PROCEEDINGS of 1st East Coast Pharmacy Research & Quality Assurance Conference

Date: 29th – 30th August 2025

Venue: AC Hotel Kuantan

Theme: Pharmacy Revolution with Technology: Transforming Research and Quality Initiatives Into Smarter Patient Care

Editors

• Muhammad Nasri bin Yusoff
• Wan Mastura binti Wan Mohamad Azlan
• Muhammad Azzim bin Izudin
• Noor Mariati binti Othman
• Mastura binti Ahmad

Contents

Oral Presentations

• RO-01
  Awareness and Satisfaction of Healthcare Providers on Drug Information Services at Hospital Sultanah Nur Zahirah
  Sue Chyen, Tay; Mohd Yusof, Nurul Faezah; Wan Ibrahim, Wan Nur Hamizah; Omar, Hasniza
• RO-02
  Clinical Features and Treatment Outcomes of Scrub Typhus: A Multicenter Malaysian Hospital-Based Study on Risk Factors, Laboratory Variations and Antibiotic Efficacy
  Kwong, Kien Seang; Rozimi, Ahmad Hafizi; Ye Thut @ Mohammad Iqbal, Faisal; Chui, Kuan Lee; Mahesparan, Vishnu
• RO-03
  The Direct Cost of National Immunisation Programme in Eastern Region of Pahang
  Cheong, Jia Yi; Ngoh,Yee Ling; Abdul Halim, Siti Nurul Asyiqeen; M Nordin, Nuratikah; Mohd Noor Rawi, Nor Mustaqim; Anan, Nur Fatihah; Kwong, Kian Seang; Choo, Yai Wen; Bahari, Mohd Shahri
• RO-04
  Impact of Pharmacy Integrated Community Care (PICC) on Quality of Life in Diabetic Patients: A Multicentre Study in Terengganu
  Rosli, Masturah; Yusof, Mohd Syafiq; Aziz, Norazli Syarifah; Awang, Ruzita; Hashim@Abdullah, Rosnida, Talib, Norsamira
• RO-05
  Awareness and Knowledge of Glycosylated Hemoglobin (HbA1c) among Type 2 Diabetes Patients (T2DM) in Besut District
  Mohd Zunaidi, Nur Aqilla; Abdul Rahman, Zanariah; Mamat, Che Fadhilah; Zakaria, Zarida; Musa, Mohd Sollahuddin; Hussin, Ema Shafiqah; Mustaffa, Muna Aqilah; Wan Mahamad, Wan Nor Albaniah
• RO-06
  Evaluation of Pharmacy Drive Through Service in Hospital Tanah Merah
  Wan Taman, Wan Muhammad Taufik; Mohd Roby, Bizura Azira; Rozali, Muhamad Hazimi
• RO-07
  Effectiveness of ‘Kampungku Celik Ubat (KCU)’ Programme on Medication Knowledge and Use among Community in Dungun, Terengganu: A Quasi Experimental Study
  Tuan Ibrahim, Tuan Nur Akmal Wahidah; Mohd Norizan, Nuraina; Ramli, Nurul Izzaty; Mat Jali, Nurul Aimuni
• RO-08
  Knowledge, Attitude and Practice of Post Exposure Prophylaxis (PEP) Against HIV Infection among Healthcare Practitioners in Pejabat Kesihatan Daerah Kota Bharu
  Mat Zaid, Saiyida Syahira; Sidek, Nur Farhana Hafizah; Muhammad Hashim Koh, Salmi Koh; Nik Mohd Safri, Nik Nur Aleeza
• RO-09
  Knowledge, Awareness and Perception on Contraception among Healthcare Workers in District Hospitals in Kelantan: A Cross-Sectional Study
  Kasim, Siti Nursyahida; Ab Halim, Amin Nasrin; Che Hassan, Nur Fazzlin; Zakaria, Nur Fakhira; Tan,Yan Ling; Rosdi, Nur Intan Athirah
• RO-10
  Assessment of Knowledge and Inhaler Technique among Patients in Hospital Hulu Terengganu, Terengganu
  Abd Rashid, Nur Akma Suhada; Aziz, Nur Syahirah; Abdullah, Nursyafiqah; Mohd Zawawi, Arwa Zahidah; Mohd Shukri, Nur Farah Adibah; Abdul Rahman, Nor Bahiyah
• RO-11
  Clinical and Cost Evaluation on Oral Treatment of Iron Deficiency Anemia among Children in Pahang
  Nordin, Nuratikah; Shamsudin, Fatin ‘Izzati, Md Fadzilah, Fadzliany, Syed Roslie, Syarifah Nasyirah , Mohd Aznan, Nurain Afiqah, Mustafa Kamal, Aina Liyana; Zainal Abidin, Nor Izwani; Abu Johan, Afiq Aizuddin; Zamri, Siti Hajar
• RO-12
  Clinical and Economic Impact of Pharmacist-led Interventions on Drug-related Problems in Haematology Unit, Hospital Tengku Ampuan Afzan
  Chua, Peck Wei; Yusoff, Muhammad Nasri; Nordin, Nuratikah
• RO-13
  Assessment of Haemoglobin Level and its Determining Factors among Pregnant Women using Different Oral Iron-Containing Supplements in Public Health Clinics at Kuala Krai
  Abdul Bielal, Alifah Ilyana; Yusoff, Rozida; Che Razali, Muhammad Rahim; Muhammed, Nurul Asyikin; Ishak, Nor Aishah; Saizan, Sarah
• RO-14
  Validation and Item Reduction Potential of the Malaysia Medication Adherence Assessment Tool (MyMAAT) in Non-Dialysis Chronic Kidney Disease Patients
  Lim, Ming Chiang; Md Hatah, Ernieda; Goh, Jia Ean; Abd Manan, Ahmad Ramdani; Tan, Joyce Chu Yee; Mohamed Iqbal, Nur Nabilah; Masor, Nur Syahidah; Balu, Deneshwary; Khamar Ludin, Norhidayah; Mamat, Norlaila Kartina Malini; Mohammed Yusof, Noorazyani; Ong, Angeline Huey Sim; Zaidin, Musliza; Mohammad, Norain
• RO-15
  Knowledge and Adherence to Oral Iron Consumption Among Pregnant Women Attending Health Clinic in PKD Machang
  Abd Malik, Nur Alyaa Bajana; Abdul Ghani, Nur Afera; Ismail, Eni Fazihan; Mohd Hasali, Nor Hafizah

