Displaying publications 1 - 20 of 70 in total

  1. Pettit JH
    Med. J. Malaysia, 1963 Dec;18:87-90.
    PMID: 14117286
    Matched MeSH terms: Drug Prescriptions*
  2. Kamaruzaman WS
    Med. J. Malaysia, 1995 Dec;50(4):396-400.
    PMID: 8668063
    An analysis of 524 unclaimed prescriptions (which contributed 0.9% of the total prescriptions) showed that 23.8% were for vitamins, 17.7% for anti-inflammatory drugs, 16.4% medications for skin and mucous membrane and 9.9% for antibiotics. The unclaimed prescription rates varied inversely to the staff-strength working in the dispensary. Sixty-eight point nine per cent of the unclaimed drugs could be purchased at the pharmacy shops without doctor's prescription.
    Matched MeSH terms: Drug Prescriptions*
  3. Mastura I, Teng CL
    Med. J. Malaysia, 2008 Oct;63(4):315-8.
    PMID: 19385492
    The quality of physician prescribing is suboptimal. Patients are at risk of potentially adverse reaction because of inappropriate or writing error in the drug prescriptions. We assess the effect of "group academic detailing" to reduce writing drug name using brand name and short form in the drug prescriptions in a controlled study at two primary health care clinics in Negeri Sembilan. Five medical officers in Ampangan Health Clinic received an educational intervention consisting of group academic detailing from the resident Family Medicine Specialist, as well as a drug summary list using generic names. The academic detailing focused on appropriate prescribing habit and emphasized on using the full generic drug name when writing the drug prescription. Analyses were based on 3371 prescriptions that were taken from two clinics. The other health clinic was for comparison. The prescribing rates were assessed by reviewing the prescriptions (two months each for pre- and post-intervention phase). Statistically significant reduction in writing prescription using brand name and using short form were observed after the educational intervention. Writing prescription using brand name for pre- and postintervention phase were 33.9% and 19.0% (postintervention vs pre-intervention RR 0.56, 95% CI 0.48 to 0.66) in the intervention clinic. Prescription writing using any short form for pre- and post-intervention phase were 49.2% and 29.2% (post-intervention vs pre-intervention RR 0.59, 95% CI 0.53 to 0.67). This low cost educational intervention focusing on prescribing habit produced an important reduction in writing prescription using brand name and short form. Group detailing appears to be feasible in the public health care system in Malaysia and possibly can be used for other prescribing issues in primary care.
    Matched MeSH terms: Drug Prescriptions/standards*
  4. Rahman AR, Noor AR, Hassan Y
    Med. J. Malaysia, 1994 Dec;49(4):364-8.
    PMID: 7674972
    The training of doctors in therapeutics has created interesting discussions internationally. A survey of senior hospital pharmacists currently practising throughout West Malaysia was embarked on during a recent postgraduate seminar. About sixty per cent said prescribing errors were common amongst doctors. Sixteen per cent of the prescribing errors were potentially serious. Most of the time errors were due to carelessness, lack of knowledge on drug action or a combination of both. Nearly 35% of prescribing errors were not acknowledged by doctors. Most doctors did not give reasons for not acknowledging pharmacists' intervention. About half (46.5%) of the respondents thought that doctors were not adequately trained in the use of drugs.
    Matched MeSH terms: Drug Prescriptions*
  5. Hor JY
    Med. J. Malaysia, 2008 Jun;63(2):125-30.
    PMID: 18942298 MyJurnal
    A cross-sectional study was conducted to examine the use of prescription drugs among elderly patients (> or = 60 years old) admitted to medical wards in Hospital Kuala Lumpur, Malaysia. A total of 204 elderly (101 men and 103 women) were interviewed. Eighty two percent of the elderly were taking at least one prescription drug, with 39.2% taking > or = 5 drugs. Prescription drugs commonly used were antihypertensives (54.4%), antidiabetics (40.2%), drugs used in haemostasis (36.8%), nitrates (33.3%) and diuretics (32.4%). Factors associated with increased use of prescription drugs were: more number of chronic diseases, self-rated health status as poor, low Barthel score, and Chinese women.
