 years old were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. The prevalence and pattern of PIM/PPO before and after the intervention were compared. The intervention targeted the physicians and clinical pharmacists and it consisted of academic detailing and a newly developed smartphone application (app).
Results: The study involved 240 patients before (control group) and 240 patients after the intervention. The prevalence of PIM was 22% and 27% before and after the intervention, respectively (P = 0.213). The prevalence of PPO in the intervention group was significantly lower than that in the control group (42% Vs. 53.3%); P = 0.014. This difference remained statistically significant after controlling for other variables (P = 0.015). The intervention was effective in reducing the two most common PPOs; the omission of vitamin D supplements in patients with a history of falls (P = 0.001) and the omission of angiotensin converting enzyme inhibitor in patients with coronary artery disease (P = 0.03).
Conclusions: The smartphone app coupled with academic detailing was effective in reducing the prevalence of PPO at discharge. However, it did not significantly affect the prevalence or pattern of PIM.
Aims: This study aimed to explore the general public's perception toward electronic cigarette use. Public support toward electronic cigarette regulation was also examined.
Settings and Design: This was a Malaysian population-based survey.
Materials and Methods: Data were obtained from the National E-Cigarette Survey (NECS) 2016, which used a multistage stratified cluster sampling household survey representing all Malaysian adults aged 18 years old. A cross-sectional survey was conducted among a total of 4288 adults.
Statistical Analysis Used: Descriptive and logistic regression analysis.
Results: Majority were aged 25-44 years old (44%), completed at least secondary education (69%), of Malay ethnicity (73%), and married (68%). Majority (88.1%) have never used electronic cigarette. A quarter (25.5%) perceived electronic cigarette helps people quit cigarette smoking, whereas 20.3% perceived electronic cigarette helps people to maintain cigarette abstinence. Approximately 85% believed that electronic cigarette use does not help in improving breathing and coughing. Majority (91.8%) disagreed that electronic cigarettes should be allowed in places where tobacco smoking is banned. Thus, 63.4% agreed that electronic cigarette should be banned completely rather than regulated.
Conclusion: Majority of general public had negative perception about electronic cigarette use.
METHODS: A cross-sectional study was conducted among Malaysian CPs from April to June 2021. A validated online questionnaire was distributed through social media, instant messaging, email, and pharmacy societies.
RESULTS: Of 492 CPs recruited throughout Malaysia, 439 (89.2%) expressed willingness to provide vaccination services to the public, 403 (81.9%) agreed with the accessibility of community pharmacies to the public, and 73.4% agreed that their role in vaccination could help to improve the overall vaccination coverage rate. The lack of pharmacist training in vaccination and concerns on maintaining patient safety were identified as barriers to CPs' implementation of vaccination services, with 52.8% and 47.8% of them agreeing, respectively. Training sessions and operational guidelines on providing vaccination services are required to overcome the barriers.
CONCLUSION: CPs in Malaysia were ready and willing to provide vaccination services to the public. However, the implementation demands training workshops and re-evaluation of CPs in public vaccination programmes by Malaysian healthcare policymakers.
DESIGN: A 13-station OSCE was designed and implemented in the 2007-2008 academic year as part of the assessment methods for a clinical pharmacy course. The broad competencies tested in the OSCE included: patient counseling and communication, clinical pharmacokinetics (CPK), identification and resolution of drug-related problems (DRPs), and literature evaluation/drug information provision.
ASSESSMENT: Immediately after all students completed the OSCE, a questionnaire containing items on the clarity of written instructions, difficulty of the tasks, perceived degree of learning gained and needed, and the suitability of the references or literature resources provided was administered. More than 70% of the students felt that a higher degree of learning was needed to accomplish the tasks at the 2 DRP stations and 2 CPK stations and the majority felt the written instructions provided at the phenytoin CPK station were difficult to understand. Although about 60% of the students rated OSCE as a difficult form of assessment, 75% said it should be used more and 81% perceived they learned a lot from it.
CONCLUSION: Although most students felt that the OSCE accurately assessed their skills, a majority felt the tasks required in some stations required a higher degree of learning than they had achieved. This may indicate deficiencies in the students' learning abilities, the course curriculum, or the OSCE station design. Future efforts should include providing clearer instructions at OSCE stations and balancing the complexity of the competencies assessed.
OBJECTIVE: To examine the relationships between health-related quality of life (HRQoL) scores with the stages of change of adequate physical activity and fruit and vegetables intake.
DESIGN: This was a cross-sectional study conducted among employees of the main campus and Engineering campus of Universiti Sains Malaysia (USM) during October 2009 and March 2010.
MAIN VARIABLES STUDIED: Data on physical activity and fruit and vegetable intake was collected using the WHO STEPS instrument for chronic disease risk factors surveillance. The Short Form-12 health survey (SF-12) was used to gather information on participants' HRQoL. The current stages of change are measured using the measures developed by the Pro-Change Behaviour Systems Incorporation.
STATISTICAL ANALYSIS: One way ANOVA and its non-parametric equivalent Kruskal-Wallis were used to compare the differences between SF-12 scores with the stages of change.
RESULTS: A total of 144 employees were included in this analysis. A large proportion of the participants reported inadequate fruits and vegetable intake (92.3%) and physical activity (84.6%). Mean physical and mental component scores of SF-12 were 50.39 (SD = 7.69) and 49.73 (SD = 8.64) respectively. Overall, there was no statistical significant difference in the SF-12 domains scores with regards to the stages of change for both the risk factors.
CONCLUSIONS: There were some evidence of positive relationship between stages of change of physical activity and fruit and vegetable intake with SF-12 scores. Further studies need to be conducted to confirm this association.
METHODS: We obtained the validity and reliability evidence for the SAS-M-SF using a group of 307 pre-university students in Universiti Putra Malaysia (UPM), Serdang, Selangor, Malaysia with a mean age of 18.4±0.2 years (70.4% female and 29.6% male). A questionnaire containing the Malay version of Smartphone Addiction Scale (SAS-M), the Malay version of the short form Smartphone Addiction Scale (SAS-M-SF), and the Malay version of the Internet Addiction Test (IAT-M) was administered on the adolescents.
RESULTS: The SAS-M-SF displayed good internal consistency (Cronbach's α=0.80). Using principle component analysis, we identified a 4-factor SAS-M-SF model. A significant correlation between the SAS-M-SF and the IAT-M was found, lending support for concurrent validity. The prevalence of smartphone addiction was 54.5% based on cut-off score of ≥36 with a sensitivity of 70.2% and a specificity of 72.5%.
CONCLUSIONS: The 10-item SAS-M-SF is a valid and reliable screening tool for smartphone addiction among adolescents. The scale can help clinicians or educators design appropriate intervention and prevention programs targeting smartphone addiction in adolescents at clinical or school settings.