Poster Presentations

• RP-01
  Health Related Quality of Life among Solid Cancer Patient in Hospital Tengku Ampuan Afzan
  Amir Azhar, Nur Afiqah; Ahmad, Mastura; T. Syed Manso, Syarifah Syafiqah; Mohamad Hanapi, Nurul Najihah; Noor Hazrulhisham, Nur Nazatul Hanis; Khairul Hafidz, Muhammad Hafizul Aniq; Zaharudie, Idham; July, Airene
• RP-02
  Nicotine Replacement Therapy (NRT) Regimens in Smoking Cessation Programs at Health Clinics, Kemaman
  Talib, Siti Syauqina; Wan Jusoh, Wan Ruzana; Sa’ari, Siti Akmal
• RP-03
  Costing Study on Treatment of Anemia in Pregnancy Among Orang Asli Patients in Zon Pahang Barat
  Lee, Chen Yuan; Mohammad Yunus, Mohammad Hafiz; Mohammad Sharohhuddin, Mohammad Yazid; Abd Razi, Khairunnisa; Abdul Samad, Noor Faeizan; Aziz, Azliana; Chen, Tze Seong; Azman, Radhiah; Devarajooh, Cassidy
• RP-04
  Evaluation of ADRs at HS: A 5-year Retrospective Study
  Tahir, Nurul Ain; Fami, Muhammad Luqman Alhakim; Juraimi, Nur Rashida Hani; Mohd Azmi, Nur Aqilah; Shafie, Nur Aizahakiki; Abdul Rashid, Rabihah
• RP-05
  From Struggle to Strategies: A Qualitative Study on Smoking Cessation Barrier Among Patients with Chronic Obstructive Pulmonary Disease
  Md Khairi, Lukman Nul Hakim; Mukhtar, Mazlina; Wan Zakaria, Wan Aimuni; Sopi, Muhammad Fais; Gnanasan, Shubashini; Samsudin, Azlina
• RP-06
  Knowledge, Attitude and Practice of Painkillers among Patients in Jeli District Health Clinics, Kelantan
  Zulkifli, Nur Amni Syairah; Ishak, Fatin Najihah; Ab Ghani, Siti Nor Asiah; Mohd Hanafi, Muhammad Abu Bakar
• RP-07
  A Game Changer in Community Diabetes Care: Impact of the Pharmacy Integrated Community Care (PICC) on Medication Adherence and Clinical Outcomes in Terengganu
  Yusof, Mohd Syafiq; Rosli, Masturah; Aziz, Norazli Syarifah
• RP-08
  Analysis of Pharmacist Intervention at Outpatient Pharmacy Setting in West Pahang Region
  Kwong, Kien Seang; Chen, Tze Seong; Zamri, Siti Hajar; Mohamed Koya, Saiful Nizam; Chase-Currier, Alyson; Mohd Razali, Fatin Syafiqa; Salleh @ Ariffin, Nur Hanani; Hong, Jason; Mohamed Zaid, Nur Aliea; Salleh, Nurul Hidayah
• RP-09
  The Utilization Pattern of Psychotropic Drugs in a District Hospital in Pahang – Hospital Bera (HOSBER)
  Yahaya, Siti Rasyidah; Wan Khazanah @ Wan Salleh, Wan Muhamad Azri; Radzuan, Nurul Syahida; Zulkofli, Syazwani
• RP-010
  Knowledge on the Use of PPIs among Healthcare Professionals in Terengganu Health Clinic
  Zainuddin, Nur Fajrina; Wan Mahmood, Wan Noraini; Omar, Nur Sulaihah
• RP-11
  Low Molecular Weight Heparin Versus Unfractionated Heparin as Venous Thromboembolism Prophylaxis in Neurosurgery
  Yeoh, Mei Ting; Ahmad, Mastura1; Chua, Peck Wei; Mohamed Yusof, Safwah Suad; Zainul Ibrahim, Aida Mardhiyah; Aminudin, Nurul Hazirah; -Mohd Jaferi, Nurul Asyikin; Mustafa, Nur Hanisah
• RP-12
  Return And Disposal of Unused and Expired Medications (ReDiUEM) Among Patients Visiting Outpatient Clinics in PKD Pasir Puteh, Kelantan
  Tuan Mohamad, Tuan Nur Syafiqah; Wan Ahmad, Wan Nurhanis Insyirah; Che Din, Muhammad Firdaus; Syed Azmy, Syed Mohamad Rahimi
• RP-13
  Evaluation of Antimicrobial Stewardship (AMS) Programme at Hospital Tengku Anis, Kelantan
  Mohd Nasir, Ainil Nasuha; Mohd Jaaffar, Mohd ‘Izzuddin ; Mokhtar, Nur Ainun Anis
• RP-14
  Treatment Costs of Bleeding Complications in Hospitalized Patients on Warfarin Therapy in Hospital Tengku Ampuan Afzan
  Abdul Malek, Fairuz; Sohaimi, Nurul Farahin; Choo,Yai Wen; Abdul Talib, Mat Sharil; M. Nazeri, Muhammad Aizat; Rosdi, Muhammad Siddiq Faqaruddin; W. Mustappa, Wan Muhammad Syahir; Kanasan, Shantini
• RP-15
  Patient Preferences for Inhaler Devices in Chronic Obstructive Pulmonary Disease (COPD) Patients in Hospital Muadzam Shah (HMS): A Qualitative Study
  Ahmad, Nur Syafiqah; Sabri, Muhammad Afiq; W Mustappa, W Muhammad Syahir; Mazuki, Khairun Nisa, Teng, Chin Siew; Che Wan Ahmad, Che Wan Mohd Hafidz
• RP-16
  Knowledge, Attitude and Practice Regarding Disposal of Unused and Expired Medicines among Patients in Outpatient Pharmacy in PKD Tanah Merah, Kelantan
  Mukhtar, Suzita; Salleh, Amanina; Abd Rahman, Syaheerah; Pauzi, Fatin Husna; Shaari, Syuhada; Zahari, Amalina Zaiza; Che Khalid, Akmal; Shukri, Amalin Aisyah; Rosedi, Anas; Adib, Aida
• RP-17
  Impact of Educational Intervention Towards Knowledge and Practice of Sublingual Glyceryl Trinitrate among Acute Coronary Syndrome Patients in Dungun Hospital
  Ruslan, Noor Faeza; Alias, Siti Kamsida; Raja Musa, Puteri Aimi Athira; Taib, Nur Alya Syahirah; Ab Supian, Muhammad Yusuf Hakim
• RP-18
  Pain As 5th Vital Sign: An Evaluation of Knowledge among Healthcare Worker in Hospital Tanah Merah, Kelantan
  Malihah Hanani binti Mahmood, Ku Jaya, Tengku Nur Eqhwana
• RP-19
  Investigating Decline in Estimated Glomerular Filtration Rate in Atrial Fibrillation Patients Treated with Warfarin vs Novel Oral Anticoagulants (IDEAL-AF)
  Khamar Ludin, Norhidayah; Ramlan, Aida Roziana; Abdul Majid, Nadiah; Azmi, Nur Amalina; Mohd Kaman, Nur Najihah; Mohamed Dhalan, Nurul Hidayah; Nadzmi, Nurul Afina.
• RP-20
  Knowledge, Attitude, and Practice of Community Pharmacy Professionals on Generic Medicines in Pahang
  Khairul Hafidz, Muhammad Hafizul Aniq; Izuddin, Muhammad Azzim
• RP-21
  Exploring the Perceptions of Hemodialysis Patients towards Medication Therapy Adherence Clinic Services
  Chase-Currier, Alyson; Kwong, Kien Seang; Ibrahim, Rosmaisarah; Lee, Chen Yuan; Chen, Tze Seong
• RP-22
  A Study of High Dose Versus Moderate Dose Methadone Maintenance: Evaluating Outcome in Controlling Illicit Substance Use
  Kwek, Cheng Hau; Muzafar Shah, Najihah Mohd; Wahairi, Nurfarahaneem
• RP-23
  Stroke Risk and Behaviour Change of Working-Age Adults (18–64 Years) with Hypertension in a Malaysian Setting
  Ibrahim, Yasmin; Yahya, Abqariyah
• RP-24
  Evaluation of Meropenem Dosing Adequacy and Clinical Outcomes in ICU Patients: A Model-Informed Retrospective Study
  Md Rosly, Nurul Aida; Abdullah, Mursyida; Mat Sulaiman, Farhana Nabilla1; Ali, Mohd Nazri; Zakaria, Fazilawati; Mustafa, Suzana
• RP-25
  Evaluation of Healthcare Providers’ Knowledge and Attitude about the Handling of Chemotherapy Drugs at Hospital Setiu, Terengganu
  Sulaiman, Saiful Hazim; Mohd Rahim, Nur Fahimah; MD Husin, Nur Najwa Hasnifalina
• RP-26
  Knowledge, Attitude, Practice and Complication Awareness Among Type 2 Diabetes Mellitus Patients in Health Clinics, PKD Bachok
  Md Adnani, Nur Thaqifah; Nik Mustapha, Nik Suraima
• RP-27
  The Appropriateness of Intravenous Proton Pump Inhibitors Usage and its Direct Costs in Hospital Tengku Ampuan Afzan, Kuantan
  Fazil, Azra Farzana; Ahmad, Mastura; Nik Mohd Sabri, Nik Nur Naseela Fathin; Mohd Zain, Mimi Nurul Syafilla; Rosli, Nur Amalina; Tengku Mokhtar, Tengku Hanim Syahmina; Goh, Suzanne; Wan Nasruddin, Wan Anwar; Yousry, Nur Ain Atiqah
• RP-28
  The Impact of Medication Therapy Adherence Clinic (MTAC) on The Understanding of Medication Knowledge, Adherence and Clinical Outcomes for Dialysis Patients in
  Kelantan: A Multicentre Study
• RP-29
  The Impact of Medication Regimen Complexity Level on Glycemic Control in Older Adults with Type 2 Diabetes Mellitus (T2DM) in A Primary Health Care, Pasir Mas, Kelantan
  Zammari, Nur Farahiah; Tuan Aziz, Wan Hazni; Hamil, Nor Liyana Izzati; Ab Rahman, Fatin Nabila; Wan Nazman, Wan Nazmin; Mazlan, Marsya Aida

Oral Presentations

RO-01

Awareness and Satisfaction of Healthcare Providers on Drug Information Services at Hospital Sultanah Nur Zahirah

Authors: Sue Chyen, Tay1*; Mohd Yusof, Nurul Faezah1; Wan Ibrahim, Wan Nur Hamizah1; Omar, Hasniza1

• 1Department of Pharmacy, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu

*Corresponding author: taysuechyen@moh.gov.my

Abstract

Introduction: Drug Information Services (DISs) are established in most hospitals to support healthcare providers (HCPs) by delivering timely and accurate drug-related information. However, the actual utilization and reliance on DISs remains questionable.

Objectives: To study awareness and satisfaction of HCPs on DISs at Hospital Sultanah Nur Zahirah (HSNZ).

Materials and Methods: A cross-sectional study was conducted among HCPs working in HSNZ via stratified sampling using an 18-item electronic anonymous validated questionnaire between November 2022 to April 2024. Sample size was calculated using Raosoft calculator and the sample size was 341 respondents which were distributed proportionally according to work designation. Data was analyzed using chi-square test, IBM SPSS (Version 27). A p-value <0.05 was set as statistically significant.

Results: A total of 341 HCPs participated in this study comprising 119 doctors, 173 nurses, 30 medical assistants and 19 pharmacists. The majority of respondents were female (82.7%) and nearly half (47.5%) reported having more than 10 years of working experience. The most sought after drug-related information were dosage/administration (90.0%), adverse drug reaction/side effects (58.4%) and contraindications (53.5%). Overall, 66.0% (n=225) of HCPs were aware of DIS HSNZ. Awareness towards DIS was found to be significantly associated with gender (p=0.036), working experience (p=0.002) and work designation (p<0.001). HCPs primarily relied on pharmacists (82.7%) and followed by internet/website (64.8%) for drugrelated information. 58.9% of them never used the services provided by DIS. 37.5% of respondents expressed satisfaction towards DIS and the satisfaction level was significantly associated with work designation (p=0.017).

Conclusion: The majority of HCPs were aware of the DIS at HSNZ however, overall satisfaction levels remained low. Therefore, greater efforts are needed to raise awareness and promote DIS among HCPs.

Keywords: Healthcare provider, Drug Information Services, awareness, satisfaction

NMRR ID: NMRR ID-22-01508-PNA

RO-02

Clinical Features and Treatment Outcomes of Scrub Typhus: A Multicenter Malaysian Hospital-Based Study on Risk Factors, Laboratory Variations and Antibiotic Efficacy

Authors: Kwong, Kien Seang1*; Rozimi, Ahmad Hafizi2; Ye Thut @ Mohammad Iqbal, Faisal2; Chui, Kuan Lee2; Mahesparan, Vishnu3

• 1Department of Pharmacy, Hospital Raub, Raub, Pahang
• 2Department of Internal Medicine, Hospital Lipis, Lipis, Pahang
• 3Department of Pharmacy, Hospital Lipis, Lipis, Pahang

*Corresponding author: kkseang@yahoo.com

Abstract

Introduction: Scrub typhus caused by Orientia tsutsugamushi, is a significant re-emerging public health threat in Malaysia. Persistent diagnostic challenges often delay crucial treatment, thereby increasing patient risks.

Objectives: This study aimed to characterize demographic, clinical, and laboratory parameters of scrub typhus patients; determine associations between clinical/laboratory findings and disease severity; assess factors impacting length of hospital stay.

Materials and Methods: Cross-sectional study was conducted at Hospital Kuala Lipis and Hospital Raub using universal sampling. Subjects were included in study who fulfilled the inclusion criteria. A standardized form was used to extract demographics, clinical manifestations, laboratory data, antibiotic regimens, complications, length of stay. Multiple logistic regression was used to determine the factor association to disease severity while multiple linear regression was used to assess factor association to length of hospital stay.

Results: Mean age of 62 patients were 40.4 (±15.5) years, with male majority (69.4%); most were rural residents (82.3%) engaged in agriculture (66.1%). Almost all patients presented with fever (98.4%), and eschar 62.9% (n=39). The presence of eschar showed a significant association with scrub typhus diagnosis (p &lt; 0.001). Laboratory findings upon admission included elevated liver enzymes in 85.5% of patients, thrombocytopenia (59.7%), and proteinuria (45.2%). Over half the patients (58.1%, n=36) experienced moderate-to-severe disease, significantly predicted by factors including transaminitis (OR 28.7, 95% CI 5.86- 139.98, <0.001), proteinuria (OR 4.7, 95% CI 1-21.82, p=0.050), elevated creatinine (OR 5.75, 95% CI 1-33.13, p=0.050). Doxycycline was the predominant antibiotic (91.9%) used to treat scrub typhus. The mean hospital stay was 5.57 (±4.10) days. Factors prolonging hospitalization included proteinuria (B=1.966, p=0.013) and diagnostic-to-antibiotic delay (B=1.224, p=0.025).

Conclusion: Clinical and laboratory predictors for scrub typhus severity and prolonged hospitalization were identified.

Keywords: Scrub Typhus, Rickettsia, tsutsugamushi

NMRR ID: NMRR ID-25-01033-QJB

RO-03

The Direct Cost of National Immunisation Programme in Eastern Region of Pahang

Authors: Cheong, Jia Yi1*; Ngoh,Yee Ling2; Abdul Halim, Siti Nurul Asyiqeen3; M Nordin, Nuratikah3; Mohd Noor Rawi, Nor Mustaqim4; Anan, Nur Fatihah5; Kwong, Kian Seang6; Choo, Yai Wen7; Bahari, Mohd Shahri8

• 1Department of Pharmacy, Klinik Kesihatan Indera Mahkota, Kuantan, Pahang
• 2Department of Pharmacy, Klinik Kesihatan Paya Besar, Kuantan, Pahang
• 3Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang
• 4Department of Pharmacy, Klink Kesihatan Bandar Tun Razak, Rompin, Pahang
• 5Department of Pharmacy, Klink Kesihatan Nenasi, Pekan, Pahang
• 6Department of Pharmacy, Hospital Raub, Pahang
• 7Pharmacy Policy and Strategic Planning Division, Pharmaceutical Services Programme, Ministry of Health, Petaling Jaya, Selangor
• 8Institute for Health Systems Research, National Institute of Health, Setia Alam, Selangor

*Corresponding author: dcnip2023@gmail.com

Abstract

Introduction: Malaysia’s National Immunisation Programme (NIP) has provided free vaccinations since the 1950s. However, understanding its operational costs from a public health provider perspective are limited.