    Matched MeSH terms: Drug Prescriptions*
  6. Lai PS, Sim SM, Chua SS, Tan CH, Ng CJ, Achike FI, et al.
    BMC Med Educ, 2015;15:153.
    PMID: 26391883 DOI: 10.1186/s12909-015-0433-z
    BACKGROUND: Prescribing incompetence is an important factor that contributes to prescribing error, and this is often due to inadequate training during medical schools. We therefore aimed to develop and validate an instrument to assess the prescribing readiness of medical students (PROMS) in Malaysia.
    METHODS: The PROMS comprised of 26 items with four domains: undergraduate learning opportunities; hands-on clinical skills practice; information gathering behaviour; and factors affecting the learning of prescribing skills. The first three domains were adapted from an existing questionnaire, while items from the last domain were formulated based on findings from a nominal group discussion. Face and content validity was determined by an expert panel, pilot tested in a class of final year (Year 5) medical students, and assessed using the Flesch reading ease. To assess the reliability of the PROMS, the internal consistency and test-retest (at baseline and 2 weeks later) were assessed using the Wilcoxon Signed Ranks test and Spearman's rho. The discriminative validity of the PROMS was assessed using the Mann-Whitney U-test (to assess if the PROMS could discriminate between final year medical students from a public and a private university).
    RESULTS: A total of 119 medical students were recruited. Flesch reading ease was 46.9, indicating that the instrument was suitable for use in participants undergoing tertiary education. The overall Cronbach alpha value of the PROMS was 0.695, which was satisfactory. Test-retest showed no difference for 25/26 items, indicating that our instrument was reliable. Responses from the public and private university final year medical students were significantly different in 10/26 items, indicating that the PROMS was able to discriminate between these two groups. Medical students from the private university reported fewer learning opportunities and hands-on practice compared to those from the public university. On the other hand, medical students from the private university reported more frequent use of both web based and non-web-based resources compared to their public university counterparts.
    CONCLUSIONS: The PROMS instrument was found to be a reliable and valid tool for assessing medical students' readiness to prescribe in Malaysia. It may also inform on the adequacy of medical programmes in training prescribing skills.
    Matched MeSH terms: Drug Prescriptions
  7. Rashed AN, Wong IC, Wilton L, Tomlin S, Neubert A
    Drugs Real World Outcomes, 2015;2(4):397-410.
    PMID: 26690854
    To investigate and compare drug prescription patterns in children admitted to a paediatric general medical ward in five countries.
    Matched MeSH terms: Drug Prescriptions
  8. Sim SM, Foong CC, Tan CH, Lai PS, Chua SS, Mohazmi M
    Med Teach, 2014 Feb;36(2):182.
    PMID: 24156275 DOI: 10.3109/0142159X.2013.848977
    Matched MeSH terms: Drug Prescriptions/standards*
  9. Al-Areefi MA, Hassali MA, Mohamed Ibrahim MI
    Res Social Adm Pharm, 2013 Nov-Dec;9(6):981-8.
    PMID: 23218551 DOI: 10.1016/j.sapharm.2012.10.006
    Prescribing decisions are a complex phenomenon and influenced by many pharmacological and non-pharmacological factors. Little is known about the actual prescribing behaviors of physicians or the factors behind their prescribing decisions.
    Matched MeSH terms: Drug Prescriptions*
  10. Sim SM, Choo WY, Ng CJ
    Med Educ, 2009 May;43(5):492.
    PMID: 19422512 DOI: 10.1111/j.1365-2923.2009.03352.x
    Matched MeSH terms: Drug Prescriptions/standards*
  11. Sarriff A, Aziz NA, Hassan Y, Ibrahim P, Darwis Y
    J Clin Pharm Ther, 1992 Apr;17(2):125-8.
    PMID: 1583080
    This study examined out-patients' interpretation of prescription instructions at a community hospital. The results showed a wide range of misinterpretation with respect to drug name, dose schedule, and auxiliary labels. Age level, education and financial status emerged as the most significant variables associated with the patient's response. Therefore, both physicians and pharmacists may wish to review their traditional prescribing and dispensing procedures to help out-patients make better use of potent medication.
    Matched MeSH terms: Drug Prescriptions*
  12. Alabid AH, Ibrahim MI, Hassali MA
    J Clin Diagn Res, 2014 Jan;8(1):119-23.