Objectives: This study aims to identify the major cost components contributing to the direct costs of the NIP in the eastern region of Pahang, estimate the total cost of complete immunisation per child up to 18 years of age, and compare the costs incurred between self-initiated visits to health facilities and school-based outreach vaccination services.

Materials and Methods: This costing analysis using both top-down and bottom-up approaches, was conducted across five health facilities (one tertiary hospital, two clinics, two School Health Units) in the districts of Kuantan, Rompin, and Pekan. Data on vaccines, consumables, personnel, and transport were sourced from logistics stores, facility records, and time-motion studies.

Results: Total of 186,630 vaccinees with total estimated direct cost of RM 7,949,018.59 were reported in year 2023. Vaccines were the predominant cost driver (96.1%), followed by personnel (3.0%), consumables (0.8%), and transportation (0.1%). The total cost for complete immunisation was RM 843.51 per girl and RM 538.01 per boy. The personnel cost was the main contributor to the cost per school visit. Higher number of vaccinees contributed to lower total cost per vaccine injection. The median total cost was lowest in School Health Units in Kuantan compared to Pekan and Rompin (RM 3.71, n=20,294 vs RM 5.34, n=5,113 & RM7.66, n=4,052, p<0.01). School-based outreach delivery demonstrated a significantly higher median injection cost compared to facility-based self-visits (RM 4.89 vs RM 1.13, p<0.01).

Conclusion: The study has identified vaccines as principal expenditures and higher cost of outreach strategies. The cost of school outreach programme might be reduced if the volume of vaccinees increase in district with larger area. The detailed cost data is vital to enhance vaccine delivery model efficiency for financial sustainability.

Keywords: Vaccines, direct costs, national immunisation programme

NMRR ID: NMRR ID 23-01588 WJE

RO-04

Evaluating the Impact of Pharmacy Integrated Community Care (PICC) on Quality of Life Among Diabetic Patients in Terengganu

Authors: Rosli, Masturah1*; Yusof, Mohd Syafiq1; Aziz, Norazli Syarifah2

• 1Pharmaceutical Services Division, Terengganu State Health Department, Kuala Terengganu, Terengganu
• 2Hospital Besut, Jerteh, Terengganu

*Corresponding author: masturah.rosli@moh.gov.my

Abstract

Introduction: Diabetes mellitus is a chronic condition that affects physical and mental health, resulting in diminished quality of life (QoL). Increasing attention is being directed to QoL outcomes due to the influence of psychosocial factors on disease management. Therefore, Terengganu State Health Department had introduced Pharmacy Integrated Community Care (PICC) programme, a pharmacist-led community-based initiative comprising four interactive education modules in enhancing diabetic care.

Objectives: This study intended to evaluate changes in glycemic control and QoL among diabetic patients before and after participating in the PICC programme across Terengganu.

Materials and Methods: This quasi-experimental study was conducted at different places outside healthcare facilities from May to October 2024. Diabetic patients were selected based on inclusion and exclusion criteria from all districts in Terengganu. They were engaged in PICC and attending four pharmacist-led interactive sessions. Over a four-month period, four education modules were delivered (diabetes introduction, medication, complication and healthy lifestyle). The Revised Version of the Diabetic Quality of Life questionnaire (RVDQOL13) was administered before and after PICC to assess QoL (three domains: satisfaction, impact, and worry; 1-5 Likert responses, higher scores indicated poorer QoL). Data were analysed using descriptive and parametric tests (SPSSv.27), with p<0.05 considered statistically significant.

Results: A total of 92 patients participated with majority being females (65.2%), Malay (98.9%) and mean age of 59.8+1.38 years. Patients showed significantly better in glycemic control and overall QoL following the PICC intervention (p<0.001). The mean HbA1c was reduced from 10.16%+2.02 to 9.51%+1.92 post PICC. Interestingly, the mean overall QoL scores decreased from 46.85±14.31 to 36.00±10.16 post intervention, which lower scores denoted better QoL. Meanwhile, significant QoL improvements were also observed across all domains after PICC (p<0.001).

Conclusion: The PICC programme led to significant improvements in glycemic control and QoL among diabetic patients. These findings support its continued implementation as part of comprehensive diabetes care strategies.

Keywords: Community-based initiative, diabetes mellitus, glycemic control, pharmacist-led intervention, QoL, PICC

NMRR ID: NMRR ID-23-02439-SJQ

RO-05

Awareness and Knowledge of Glycosylated Hemoglobin (HbA1c) among Type 2 Diabetic Mellitus Patients (T2dM) in Besut District

Authors: Mohd Zunaidi1*, Nur Aqilla; Abdul Rahman, Zanariah1; Mamat, Che Fadhilah1; Zakaria, Zarida1; Musa, Mohd Sollahuddin1; Hussin, Ema Shafiqah1; Mustaffa, Muna Aqilah1; Wan Mahamad, Wan Nor Albaniah

• 1Department of Pharmacy, Besut District Health Office, Kota Putra, Besut, Terengganu

*Corresponding author: rndfarmasibesut@gmail.com

Abstract

Introduction: The National Health and Morbidity Survey in 2023 reported that 15.6% of Malaysian adults had diabetes, with 40% unaware of their disease and 56% experiencing poor glycemic control. Previous study revealed that patients had low to moderate levels of awareness about their condition (35%–50%), highlighting ongoing challenges in diabetes management.

Objectives: This study aimed to determine the awareness and knowledge of Glycosylated Hemoglobin (HbA1c) among Type 2 Diabetes Mellitus (T2DM) patients and their association with HbA1c level as well as the factors associated with good HbA1c knowledge.

Materials and Methods: A survey study was conducted involving T2DM patients receiving treatment at seven clinics in Besut from March-May 2025. Eligible patients were aged ≥18 years and registered in the National Diabetic Registry. Trained pharmacists employed standardized form to collect demographic details, and patients’ awareness and understanding of HbA1c. Previous HbA1c results were retrieved from laboratory information system with permission. Data were analyzed using SPSSv.27.

Results: Overall, 414 patients participated with a mean age of 58.49±10.97 years and average of 6.5±5.03 years duration of diabetes. Majority were Malay (99.6%, n=412), women (71.3%, n=295) and had secondary education level (69.6%, n=288). Mean HbA1c was 8.717±2.66 wherein 46% (n=190) had well controlled HbA1c. Awareness of HbA1c was noted by 56% (n=232), of whom only 59.1% (n=137) possessed good knowledge. There was no significant association between knowledge and HbA1c level. Higher education level, higher income and had performed self-monitoring blood glucose were factors associated with good knowledge of HbA1c (aOR:p<0.001; aOR:p=0.017; aOR:p=0.002), respectively.

Conclusion: Almost half of patients demonstrated poor knowledge of HbA1c. Continuing efforts must be made to improve patient’s awareness and knowledge of their disease to optimize glucose control.

Keywords: Type 2 diabetes mellitus, glycosylated haemoglobin (HbA1c), awareness, knowledge, Besut

NMRR ID: NMRR ID-25-00215-RJB

RO-06

Evaluation of Pharmacy Drive Through Service in Hospital Tanah Merah

Authors: Wan Taman, Wan Muhammad Taufik1*; Mohd Roby, Bizura Azira1; Rozali, Muhamad Hazimi1

• 1Department of Pharmacy, Hospital Tanah Merah, Kelantan

*Corresponding author: wmtaufik@moh.gov.my

Abstract

Introduction: Pharmacy Drive Through Service (PDTS) is a part of the broader Pharmacy Value-Added Services (PVAS) framework aimed at improving the quality and efficiency of pharmacy services in public healthcare institutions. There is currently limited data on user satisfaction and demographic patterns of its users. Understanding these factors is essential for evaluating the effectiveness of the service and identifying areas for improvement.

Objectives: To evaluate the level of customer satisfaction with the Pharmacy Drive-Through Service at Hospital Tanah Merah and to determine its association with customer demographic characteristics.

Materials and Methods: A cross-sectional study using convenience sampling was conducted to assess customer satisfaction with the Pharmacy Drive-Through Service (PDTS) at Hospital Tanah Merah. A total of 310 respondents (N=310) completed a survey consisting of demographic questions and a 14-item PDTS satisfaction scale.

Results: A total of 310 respondents participated, with a high overall satisfaction score of 93.09%. The most highly rated aspect was reduced waiting time (95.8% very satisfied), while signage and directions received the lowest satisfaction (18.7% dissatisfied). Satisfaction was also high for medication quantity, helpful staff, and accessibility. One-Way ANOVA showed that only education level had a significant effect on satisfaction scores [F(2, 307) = 4.439, p = 0.013]. Post hoc analysis found that respondents with tertiary education were significantly more satisfied than those with only primary education (p = 0.014).

Conclusion: The study found that most users were highly satisfied with the Pharmacy Drive-Through Service. Short waiting time, helpful staff, and convenience are elements that are mostly favoured by users. However, some users felt that the signs, packaging, and weather protection could be improved. People with higher education levels were more satisfied with the service. Overall, the PDTS is a helpful and well-received service, with a few areas that can be made better.

Keywords: PDTS, satisfaction, demographic

NMRR ID: NMRR ID-25-00839-1LN

RO-07

Effectiveness of ‘Kampungku Celik Ubat (KCU)’ Programme on Medication Knowledge and Use Among Community in Dungun, Terengganu: A Quasi Experimental Study

Authors: Tuan Ibrahim*, Tuan Nur Akmal Wahidah1; Mohd Norizan, Nuraina2; Ramli, Nurul Izzaty3; Mat Jali, Nurul Aimuni4

• 1 Department of Pharmacy, Klinik Kesihatan Al-Muktafi Billah Shah, Dungun Terengganu
• 2 Department of Pharmacy, Klinik Kesihatan Kuala Dungun, Dungun, Terengganu
• 3 Department of Pharmacy, Klinik Kesihatan Jerangau, Dungun, Terengganu
• 4 Department of Pharmacy, Klinik Kesihatan Kuala Abang, Dungun, Terengganu

*Corresponding author: tuannurakmal@moh.gov.my

Abstract

Introduction: A National Survey on the Use of Medicines (NSUM) III 2015 reported that 35% of respondents did not fully understand the proper use of their medicines. Thus, the Kampungku Celik Ubat (KCU) programme was launched to educate the community on proper medication use.

Objectives: This study aimed to determine the difference in mean scores of knowledge and practice on appropriate use of medicines among control and intervention groups and to find association between demographic characteristics with patients’ knowledge and practice.

Materials and Methods: A quasi-experimental study was conducted from May to December 2024 in Kampung Burung Baru (intervention group) and Kampung Al-Muktafi Billah Shah (control group). A validated Malay NSUM III questionnaire was used to assess knowledge (12 items) and practice (9 items). KCU Programme was conducted at Kampung Burung Baru as an intervention tool comprising activities like Kenali Ubat Anda talk, exhibition and created an education corner and also informative signages placed in strategic areas around this village. All outcomes were evaluated as pre and post-intervention with 2-months interval. Data were analysed using descriptive and parametric tests with p<0.05 considered statistically significant (SPSSv.27).

Results: A total of 109 respondents were recruited with 57 in control and 52 in the intervention group. The mean age was 46.9±12.53 years (intervention group) and 43.7±16,27 years (control group). Majority were female (52.3%) and employed (61.5%). A significant improvement of knowledge was observed in the intervention group (p=0.004). No significant difference was detected for both parameters in the control group. Higher improvement in knowledge (2.0%) and practice score (1.6%) was seen in the intervention group as compared to the control group. No significant associations were found between knowledge and practice in different sociodemographic characteristics.

Conclusion: The KCU programme showed a positive impact on community knowledge regarding proper use of medicines. Therefore, this pharmacist-led community-based initiative is crucial to deliver accurate health information effectively.

Keywords: KCU; community; knowledge; practice; use of medicine, Dungun

NMRR ID: NMRR ID-24-02619-TIC

RO-08

Knowledge, Attitude, and Practice (KAP) of Post-Exposure Prophylaxis (PEP) Against HIV Infection Among Healthcare Practitioners (HCP) in Pejabat Kesihatan Daerah Kota Bharu

Authors: Mat Zaid, Saiyida Syahira1; Sidek, Nur Farhana Hafizah2; Muhammad Hashim Koh, Salmi Koh3*; Nik Mohd Safri, Nik Nur Aleeza4

• 1Pharmacy Unit, Pengkalan Chepa Health Clinic, Ministry of Health Malaysia
• 2Pharmacy Unit, Bandar Kota Bharu Health Clinic, Ministry of Health Malaysia
• 3Pharmacy Unit, Lundang Paku Health Clinic, Ministry of Health Malaysia
• 4Pharmacy Unit, Penambang Health Clinic, Ministry of Health Malaysia

*Corresponding author: salmikoh@gmail.com

Abstract

Introduction: Healthcare practitioners (HCPs) face a significant risk of HIV infection due to occupational exposures, including needlestick injuries and contact with infected body fluids. Post-exposure prophylaxis (PEP) denotes a promising preventive strategy. However, its effectiveness is reliant on the knowledge, attitudes, and practices (KAP) of HCP. This study evaluates the KAP concerning PEP among HCPs in primary care clinics operating under the Pejabat Kesihatan Daerah Kota Bharu (PKDKB) in Kelantan.

Objective: To evaluate knowledge, attitude, and practice regarding PEP among HCPs and assess the professional demographic factors that influence KAP on PEP.

Materials and Methods: A cross-sectional study was conducted at four clinics using a structured, self-administered, and validated KAP questionnaire that had been previously applied in international studies. The study employed a comprehensive sampling method including 205 healthcare professionals who met the specified inclusion criteria. Data were analyzed using descriptive statistics and chi-square tests (SPSS v25), with statistical significance set at p<0.05.

Results: Of the 205 participants, only 32.2% demonstrated good knowledge of PEP, while 85.9% showed a positive attitude. However, only 12.7% reported good practices in managing occupational HIV exposure. Significant correlations were identified between KAP level and variables such as duration of service, prior occupational exposure and participation in Post-Exposure Prophylaxis (PEP) training.

Conclusion: The study indicates that there is a gap between HCPs positive attitude toward HIV PEP and their poor knowledge and inadequate practice. Hence, comprehensive measures such as continuous training, standardized protocols, and institutional support are essential to enhance PEP-related competencies and protect front-line healthcare personnel.

Keywords: Knowledge, Attitude, Practice, Post-Exposure Prophylaxis (PEP), HIV, Healthcare Practitioners, Occupational Exposure, Cross-sectional, Chi-square

NMRR ID: NMRR ID-24-00028-MXV

RO-09

Knowledge, Awareness and Perception on Contraception Among Healthcare Workers in District Hospitals in Kelantan: A Cross-Sectional Study

Authors: Kasim, Siti Nursyahida¹*; Ab Halim, Amin Nasrin¹; Che Hassan*, Nur Fazzlin¹; Zakaria, Nur Fakhira¹; Tan,Yan Ling²; Rosdi, Nur Intan Athirah²

• ¹Pharmacy Unit, Hospital Jeli, Jeli, Kelantan
• ²Pharmacy Unit, Hospital Tumpat, Tumpat, Kelantan

*Corresponding author: siti.nursyahida@moh.gov.my

Abstract

Introduction: Contraception is key to reducing unintended pregnancies and sexually transmitted diseases, yet usage remains suboptimal in Malaysia. Healthcare workers (HCWs) play a central role in educating patients, making their understanding and attitudes crucial.

Objective: To assess the level of knowledge, awareness and perception of contraception among HCWs in Hospital Jeli and Hospital Tumpat.

Materials and Methods: A prospective, cross-sectional observational study was conducted from May 2023 to June 2025 among 221 HCWs in Hospital Jeli and Hospital Tumpat, using a validated online questionnaire. Stratified sampling methods were applied to include pharmacists, doctors, nurses, medical assistants, and pharmacy assistants. Descriptive statistics, Chi-square and Pearson correlation tests were used to analyze data.

Results: Most participants were female (71.9%) and aged 30–39 years (60.2%). A majority (73.8%) showed good knowledge (mean=5.33±1.39), and 96.8% had good awareness (mean=36.39±5.29). However, only 6.8% demonstrated good perception (mean=26.94±5.23). Significant associations were found between knowledge and position/education, awareness with age/position, and perception with position/education. Weak but statistically significant positive correlations were observed between knowledge and awareness (r=0.215, p=0.004) and between awareness and perception (r=0.161, p=0.032). However, no significant correlation was found between knowledge and perception.

Conclusion: Despite high awareness and moderate knowledge, negative perceptions among HCWs highlight the need for targeted training to enhance contraceptive counselling in district hospitals.

Keywords: Contraception; Knowledge; Awareness; Perception; Healthcare Workers

NMRR ID: NMRR ID-25-00199-KO6

RO-010

Assessment of Knowledge and Inhaler Technique among Patients in Hospital Hulu Terengganu, Terengganu

Authors: Abd Rashid, Nur Akma Suhada1*; Aziz, Nur Syahirah1; Abdullah, Nursyafiqah1; Mohd Zawawi, Arwa Zahidah1; Mohd Shukri, Nur Farah Adibah1; Abdul Rahman, Nor Bahiyah1

• ¹Pharmacy Department, Hospital Hulu Terengganu, Terengganu

*Corresponding author: akmasuhada@gmail.com

Abstract

Introduction: Inhalers served as the primary treatment of asthma and chronic obstructive pulmonary disease (COPD), offering efficient drug delivery to the lungs with fewer side effects compared to oral or injectable therapies. Previous studies and practices revealed that nearly 90% of asthmatic patients did not use their inhalers properly. Correct inhalation technique was crucial to ensure optimal therapeutic outcomes and minimize side-effects.

Objectives: This study aimed to (1) assess knowledge on inhaler technique; (2) identify the prevalence of poor inhaler technique and (3) determine the factors associated with poor inhaler technique among patients at Hospital Hulu Terengganu (HHT).

Materials and Methods: This cross-sectional study was conducted among asthma and COPD patients at HHT from October 2024 to May 2025. Patients were guided and assessed by trained pharmacists using validated questionnaires (part 1: demography; part 2:10 items on knowledge; part 3: 9 items on inhaler technique). Responses were scored as 1=correct answer; 0=incorrect or unsure. Total score ≥7 was indicated as good knowledge and technique. Data was analysed using Pearson chi-square test (SPSSv.27).

Results: Of 95 patients, the mean age was 57.84±15.09 years with majority of them were males (62.4%), diagnosed with asthma (52.6%), and employed (49.5%). Most patients had been using inhalers for 1–5 years (58.8%) and used multiple inhalers (70.5%). Approximately 63.2% of them demonstrated good knowledge on inhaler technique. Poor technique was primarily observed among Metered Dose Inhaler [MDI] (20.2%) and Accuhaler (17.0%) users, while Breezhaler and Turbuhaler users exhibited good technique. Poor MDI technique was significantly associated with employment status (p=0.048), duration of inhaler use (p=0.024), and the number of inhalers used (p=0.031).

Conclusion: The study revealed that targeted education was vital for improving inhaler technique and treatment outcomes, especially among MDI users and those with extended or single inhaler use.

Keywords: COPD; asthma; inhaler; knowledge; technique; Terengganu

NMRR ID: NMRR ID-24-01520-UOI

RO-011

Clinical and cost evaluation on oral treatment of iron deficiency anemia among children in Pahang

Authors: Nordin, Nuratikah1*; Shamsudin, Fatin ‘Izzati1; Md Fadzilah, Fadzliany1; Syed Roslie, Syarifah Nasyirah1; Mohd Aznan, Nurain Afiqah1; Mustafa Kamal, Aina Liyana1; Zainal Abidin, Nor Izwani2; Abu Johan, Afiq Aizuddin3; Zamri, Siti Hajar4

• 1Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang
• 2Department of Pharmacy, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang
• 3Department of Pharmacy, Hospital Pekan, Pahang
• 4Department of Pharmacy, Hospital Kuala Lipis, Pahang

*Corresponding author: atikahnordin@gmail.com

Abstract

Introduction: Iron deficiency anaemia (IDA) is one of the most prevalent causes of anaemia in children and is typically managed by giving syrup ferric ammonium citrate and syrup iron polymaltose. Although both formulations demonstrate comparable efficacy, there is a considerable cost disparity between them. There is an increasing trend of prescribing syrup iron polymaltose in the current setting that may contribute to increment in overall hospital expenditure on the treatment of iron deficiency anemia.

Objectives: This study aimed to evaluate the efficacy of oral iron supplement treatment among iron deficiency paediatric patients in Pahang Hospital, to compare cost of medication for IDA in children and to describe the effect of weight, gender, dose, price and personnel that may affect cost of medication.

Materials and Methods: This was a multi-centre, retrospective, cohort study. Data was retrieved through an electronic system from 4 different hospitals in Pahang from January 2022 to December 2023. Patients with IDA aged less than 12 years old receiving oral iron medication with available data on baseline haemoglobin and 3 months after initiation of current therapy were included in the study. Patients with renal disease and cancer were excluded. Haemoglobin changes were compared using paired t-test. Direct costs included were medication cost and personnel cost. Tornado diagram was used to describe variables that may affect the price changes.

Results: A total of 298 patients were included in this study. 189 was on syrup FAC and 108 was on syrup iron polymaltose. Paired t-test shows an increment of 9.71 to 11.8 (p=<0.001) in the FAC group and an increment of 10.45 to 11.45 (p=<0.001) in the iron polymaltose group. The cost of treatment per month of a 6kg weight child with iron polymaltose was RM12.96 per patient and FAC was RM2.03 per patient. Situational analysis showed that an increment of 1 kg will increase cost of RM2.16 for iron polymaltose and RM0.33 in FAC per month. Weight of the child is the most affecting variable on the cost, followed by dose, price and personnel.

Conclusion: While both iron supplements effectively increased hemoglobin levels, syrup ferric ammonium citrate emerged as a cheaper option in managing pediatric IDA.