    PMID: 24596741 DOI: 10.7860/JCDR/2014/6199.3923
    BACKGROUND: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular.
    AIM: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics.
    METHOD: The study used trained Simulated Patients (SPs), who used a scenario of common cold symptoms at GP private clinics and community pharmacies to observe and explore the practice of antibiotics dispensing. The study was conducted within the period of May to September 2011 in Penang, Malaysia. The data was analysed using descriptive statistics, Chi-square and Fisher's Exact Tests at alpha level of 0.05.
    RESULTS: GPs dispensed more antibiotics than CPs (p= 0.001) for common cold symptoms. They dispensed more Amoxicillin (n = 14, 35%) than CPs (n = 11, 11%) (p < 0.001) and more Tetracycline (n = 3, 7.5%) while no CP dispensed this category (p = 0.022). On the other hand, CPs (n = 11, 11%) suggested brand antibiotics where as GPs dispensed only generic antibiotics (p < 0.001). Generally GPs comply better with the symptomatic diagnosis standard e.g. when asking SPs about the symptoms they had, all GPs (n = 40, 100%) complied better with this standard. Despite that, they dispensed more antibiotics (n = 26, 65%) than CPs (n = 29, 29%) (p = 0.001). GPs (n = 22, 55%) also are better than CPs (n = 16, 16%) in adherence to therapeutic doses (p< 0.001).
    CONCLUSION: Findings showed poor adherence to rational dispensing of antibiotics by both providers. Although, GPs adhere better to symptomatic diagnosis and therapeutic dosing of antibiotics than CPs, they unnecessarily prescribe and dispense more antibiotics for Upper respiratory tract infection (URTI) symptoms. Establishing prescription guidance and regulatory actions, especially for URTIs treatment, and separating of medication dispensing are seemed to be crucial steps for the reform.
    KEYWORDS: Community pharmacists; Dispensing doctors; Dispensing separation; General practitioners; Simulated patients ligament
    Matched MeSH terms: Drug Prescriptions*
  13. Balan S, Hassali MAA, Mak VSL
    World J Pediatr, 2018 12;14(6):528-540.
    PMID: 30218415 DOI: 10.1007/s12519-018-0186-y
    BACKGROUND: In the past two decades, many legislative and regulatory initiatives were taken globally to improve drug use in children. However, children are still found to be prescribed with off-label drugs. This study was conducted to provide an overview of the worldwide trend in off-label prescribing in children from the year 1996 to 2016.

    DATA SOURCES: The articles published in PubMed, MEDLINE and Google Scholar were searched using text words: off-label, unlicensed, paediatric and children. Additional articles were identified by reviewing the bibliography of the retrieved articles. Full-text articles published in English which reported on the prevalence of off-label prescribing in children between January 1996 and December 2016 were included.

    RESULTS: A total of 101 studies met the inclusion criteria. Off-label prescribing definition included four main categories: age, indication, dose and route of administration. The three most common reference sources used in the studies were summary of product characteristics, national formularies and package inserts. Overall, the off-label prescribing rates in children ranged from 1.2 to 99.7%. The most common category of off-label prescribing in children was dose and age.

    CONCLUSIONS: This review highlighted that off-label prescribing in children was found to be highly prevalent throughout the past two decades, persistently in the neonatal intensive care units. This suggests that besides legislative and regulatory initiatives, behavioural, knowledge aspects and efforts to integrate evidence into practice related to off-label prescribing also need to be evaluated and consolidated as part of the concerted efforts to narrow the gaps in prescribing for children.

    Matched MeSH terms: Drug Prescriptions*
  14. Murshid MA, Mohaidin Z
    Pharm Pract (Granada), 2017 Apr-Jun;15(2):990.