Keywords: anemia, children, iron supplement

NMRR ID: NMRR ID-24-00416-GPE

RO-012

Clinical and Economic Impact of Pharmacist-led Interventions on Drug-related Problems in Haematology Unit, Hospital Tengku Ampuan Afzan

Authors: Chua, Peck Wei1*; Yusoff, Muhammad Nasri2; Nordin, Nuratikah2

• 1Department of Pharmacy, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang.
• 2Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang

*Corresponding author:

Abstract

Introduction: Clinical pharmacists play a vital role in haematology by resolving drug-related problems (DRPs), especially in patients with hematological malignancies who face high risks due to immunosuppression and complex treatments. However, the clinical and economic impact of this service remains underexplored.

Objectives: This study aimed to evaluate the clinical and economic impact of clinical pharmacist interventions in the haematology unit, and identify factors associated with DRP occurrence.

Materials and Methods: A retrospective study was done among patients reviewed by clinical pharmacists in the haematology wards. The DRPs identified were classified according to Pharmaceutical Care Network Europe (PCNE). Clinical impact was graded from -1C (negative) to 4C (avoids fatality). Economic impact was determined by the net economic benefit and benefit-cost ratio. Generalised estimating equations (GEE) was used to identify factors associated with DRP.

Results: A total of 368 patients with 1052 admissions were included. Most were Malay (83.7%), male (57.6%), and malignant cases (82.6%). Thirty-five percent had DRP, totalling 730 interventions. Most interventions involved anti-infectives (27.9%) and antineoplastics (18.5%). Majority of the DRPs occurred on the treatment effectiveness (57.8%) and commonly caused by drug selection (n=485). The acceptance rate was high (98.9%). The majority of DRPs had moderate impact (51.5%), while 17.3% had major impact, translating into cost avoidance of RM1,037,434.81. The net economic benefit was RM611,698.14with benefit-cost ratio of 2.39. Length of stay (OR 1.14, 95%CI 1.09-1.19), chemotherapy (OR 1.84, 95%CI 1.35-2.51), and presence of infection (OR 2.72, 95%CI 1.65-4.44) were identified as contributing factors towards DRP.

Conclusion: Clinical pharmacists contribute significantly to both clinical and economic outcomes in haematology. Further validation is warranted, and credentialing should be considered to strengthen the service delivery in this subspecialty.

Keywords: clinical pharmacy, haematology, clinical impact, economic impact, pharmacy services

NMRR ID: NMRR ID-24-01874-7QP

RO-013

Assessment of Haemoglobin Level and its Determining Factors among Pregnant Women using Different Oral Iron-Containing Supplements in Public Health Clinics at Kuala Krai

Authors: Abdul Bielal, Alifah Ilyana¹; Yusoff, Rozida¹; Che Razali, Muhammad Rahim¹*; Muhammed, Nurul Asyikin¹; Ishak, Nor Aishah¹; Saizan, Sarah2

• 1Pharmacy Department, Kuala Krai District Health Office, Kelantan
• 2Kuala Krai District Health Office, Kelantan

*Corresponding author:

Abstract

Introduction: Anemia in pregnancy remains a significant public health issue, particularly in developing countries. Anemia is defined as a haemoglobin level less than 11 g/dL, with iron deficiency accounting for approximately 95% of cases. In Malaysia, the prevalence of iron deficiency anemia (IDA) among pregnant women ranges between 31.6% and 34.6%. IDA during pregnancy has been associated with increased risks of preterm delivery, low birth weight, and maternal morbidity. The significance of this study is to identify the most appropriate regimen for the treatment of IDA in pregnant women.

Objective: This study aimed to determine prevalence of IDA in pregnant women at Kuala Krai, to identify demographic and clinical factors associated with IDA, and to determine mean changes of haemoglobin level among three groups of oral iron supplement.

Methodology: A retrospective longitudinal study was conducted in public health clinics at Kuala Krai. From 1197 antenatal patients registered in 2023, 230 fulfilled the criteria. Data taken from antenatal books by using standardized data collection forms were categorized into demographic, antenatal, and clinical characteristics. Haemoglobin changes before and after treatment with three types of oral iron supplements were compared using one-way ANOVA testing.

Results: Prevalence of IDA in pregnant women at Kuala Krai was 19.21%. Among 230 patients, analysis revealed no statistically significant differences in haemoglobin level improvement between the different iron supplement regimens (p = 0.275, α = 0.05). The overall mean (SD) hemoglobin change was 0.689 (0.867) g/dL. Additionally, pregnant women of Malay ethnicity, with secondary education and who were unemployed, were more likely to be affected by IDA.

Conclusion: Different oral iron supplement regimens yielded comparable outcomes in hemoglobin improvement among pregnant women with anemia. Further research should explore other contributing factors such as dietary intake, supplement adherence, and comorbid conditions that may influence treatment effectiveness.

Keywords: Oral iron-containing supplements, hemoglobin, iron deficiency anemia, pregnant women

NMRR ID: NMRR ID-24-03591-IS6

RO-014

Validation and Item Reduction Potential of the Malaysia Medication Adherence Assessment Tool (MyMAAT) in Non-Dialysis Chronic Kidney Disease Patients

Authors: Lim, Ming Chiang1*; Md Hatah, Ernieda2; Goh, Jia Ean1; Abd Manan, Ahmad Ramdani3; Tan, Joyce Chu Yee1; Mohamed Iqbal, Nur Nabilah1; Masor, Nur Syahidah1; Balu, Deneshwary4; Khamar Ludin, Norhidayah5; Mamat, Norlaila Kartina Malini6; Mohammed Yusof, Noorazyani7; Ong, Angeline Huey Sim8; Zaidin, Musliza9; Mohammad, Norain10

• 1Department of Pharmacy, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang
• 2Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur
• 3 Pharmacy Unit, Klinik Kesihatan Triang, Triang, Pahang
• 4 Department of Pharmacy, Hospital Kuala Lipis, Kuala Lipis, Pahang
• 5 Department of Pharmacy, Hospital Pekan, Pekan, Pahang
• 6 Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang
• 7 Department of Pharmacy, Hospital Jerantut, Jerantut, Pahang
• 8 Pharmacy Unit, Klinik Kesihatan Temerloh, Temerloh, Pahang
• 9 Pharmacy Unit, Klinik Kesihatan Kurnia, Kuantan, Pahang
• 10 Department of Pharmacy, Hospital Rompin, Kuala Rompin, Pahang

*Corresponding author: ernieda@ukm.edu.my

Abstract

Introduction: Medication adherence is crucial for managing chronic kidney disease (CKD) and preventing its progression. In Malaysia, adherence is commonly assessed using the 12-item Malaysia Medication Adherence Assessment Tool (MyMAAT-12), though it has yet to be validated in CKD patients. Given the complex medication regimens and frequent appointments associated with CKD, a shorter, more practical tool may enhance clinical utility.

Objectives: This study aims to validate the MyMAAT-12 and explore its potential for item reduction among non-dialysis CKD patients.

Materials and Methods: A cross-sectional, multi-centre study was conducted across eight health facilities in Pahang from December 2023 to August 2024. Non-dialysis CKD patients aged ≥18 years, with or without diabetes, attending outpatient clinics completed the self-administered MyMAAT-12 and selected items from the Beliefs about Medicines Questionnaire (BMQ). Demographics, HbA1c levels, and serum phosphate changes from the preceding three months were also collected. Exploratory factor analysis (EFA) was used to examine the scale dimensionality, reliability, and criterion validity. A simulation analysis evaluated the feasibility of reducing the number of items.

Results: A total of 246 respondents participated, predominantly female (54.5%) and Malay (91.5%), with a mean age of 59.5±12.5 years and an average CKD duration of 5.0±5.4 years. The average medication adherence score was poor to moderate (<54/60). MyMAAT-12 demonstrated excellent internal consistency (Cronbach’s alpha=0.90) and significant association with BMQ categories (χ²(2)=16.8, p<0.01). EFA identified a two-factor structure. MyMAAT-12 adherence categorization was significantly associated with HbA1c% (<8% vs. ≥8%) (χ2(2)=4.7, p=0.03) and phosphate level changes (χ2(2)=5.48, p=0.02). Results indicated that reducing MyMAAT-12 to a 7-item scale was feasible, while maintaining strong psychometric properties (Cronbach’s alpha=0.87) and a significant association with HbA1c% (ρ=-0.22, p=0.01).

Conclusion: MyMAAT-12 is a valid and reliable tool for assessing adherence in non-dialysis CKD patients. The MyMAAT-7 provides a shorter, practical alternative with robust psychometric performance, supporting its potential use in routine clinical practice.

Keywords: medication adherence; chronic kidney insufficiency; validity and reliability; beliefs about medication

NMRR ID: NMRR ID-23-02445-G6O

RO-015

Knowledge and Adherence to Oral Iron Consumption Among Pregnant Women Attending Health Clinic in PKD Machang

Authors: Abd Malik, Nur Alyaa Bajana1*; Abdul Ghani, Nur Afera1; Ismail, Eni Fazihan2; Mohd Hasali, Nor Hafizah3

• 1Department of Pharmacy, Klinik Kesihatan Labok, Machang, Kelantan
• 2Department of Pharmacy, Klinik Kesihatan Machang, Machang, Kelantan
• 3Department of Pharmacy, Klinik Kesihatan Batu 30, Machang, Kelantan

*Corresponding author: nurafera@moh.gov.my

Abstract

Introduction: Anemia in pregnancy is a significant public health concern. In PKD Machang, there has been an increasing number of anemic pregnant mother, leading to a rising demand for iron sucrose injections due to failure of oral iron therapy.

Objectives: To determine knowledge and adherence of pregnant women to oral iron consumption. The specific objectives were to determine association between knowledge score and adherence score with sociodemographic profiles, pregnancy characteristics and iron supplementation. Additionally, to determine correlation between knowledge score with adherence score.

Materials and Methods: This was a cross-sectional study conducted on 376 pregnant women attending 11 Maternal and Child Health Clinics under PKD Machang from 1st September to 31st December 2024. Data were collected using a validated, self-administered questionnaire in Malay consisting of 49 items across four sections. Descriptive statistics were used to analyze sociodemographic profiles, pregnancy characteristics, oral iron consumption details, knowledge and adherence. Associations were assessed using correlation, independent sample t-tests and one-way ANOVA. Where ANOVA results were significant, Bonferroni post hoc tests were applied. The association between knowledge score and adherence score was analyzed using Pearson’s correlation.

Results: Among 376 respondents, only 69 (18.4%) demonstrated good knowledge, while 255 (67.8%) had good adherence to oral iron consumption. Marital status, education level, occupation, husband’s education level, gestational age, gravidity, history of anemia in previous pregnancy, history of oral iron intake, awareness of their hemoglobin level, name and dose of oral iron pills were significantly associated with knowledge score. Alternatively, history of oral iron intake in previous pregnancy and education level were significantly associated with adherence score. There is a significant correlation between knowledge score and adherence score (p=0.046).

Conclusion: Knowledge regarding oral iron supplementation is significantly associated with adherence. Improving maternal knowledge through targeted health education may enhance adherence, thus reducing iron-deficiency anemia in pregnancy.