    PMID: 28690701 DOI: 10.18549/PharmPract.2017.02.990
    To date, research on the prescribing decisions of physician lacks sound theoretical foundations. In fact, drug prescribing by doctors is a complex phenomenon influenced by various factors. Most of the existing studies in the area of drug prescription explain the process of decision-making by physicians via the exploratory approach rather than theoretical. Therefore, this review is an attempt to suggest a value conceptual model that explains the theoretical linkages existing between marketing efforts, patient and pharmacist and physician decision to prescribe the drugs. The paper follows an inclusive review approach and applies the previous theoretical models of prescribing behaviour to identify the relational factors. More specifically, the report identifies and uses several valuable perspectives such as the 'persuasion theory - elaboration likelihood model', the stimuli-response marketing model', the 'agency theory', the theory of planned behaviour,' and 'social power theory,' in developing an innovative conceptual paradigm. Based on the combination of existing methods and previous models, this paper suggests a new conceptual model of the physician decision-making process. This unique model has the potential for use in further research.
    Matched MeSH terms: Drug Prescriptions
  15. Khan AH, Aftab RA, Sulaiman SA, Ali I
    Value Health, 2015 Nov;18(7):A840.
    PMID: 26534490 DOI: 10.1016/j.jval.2015.09.373
    Objectives: To review patient’s prescriptions and calculate direct cost for the treatment and management of asthma
    Methods: A prospective cross-sectional detailed review of 180 prescriptions written by 6 doctors was conducted at respiratory department of Hospital Pulau Pinang, Malaysia. Medication price was confirmed from the hospital formulary. Interview with the key personals were conducted to identify activities of each service provided to asthma patients. This was followed by determination of time taken to complete each activity using stopwatch. The duration was captured 15 times for each for three alternate days and summarized as the mean time (minutes) for each activity. The cost of each employee per single activity was obtained by multiplying the mean time (minute) spent by that employee doing a specific activity by his/her salary per minute
    Results: A total of 6 different classes of medications were prescribed to 180 asthma patients. β agonist was the most prescribed class of asthma medication that included Salbutamol 72 (39.8) and albuterol 20 (11) followed by Corticosteroids that included budisonide 59 (32.8%), prednisolone 16 (8.8%) and fluticasone 11 (6.1%). Fifty one (28.3%) units of budisonide/formoterol combination medication were prescribed followed by fluticasone/salmeterol 40 (22.2%). A total of RM 10610.79(USD) medication were prescribed to 180 asthma patients with average cost of RM 59.08 per patient. The combination medication of budisonide/formoterol RM.5253 (USD) made the majority of total cost of asthma medication. Spirometry was performed for all 180 patients at every hospital visit that costed RM 5400.00. The cost of services provided by doctors and nursing staff for 180 asthma patients for single visit was RM 1198.8 and RM 331.2 respectively
    Conclusions: Combination medication adds a substantial cost to over all asthma cost. Careful selection of asthma pharmacotherapy can greatly reduce medication cost without compromising on treatment outcomes
    Matched MeSH terms: Drug Prescriptions
  16. Lau, E.F., Mazlan, M., Shanmugam, H.
    JUMMEC, 2018;21(2):31-34.
    Phenytoin is commonly prescribed for the prophylaxis of seizures in neurosurgical patients. A phenytoininduced
    serious adverse effect of thrombocytopenia has been reported in the literature. The concurrent
    use of dexamethasone, another commonly prescribed drug in neurosurgical patients, has been reported to
    aggravate this adverse haematological effect. We present a report of phenytoin-induced thrombocytopenia
    in a patient concurrently prescribed with dexamethasone, after an intracerebral haemorrhage secondary to
    a rupture of an arteriovenous malformation. The thrombocytopenia was noted after two weeks of phenytoin
    medication. Phenytoin was immediately withheld, and seven units of random donor platelets were transfused.
    A gradual resolution of thrombocytopenia was observed within a week.
    Matched MeSH terms: Drug Prescriptions
  17. Kho BP, Ong CMY, Tan FTY, Wee CY
    Med. J. Malaysia, 2013 Apr;68(2):136-40.