Keywords: Pregnant women, anemia, oral iron consumption, knowledge, adherence

NMRR ID: RSCH-ID-24-01685-WIX

Poster Presentations

RP-01

Health-Related Quality of Life (HRQoL) among Solid Cancer Patients in Hospital Tengku Ampuan Afzan (HTAA)

Authors: Amir Azhar, Nur Afiqah1*; Ahmad, Mastura1; T. Syed Manso, Syarifah Syafiqah1; Mohamad Hanapi, Nurul Najihah1; Noor Hazrulhisham, Nur Nazatul Hanis2; Khairul Hafidz, Muhammad Hafizul Aniq3; Zaharudie, Idham4; July, Airene5

• 1Department of Pharmacy, Hospital Tengku Ampuan Afzan, Pahang
• 2Permatang Badak Health Clinic, Kuantan, Pahang
• 3Pahang State Health Department, Kuantan, Pahang
• 4Pekan Tajau Health Clinic, Maran, Pahang
• 5Tersang Health Clinic, Raub, Pahang

*Corresponding author: nurafiqahamirazhar@moh.gov.my

Abstract

Introduction: Solid cancers significantly impact Malaysian patients’ health-related quality of life (HRQoL), yet HRQoL data is scarce. Understanding HRQoL is crucial for healthcare providers to develop effective interventions.

Objectives: This study aimed to determine the HRQoL among solid cancer patients, to measure the health utilities of solid cancer patients and identifies factors associated with HRQoL among this population in HTAA.

Material and Methods: A cross-sectional study was conducted involving 149 solid cancer patients aged 18 years and above treated in-patient at the oncology wards in HTAA. HRQoL was assessed using EUROQoL EQ-5D-5L for Health Utility Index (HUI) and Visual Analogue Scale (VAS). The five domains for EQ-5D-5L are mobility, self-care, usual activity, pain/discomfort and anxiety/depression, ranging from <0 to 1 (worse to best). For VAS, patients rated their perceived health from 0 to 100 (worst to best imaginable). Data were analysed using SPSS version 21. Multiple linear regression was used to analyse sociodemographic, clinical and treatment factors associated with HUI.

Results: Patients’ average age was 52.58 ± 12.83 years, predominantly female (66.4%) and Malay (79.2%). Both the mean HUI (0.9 ± 0.11) and VAS (75.68 ± 15.15) indicated a relatively high self-perceived HRQoL. Multiple treatment modalities had significantly higher HUI scores compared to those who received chemotherapy alone (B=0.053, 95% CI 0.014-0.093; p=0.009). Patients with a moderate Charlson Comorbidity Index (CCI) had significantly better HUI scores than those with high CCI (B=0.041, 95% CI 0.004-0.078; p=0.031).

Conclusion: This study showed that solid cancer patients at HTAA had a positive perception of well-being, as reflected by a high mean health utility index. Health-related quality of life was positively influenced by combination treatment modalities and a moderate comorbidity index.

Keywords: HRQoL, EUROQOL EQ5D5L, solid cancer

NMRR ID: NMRR ID-23-02711-WN2

RP-02

Prescribing Pattern of Nicotine Replacement Therapy (NRT) in Health Clinics, Kemaman

Authors: Talib, Siti Syauqina1*; Wan Jusoh, Wan Ruzana2; Sa’ari, Siti Akmal2

• 1Pharmacy Unit, Klinik Kesihatan Air Putih, Chukai, Kemaman
• 2Pharmacy Unit, Klinik Kesihatan Cheneh, Kemaman

*Corresponding author: norsyauqina@moh.gov.my

Abstract

Introduction: Globally, the majority of smokers are aware that smoking is not good for their health but have difficulty quitting. Malaysia is still committed to strengthen the smoking cessation services. Therefore, Clinical Practice Guideline (CPG) was developed to ensure smokers gets the latest evidenced-based treatment to ensure higher quit smoking success rate.

Objectives: This study intended to observe the prescribing patterns of Nicotine Replacement Therapy (NRT), to assess adherence to National CPG on treatment recommendation and to determine the smoking cessation success rate in Health Clinics in Kemaman.

Materials and Methods: An observational study was conducted in Smoking Cessation Clinics involving eight Government Health Clinics in Kemaman from January to December 2023. All registered patients during this period were included and required data were extracted from patients’ record. Initial NRT dosing patterns and adherence to the national CPG on Treatment of Tobacco Use Disorder were analysed descriptively. The cessation success rate was analysed using Fisher’s exact test, with p<0.05 considered statistically significant.

Results: Of the 142 participants, 97.2% were male and 68.3% were employed. Among them, 78.2% had comorbidities, with hypertension (26.1%), diabetes mellitus (15.5%) and dyslipidaemia (12.0%) being the most common. The mean number of cigarettes smoked per day was 14.6 sticks. Gum 2mg was the most frequently prescribed NRT (57%), followed by gum 4mg (21.8%). Patch-only regimens were less common, with 1.4% using the 10mg patch and 2.8% the 15mg patch. Combination therapy with both patch and gum was prescribed to 24 patients (16.9%). Prescribing patterns showed high adherence to the national CPG. However, the smoking cessation success rate remained low, with only 16.2% of participants successfully quitting.

Conclusion: The success rate of smoking cessation remains low despite the availability of treatment options. Further study is necessary to identify the factors contributing to the low smoking cessation rate among patients in Health Clinics, Kemaman.

Keywords: Nicotine Replacement Therapy; smoking cessation; prescribing pattern, Kemaman

NMRR ID: NMRR ID-24-01544-FEH

RP-03

Costing Study on Treatment of Anemia in Pregnancy Among Orang Asli (OA) Patients in Pahang

Authors: Lee, Chen Yuan1*; Mohammad Yunus, Mohammad Hafiz1; Mohammad Sharohhuddin, Mohammad Yazid1; Abd Razi, Khairunnisa2; Abdul Samad, Noor Faeizan3; Aziz, Azliana4; Chen, Tze Seong5; Azman, Radhiah8; Devarajooh, Cassidy9

• 1Department of Pharmacy, Unit Farmasi Logistik, PKD Raub, Pahang
• 2Department of Pharmacy, Klinik Kesihatan Dong, Raub, Pahang
• 3Department of Mother & Child Health, Klinik Kesihatan Cheroh, Raub 27600, Pahang
• 4Department of Pharmacy, Klinik Kesihatan Cheroh, Raub, Pahang
• 7Department of Pharmacy, Klinik Kesihatan Bentong, Pahang
• 5Department of Pharmacy, Klinik Kesihatan Betau, Lipis, Pahang
• 6District Health Officer, PKD Raub, Raub, Pahang

*Corresponding author: lee_chen-yuan@hotmail.com

Abstract

Introduction: Anemia in pregnancy is a significant global health concern, particularly affecting pregnant Orang Asli (OA) women in Malaysia (37.6%), where accessing healthcare facilities is challenging.

Objectives: The study aimed to estimate the cost of managing anemia in pregnancy among the OA population in primary healthcare settings and to determine major cost components in treatment of anemia.

Materials and Methods: This cross-sectional study retrospectively analyzed antenatal OA patients meeting predefined inclusion and exclusion criteria using convenience sampling from the government’s perspective. The costing analysis used both top-down and bottom-up approaches. Data on direct (medications, lab tests and consultation) and non-direct (transportation) medical costs were collected from patients’ antenatal records spanning January 2023 to December 2023 using a structured data collection form.

Results: Initially, 181 patients were collected. After exclusions (59 non-anemic, 8 who gave birth in 2022, 3 transferred out), cost calculation used data from 111 patients. The average treatment cost per anemic antenatal patient was RM1,597.08, with individual costs ranging from RM170.32 to RM2,935.85. The prevalence of anemic antenatal patients in this study cohort was 65.29%. Direct medical costs were primarily driven by laboratory tests, which averaged RM832.26. Consultations followed with an average cost of RM315.12, while medications represented the lowest component, averaging RM107.84. Non-direct medical cost: transportation costs averaged RM22.17. Treatment costs varied; for instance, severe anemia cases, defined by a hemoglobin level below 7.0 g/dL, averaged RM1661.48 in treatment costs. Furthermore, earlier detection of anemia, specifically between 1 to 5 weeks of gestation, correlated with higher average costs of RM2479.67.

Conclusion: The average cost treatment per patient is RM1,597.08, majorly contributed by lab tests. Further study on assessing the cost-effectiveness of initiating treatment with Iberet-Folic as opposed to haematinics could be considered. Overall management of anemia in pregnant OA is deemed superior with Iberet-Folic due to improved compliance and convenience.

Keywords: Anemia, Pregnancy, Orang Asli, Antenal

NMRR ID: NMRR ID-24-00040-OI3

RP-04

Evaluation of Adverse Drug Reactions at Hospital Besut: A 5-Year Retrospective Study

Authors: Tahir, Nurul Ain1; Fami, Muhammad Luqman Alhakim1*; Juraimi, Nur Rashida Hani1; Mohd Azmi, Nur Aqilah1; Shafie, Nur Aizahakiki1; Abdul Rashid, Rabihah1

• 1Department of Pharmacy, Hospital Besut, Besut, Terengganu

*Corresponding author: nurulaintahir@moh.gov.my

Abstract

Introduction: An adverse drug reaction (ADR) is an unintended and harmful response to a medicinal product and is a significant cause of morbidity and mortality. Despite its importance, no prior systematic ADR evaluation has been conducted at Hospital Besut.

Objectives: This study aimed to analyze ADR patterns reported within 5 years (2019 to 2023) in Hospital Besut, focusing on affected organ systems and types of drugs involved, causality, severity, outcomes, and to identify associations between demographics, severity, and reaction onset.

Method: A retrospective observational study was conducted using all ADR reports recorded in Pharmacy Information System (PhIS) and submitted to the National Pharmaceutical Regulatory Agency (NPRA). Data from January 2019 to December 2023 was collected and analyzed from June to November 2024. The descriptive and statistical analysis of the Chi-square test has been used to present the findings, with significance set at p<0.05 using SPSS version 27.

Results: A total of 289 ADR forms with 413 reactions were analyzed. The occurrence of ADRs was common among females (n=151, 52.2%) followed by males (n=138, 47.8%). The average mean age of patients was 36 (SD+21.9) years. Most ADRs involved the skin (n=280, 67.8%) and respiratory system (n=44, 11.6%). The drug-reaction relationships were mostly classified as probable and possible which were 114 (39.4%) respectively. In addition, most of the onset of ADR occurred within minutes (n=117, 40.5%) and the reactions were mild (n=171, 59.2%), with 181 (62.6%) of patients recovered from the ADR. Antibiotics (n=94, 32.5%) and analgesics (n=55, 19.03%) were responsible for most ADRs. Only age was significantly associated with the reaction severity (p=0.037).

Conclusion: This study emphasizes the importance of pharmacovigilance in identifying common ADR patterns and promoting safer medication practices in Hospital Besut.

Keywords: Adverse drug reaction; ADR reports; Malaysia; Pharmacovigilance, Hospital Besut

NMRR ID: NMRR ID-24-01593-NWD

RP-05

From Struggle to Strategy: A Qualitative Study of Smoking Cessation Barriers among Patients with Chronic Obstructive Pulmonary Disease

Authors: Md Khairi, Lukman Nul Hakim1*; Mukhtar, Mazlina1; Wan Zakaria, Wan Aimuni1; Sopi, Muhammad Fais1; Gnanasan, Shubashini2; Samsudin, Azlina3

• 1Department of Pharmacy, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu
• 2Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor
• 3Department of Respiratory Medicine, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu

*Corresponding author: lukman.nh@moh.gov.my

Abstract

Introduction: Despite the clinical urgency for smoking cessation, patients with chronic obstructive pulmonary disease (COPD) face complex challenges in quitting. Understanding these barriers is crucial for developing effective, patient-centred interventions within the public healthcare setting.

Objectives: This study aimed to explore the psychological, social, and healthcare-related barriers experienced by patients with COPD in their efforts to quit smoking.

Materials and Methods: A qualitative study was conducted through in-depth interviews with a purposive sample of participants recruited from the Respiratory Clinic of Hospital Sultanah Nur Zahirah. Patients who were unable to quit smoking despite receiving treatment for COPD were included. The interviews were audio-recorded, transcribed verbatim, and thematically analysed using the Atlas.ti version 23.

Results: A model with three key themes emerged, reflecting the decision-making process of the study participants. (1) Engagement with assisted smoking cessation: Participants had limited awareness of cessation programs, misconceptions about therapy, and negative experiences with nicotine replacement products, leading to low participation and repeated quit failures; (2) Requiring support while maintaining autonomy: While many preferred to quit independently, they often lacked structured support. Family encouragement was frequently perceived as ineffective or intrusive, and healthcare referrals were inconsistent or absent; and (3) Motivational factors: Motivation to quit was volatile. Some were triggered by worsening symptoms, while others struggled with long-term dependency, negative peer influences, or lack of faith in success, often shaped by observing others’ failed attempts.

Conclusion: Smoking cessation among patients with COPD is influenced by internal struggles, limited support systems, and inadequate engagement with cessation programs. Addressing these barriers requires patient-centred interventions that improve awareness, dispel misconceptions, and offer empathetic, tailored counselling. Pharmacists are well-positioned to deliver behavioural support and personalised counselling to encourage and facilitate patients’ readiness to enrol in cessation programs. Strengthening such programs aligns with national priorities for integrated, outcome-oriented chronic disease management.

Keywords: Smoking cessation, chronic obstructive pulmonary disease, qualitative study, patient-centred care, behavioural barriers, Malaysia

NMRR ID: NMRR ID-22-01429-2ET

RP-06

Knowledge, Attitude and Practice of Painkillers among Patients in Jeli District Health Clinics, Kelantan

Authors: Zulkifli, Nur Amni Syairah1*; Ishak, Fatin Najihah2; Ab Ghani, Siti Nor Asiah3; Mohd Hanafi, Muhammad Abu Bakar1

• 1Department of Pharmacy, Klinik Kesihatan Jeli, Jeli, Kelantan
• 2Department of Pharmacy, Klinik Kesihatan Lubok Bongor, Jeli, Kelantan
• 3 Department of Pharmacy, Pejabat Kesihatan Daerah Jeli, Jeli, Kelantan

*Corresponding author: eramnizulkifli@gmail.com

Abstract

Introduction: Improper use of analgesics is an emerging public-health concern in Malaysia, yet data from rural primary-care settings remain limited. Thus, knowing how patients feel about using painkillers can help the doctors and patients communicate more effectively and support the creation of public education campaigns for patients and the general public.

Objectives: To assess patients’ knowledge, attitude and practice (KAP) on painkiller use in Jeli District Health Clinics, Kelantan, and to determine their associations with demographic factors and pain severity.

Materials and Methods: A prospective, cross-sectional observational study was conducted among 125 adults receiving painkiller prescriptions at six outpatient health clinics in Jeli, Kelantan from October 2024 to June 2025. Proportional sampling was applied. A validated self-administered questionnaire measured KAP; scores were classified using Bloom’s cut-offs (Good ≥ 80 %, Moderate 60–79 %, Poor < 60 %). Descriptive statistics and Chi-square tests examined associations between KAP domains, demographics and pain severity.

Results: Respondents were predominantly female (56%), aged 30–44 years (32%) and Malay (93.6%). Overall, 96 % exhibited poor knowledge, whereas 72 % showed good attitude and 64.8 % good practice toward painkiller use. Knowledge level was not significantly linked to any demographic variable. Education level, however, was significantly associated with attitude (P = 0.005). No significant associations emerged between demographic factors and practice. Inter-domain analysis revealed no significant relationships between knowledge and attitude (P = 0.731), knowledge and practice (P = 0.577), or attitude and practice (P = 0.116). Pain severity displayed a borderline association with knowledge (P = 0.054) but not with attitude or practice.

Conclusion: Most rural clinic patients lacked adequate knowledge of analgesics despite generally favourable attitudes and practices, suggesting that the respondents only follow the health cares’ instruction rather than understanding the underlying reasons. Educational attainment influences attitudes, and severe pain may modestly prompt information seeking. Thus, targeted, education-level–specific counselling and community outreach are recommended to bridge knowledge gaps and support safe analgesic use.

Keywords: Painkillers, Knowledge, Attitude, Practice, Outpatient, Malaysia, Jeli District

NMRR ID: NMRR ID-25-01025-Z8T

RP-07

Evaluation of the Impact of Pharmacy Integrated Community Care (PICC) on Medication Adherence and Clinical Outcomes among Diabetic Patients in Terengganu

Authors: Yusof, Mohd Syafiq1*; Rosli, Masturah1; Aziz, Norazli Syarifah2

• 1Pharmacy Service Division, Terengganu State Health Department, Kuala Terengganu
• 2Hospital Besut, Jalan Pasir Akar, Kampung Tanduk, Jerteh, Terengganu

*Corresponding author: syafiq.yusof@moh.gov.my

Abstract

Introduction: Suboptimal glycaemic control and low medication adherence remain key barriers to diabetes management in Malaysia. The National Health and Morbidity Survey 2023 reported that 40% of Malaysian adults unaware of their disease condition and 56% had poor glycemic control.

Objectives: This study aimed to evaluate the impact of PICC programme towards medication adherence and clinical outcomes among diabetic patients in Terengganu.

Material and Methods: This quasi-experimental study was conducted at different places in community settings from May to October 2024. Diabetic patients were selected based on inclusion and exclusion criteria from all districts in Terengganu. They were engaged in PICC programme and attending four pharmacist-led interactive sessions. Over a four-month period, four education modules were delivered. The Malaysian Medication Adherence Assessment Tool (MyMAAT-12) was administered before and after PICC to assess adherence (1-5 Likert responses, higher scores denoted better adherence). Other clinical parameters including glycosylated hemoglobin (HbA1c), random blood sugar (RBS) and blood pressure (BP) were also collected. Data were analysed using parametric test (SPSSv.27), with p<0.05 considered statistically significant.

Results: A total of 92 patients participated. Majority were Malay (98.9%), women (65.2%) and mean age of 59.8 ± 1.38 years. The mean adherence scores increased significantly from 46.28 ± 8.88 to 54.36 ± 5.77 (p<0.001), with the proportion of patients demonstrating good adherence rising from 32.5% to 72.5% post PICC. Patients showed significantly better in glycemic control with mean HbA1c levels decreased from 10.16%±2.02 to 9.51%± 1.92 accompanied by significant reductions in RBS (p < 0.001). Although BP readings showed numerical improvement, the changes were not statistically significant.

Conclusion: The encouraging overall findings seemed to support the adherence and clinical benefits of diabetic patients. Hopefully, this PICC programme can be expanded nationwide through strategic collaboration with community leaders, non-governmental organisations, and private sector partners to complement current healthcare services and strengthen long-term chronic disease management in Malaysia.

Keywords: Diabetes mellitus, medication adherence, HbA1c, clinical outcome, PICC, Terengganu

NMRR ID: NMRR ID-23-02439-SJQ

RP-08

Analysis of Pharmacist’s Intervention on Prescription at Outpatient Pharmacy Setting

Authors: Kwong, Kien Seang1*; Chen, Tze Seong2; Zamri, Siti Hajar3; Mohamed Koya, Saiful Nizam4; Chase-Currier, Alyson1; Mohd Razali, Fatin Syafiqa5; Salleh @ Ariffin, Nur Hanani6; Hong, Jason2; Mohamed Zaid, Nur Aliea7; Salleh, Nurul Hidayah8

• 1Department of Pharmacy, Hospital Raub, Raub, Pahang
• 2Department of Pharmacy, Pejabat Kesihatan Daerah Bentong, Pahang
• 3Department of Pharmacy, Hospital Kuala Lipis, Pahang
• 4Department of Pharmacy, Hospital Bentong, Pahang
• 5Department of Pharmacy, Pejabat Kesihatan Daerah Lipis, Pahang
• 6Department of Pharmacy, Hospital Sultanah Hajjah Kalsom, Cameron Highlands, Pahang
• 7Department of Pharmacy, Pejabat Kesihatan Daerah Raub, Pahang
• 8Department of Pharmacy, Pejabat Kesihatan Daerah Cameron, Pahang

*Corresponding author: kkseang@yahoo.com

Abstract

Introduction: Medication error is a risk for patient safety. Pharmacist interventions are key, but underreporting hinders improvement. Better understanding of intervention can help to improve medication safety.

Objectives: To calculate percentage underreporting of pharmacists’ intervention through Medication Error Reporting System (MERS). To analyse pharmacists’ intervention; to compare type of intervention done between hospital and clinic.

Materials and Methods: A cross-sectional study in West Pahang outpatient pharmacies. Real-Time Observation technique was used to observe pharmacists’ interventions over one week. Using purposive sampling, data on interventions, MERS use, and personnel details were collected via standardized form. Chi square test was used to compare type of intervention done between facility.

Results: Out of 6,930 prescriptions, 169 (2.44%) involved pharmacist interventions. Documentation practices revealed that 76.33% of these interventions were recorded in pharmacy reports, whereas only 3.55% were reported through the MERS. Pharmacists performed most interventions, with an average service length of 6.67 years. The predominant error type leading to intervention was inappropriate prescriptions (63.31%), followed by incomplete prescriptions; miscellaneous errors were least common (2.37%). There was no significant association between facility type (Hospital vs. PKD) and the intervention (χ²=1.011, p=0.315). Fisher’s Exact Test showed significant association between prescription type (manual vs. electronic) and type intervention (p<0.001). Electronic prescriptions linked to lesser incomplete prescription errors (post hoc p<0.001). Majority of interventions (84.13%) pertained to commonly prescribed medications. The highest number of interventions performed by pharmacists occurred between 11am and 12 pm with 16.57% of total interventions.

Conclusion: Pharmacist interventions are vital for medication safety, yet significant MERS underreporting persists. Promoting MERS use and addressing all error types are crucial. Higher prescribing errors during peak hours may be caused by increased patient load, practitioner stress, and critical distractions. The administration should address this issue to reduce prescribing errors and improve medication safety.

Keywords: Pharmacist intervention; prescribing errors; medication errors; outpatient pharmacy; MERS reporting; West Pahang.

NMRR ID: NMRR ID-23-03614-BAA

RP-09

The Utilization Pattern of Psychotropic Drugs in a District Hospital in Pahang – Hospital Bera (HOSBER)

Authors: Yahaya, Siti Rasyidah1*; Wan Khazanah @ Wan Salleh, Wan Muhamad Azri1; Radzuan, Nurul Syahida1; Zulkofli, Syazwani1

• 1Department of Pharmacy, Hospital Bera, Bera 28200, Pahang

*Corresponding author: sitirasyidahyahaya@gmail.com

Abstract

Introduction: Mental health disorders pose a significant burden on healthcare systems globally. Psychotropic medications play a crucial role in managing psychiatric conditions, yet in Malaysia, studies on their utilization patterns remain limited, especially in district hospital settings. Understanding drug utilization supports effective pharmacotherapy review and resource allocation.