    PMID: 23629559 MyJurnal
    Upper respiratory tract infection (URTI) is mostly viral in aetiology, but patients presenting with such complaints are frequently prescribed antibiotics. This may result in increased development of antimicrobial resistance. The objectives of this study are to determine the choice and proportion of oral antibiotics prescribed in patients with URTI, in a Sarawak district hospital setting. All outpatient prescriptions received in July 2011 in 10 hospitals with relevant diagnoses were analysed. A total of 6747 URTI prescriptions met the inclusion criteria, and 64.8% (95% CI 63.7%, 65.9%) had antibiotic prescribed. Medical Assistants (MAs) were significantly more likely to prescribe antibiotics compared to Medical Officers (MOs) (p < 0.001). Prescribers were significantly influenced by the patient's age and specific diagnosis when prescribing antibiotics for URTI (p < 0.001). Antibiotic choices differed between MOs and MAs, where some of the antibiotic choices were inappropriate. There is a need for multi-faceted interventions to improve antibiotic prescribing rate and choice.
    Study site: 10 district hospitals, Sarawak, Malaysia
    Matched MeSH terms: Drug Prescriptions*
  18. Hassan Y, Al-Ramahi R, Abd Aziz N, Ghazali R
    Ann. Acad. Med. Singap., 2009 Dec;38(12):1095-103.
    PMID: 20052447
    One of the most important drug-related problems in patients with chronic kidney disease (CKD) is medication dosing errors. Many medications and their metabolites are eliminated through the kidney. Thus, adequate renal function is important to avoid toxicity. Patients with renal impairment often have alterations in their pharmacokinetic and pharmacodynamic parameters. The clearance of drugs eliminated primarily by renal filtration is decreased by renal disease. Therefore, special consideration should be taken when these drugs are prescribed to patients with impaired renal function. Despite the importance of dosage adjustment in patients with CKD, such adjustments are sometimes ignored. Physicians and pharmacists can work together to accomplish safe drug prescribing. This task can be complex and require a stepwise approach to ensure effectiveness, minimise further damage and prevent drug nephrotoxicity.
    Matched MeSH terms: Drug Prescriptions/standards*
  19. Al-Junid SM, Ezat WP, Surianti S
    Med. J. Malaysia, 2007 Mar;62(1):59-65.
    PMID: 17682574 MyJurnal
    A prevalence study was conducted, measuring drug cost and prescribing patterns of clinicians treating cardiovascular patients in UKM Hospital (HUKM). One Hundred and thirty-five patients' case-notes were selected from the Case-Mix database of HUKM. The average and median number of drugs prescribed per patient was 7.56 (+/- 3.37) and 7.0 (+/- 3) respectively. Generic drug prescription rate was still low (45.2%). Significant relationship was observed between generic drug prescriptions with age of patients, types of wards and different levels of clinicians' training. Younger patients, admitted to Coronary Care Unit (CCU) and Cardiology Rehabilitation Ward (CRW) were more likely to be prescribed with branded drugs. Lower generic drugs prescription and higher cost of drugs were mostly practised by Consultants. CCU and CRW wards were the only predictor to having low generic drugs prescriptions. Ninety-nine percent of the total RM28,879.25 drug cost was used to purchase branded drugs. Mean drug cost for a patient is RM213.92 (+/- RM333.36) and median cost is RM102.46 (+/- RM240.51). Higher drug cost and its' predictors were patients with severity level II and III, length of stay of > or = 6 days, number of drugs types of > or = 7, generic drugs prescription rate < 50% and patients admitted in CCU and CRW wards. This study is important for short and long-term decision-making, controlling of providers behaviour and resources.
    Matched MeSH terms: Drug Prescriptions*
  20. Loh LC, Wong PS
    Med. J. Malaysia, 2007 Aug;62(3):210-3.
    PMID: 18246909
    A self-answered, anonymously completed, nationwide questionnaire survey was conducted between June 2002 and May 2003 among Malaysian doctors through post and at medical meetings. Findings based on 116 government and 110 private doctors who satisfactorily completed the forms (effective respondent rate: 30.1%) showed that more than 70% of government and private doctors claimed familiarity with asthma CPGs but proportionately more private doctors considered them "unworkable" and were reluctant to adopt them in their practice setting, quoting cost as the primary reason. Between those who frequently adopted the CPGs and those who did not, there was an equally high proportion of inappropriate prescribing. Despite the shortcomings of such a survey, our findings suggest that medicinal cost and practitioner's prescribing practices are important in the acceptance and execution of asthma CPGs recommendations.
    Matched MeSH terms: Drug Prescriptions/standards*
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