Objectives: This study aims to evaluate the utilization patterns of psychotropic drugs at Hospital Bera in 2023 by analyzing prescribing trends based on age, gender, and race, and identifying the most commonly prescribed drug classes and individual agents.

Method: A retrospective observational study was conducted using outpatient data from January to December 2023. Demographic and prescription data were obtained from the Pharmacy Information System (PhIS) and Hospital Information System (HIS). Drug utilization was analyzed using descriptive statistics in Microsoft Excel and expressed as Defined Daily Dose (DDD) per 1,000 population per year. Result: A total of 202 patients met the inclusion criteria, with a male predominance (56.9%). Most patients were Malay (67.8%) and aged between 36–45 years (25.7%). Schizophrenia and related disorders (61%) were the most common diagnoses. Antipsychotics accounted for the majority of prescriptions (90.3%), followed by antidepressants (9.7%) and anxiolytics/sedatives (<0.1%). Atypical antipsychotics were predominantly used, with sulpiride (40.35 DDD/1,000/year) and quetiapine (39.45 DDD/1,000/year) being the most common. Among antidepressants, selective serotonin reuptake inhibitors (SSRIs) were preferred, with fluvoxamine (11.74 DDD/1,000/year) being the most frequently prescribed. Prescribing patterns varied across demographic groups.

Conclusion: The study highlights the predominant use of atypical antipsychotics and SSRIs in treating psychiatric conditions at Hospital Bera. These findings provide insights into current prescribing trends and support rational drug use. Further research is recommended to evaluate long-term outcomes and cost-effectiveness.

Keywords: Psychotropic drugs, drug utilization, antipsychotics, antidepressants, Malaysia, Hospital Bera

NMRR ID: NMRR ID-24-00618-72E

RP-10

Knowledge on the Use of Proton Pump Inhibitors among Healthcare Professionals in Terengganu Health Clinics

Authors: Zainuddin, Nur Fajrina1; Wan Mahmood, Wan Noraini2; Omar, Nur Sulaihah3

• 1Department of Pharmacy, Klinik Kesihatan Hiliran, Kuala Terengganu, Terengganu
• 2Department of Pharmacy, Klinik Kesihatan Manir, Kuala Terengganu, Terengganu
• 3Department of Pharmacy, Klinik Kesihatan Hiliran, Kuala Terengganu, Terengganu

*Corresponding author: nurfajrina949@gmail.com

Abstract

Introduction: Proton Pump Inhibitors (PPIs) are mostly prescribed medication for the treatment of heartburn and acid-related disorders. Poor knowledge of PPIs among healthcare professionals may lead to their unnecessary use, which can be associated with severe adverse outcomes and increased healthcare costs. These factors can ultimately affect the appropriate utilization and clinical efficacy of the drugs.

Objectives: This study intended to evaluate the knowledge on the use of PPI and to identify the association of knowledge with demographic characteristics among the healthcare professionals at three District Health Offices in Terengganu.

Materials and Methods: A cross-sectional study was conducted in 12 clinics from Marang, Kuala Terengganu and Kuala Nerus District Health Offices. Consented participants, involving medical doctors and pharmacists, were recruited from Jun to October 2024. Study tools were validated questionnaires adopted from previous study which consist of sociodemographic section and knowledge section (20 questions; ‘yes’ or ‘no’ answers; correct answer=1 point; wrong answer=0 point; ≥16 total scores=good knowledge). The data were analysed by descriptive analysis and affirmed by parametric test using SPSSv.28.

Results: Out of 252 participants, majority were medical doctors (n=161,63.9%), females (n=191, 75.8%) had bachelor’s degree (n=245, 97.2%) within 6 to 10 years of working duration (n=106, 42.1%) and mean age of 33.43±0.342 years. Most of the participants were found to have poor to moderate knowledge on the use of PPIs (n=190, 75.4%). Knowledge status was found to be significantly associated with participants’ age, types of profession and working duration (p<o.oo1). Doctors were relatively more knowledgeable about PPIs than pharmacists.

Conclusion: Knowledge on the use of PPIs was unsatisfactory and relatively lower among pharmacists compared to doctors. These findings emphasize the importance of ongoing clinical exposure and continuous professional development in maintaining up-to-date knowledge on PPIs to reduce the widespread overuse of them and financial implication.

Keywords: Knowledge; Proton Pump Inhibitor; healthcare professional; Terengganu

NMRR ID: NMRR ID-24-01554-W64

RP-11

Low Molecular Weight Heparin versus Unfractionated Heparin as Venous Thromboembolism Prophylaxis in Neurosurgery

Authors: Yeoh, Mei Ting1*; Ahmad, Mastura1; Chua, Peck Wei1; Mohamed Yusof, Safwah Suad2; Zainul Ibrahim, Aida Mardhiyah3; Aminudin, Nurul Hazirah4; -Mohd Jaferi, Nurul Asyikin1; Mustafa, Nur Hanisah1

• 1Department of Pharmacy, Hospital Tengku Ampuan Afzan, Pahang
• 2Department of Pharmacy, Hospital Raub, Pahang
• 3Pharmacy Practice and Development Division, Pahang State Health Department, Pahang
• 4Healthlane Family Pharmacy, Pahang

*Corresponding author: yeoh_meiting@gmail.com

Abstract

Introduction: Venous thromboembolic events (VTE) contribute significantly to post-operative morbidity and mortality in neurosurgery. In the local setting, there is an increasing trend of VTE post neurosurgery and unfractionated heparin (UFH) is commonly prescribed as prophylactic anticoagulant. However, direct comparison of efficacy and safety between UFH or low molecular weight heparin (LMWH) is limited.

Objectives: This study aimed to describe the use of LMWH and UFH as prophylactic anticoagulants among post-operative neurosurgical patients. Post-operative VTE rate, bleeding rate and all-cause mortality were compared between patients receiving LMWH versus UFH.

Materials and Methods: A retrospective medical record review was conducted for 40 patients admitted to neurosurgery ward at our institution from the year 2021 to 2022. Patients below 18 years old, had previous history of anticoagulant use and those who did not receive surgical procedure were excluded. Patient demographics, surgery related data and clinical characteristics were obtained. Fisher-Exact Tests were performed using Statistical Package for Social Sciences (SPSS) version 25, comparing rates of post-operative VTE, bleeding and all-cause mortality for each group.

Results: After screening and applying exclusion criteria, 40 patients were included. Thirty patients (75%) received LMWH while 10 patients (25%) received UFH. Patients receiving prophylactic LMWH and UFH, exhibited similar rates of post-operative VTE (13.3% vs 10%, p=0.554) which comprised solely of pulmonary embolism (PE). No difference was found in terms of post-operative bleeding rate by group; however, major bleeding was reported only in patients who received UFH (0% vs 10%, p=0.367). No significant difference was found for all-cause mortality (23.3% vs 10%, p=0.653). Additionally, the time of anticoagulant initiation in patients receiving LMWH was earlier as compared to UFH (4 days vs 5.5 days, p<0.01).

Conclusion: Rates for post-operative PE, bleeding complications and all-cause mortality were similar between patients received prophylactic LMWH or UFH after cranial procedures. Further studies are needed to determine whether specific subpopulations demonstrate improved benefit from either prophylactic anticoagulant.

Keywords: Venous thromboembolism; pulmonary embolism; neurosurgery; cranial procedures; unfractionated heparin; low molecular weight heparin; bleeding.

NMRR ID: NMRR ID-23-00066-5YC

RP-12

Return and Disposal of Unused and Expired Medications (ReDiUEM) Among Patients Visiting Outpatient Clinics in PKD Pasir Puteh, Kelantan

Authors: Tuan Mohamad, Tuan Nur Syafiqah1*; Wan Ahmad, Wan Nurhanis Insyirah2; Che Din, Muhammad Firdaus1; Syed Azmy, Syed Mohamad Rahimi2

• 1Department of Pharmacy, Klinik Kesihatan Banggol Pak Esah, Pasir Puteh, Kelantan
• 2Department of Pharmacy, Klinik Kesihatan Pasir Puteh, Kelantan

*Corresponding author: tuansyafiqah@moh.gov.my

Abstract

Introduction: Improper disposal of unused or expired medications poses significant risks to both environmental sustainability and public health. Pharmaceuticals that enter the environment through inappropriate disposal methods can contaminate water sources and affect ecosystems. In Malaysia, despite existing programs like the Medicine Return Programme (MRP), public awareness and participation remain low, especially in rural regions such as Pasir Puteh, Kelantan.

Objectives: This study aimed to assess knowledge, attitude, and practices (KAP) regarding medication disposal and identify associated socio-demographic factors among patients visiting outpatient clinics in PKD Pasir Puteh. Methods: A cross-sectional survey using a validated and structured questionnaire was conducted from September to December 2024. The study included 464 adult patients across eight outpatient clinics. Data analysis was performed using SPSS version 25.0, applying chi-square and non-parametric tests to determine associations between KAP scores and socio-demographic factors.

Results: A total of 464 respondents have completed the questionnaire. Most respondents were female (n=250, 53.9%) and Malay (n=378, 81.5%). While most respondents knew improper disposal harms the environment (n=444, 95.7%), only a small portion of them aware that wastewater treatment cannot remove most medicines (n=55, 11.9%). Non-adherence was common, with nearly half of them keeping unused medications (n=221, 47.7%). Most respondents preferred returning tablets (n=406, 87.5%) to pharmacies. However, unsafe method were still practiced such as pouring liquid medicines down the sink (n = 184, 39.7%) and flushing them down the toilet (n=172, 37.1%). Significant associations were found between KAP scores and variables such as age, gender, education, and healthcare employment.

Conclusion: Although knowledge on proper medication disposal is high, gaps remain in actual practices. Targeted education, community awareness, and accessible disposal facilities are essential to bridge the knowledge-practice gap and protect public and environmental health.

Keywords: Return medications, expired medications

NMRR ID: NMRR ID-24-02725-PUF

RP-14

Treatment Costs of Bleeding Complications in Hospitalized Patients on Warfarin Therapy in Hospital Tengku Ampuan Afzan

Authors: Abdul Malek, Fairuz1; Sohaimi, Nurul Farahin2; Choo,Yai Wen3; Abdul Talib, Mat Sharil1; M. Nazeri, Muhammad Aizat4; Rosdi, Muhammad Siddiq Faqaruddin1*; W. Mustappa, Wan Muhammad Syahir5; Kanasan, Shantini6

• 1Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang
• 2Public Health Development Division, Ministry of Health, Putrajaya
• 3Pharmacy Policy and Strategic Planning Division, Pharmaceutical Services Programme, Petaling Jaya
• 4Tanah Rata Health Clinic, Cameron Highlands, Pahang
• 5Department of Pharmacy, Hospital Muadzam Shah, Muadzam, Pahang
• 6Maran Health Clinic, Maran, Pahang

*Corresponding author: fairuzam@moh.gov.my

Abstract

Introduction: Treatment with warfarin imposes considerable financial burdens on healthcare systems due to its complications. There are currently limited studies in Malaysia examining warfarin use and its financial impact due to overwarfarinisation.

Objectives: This study aimed to describe the demographic and clinical characteristics of patients with bleeding complications, estimate the treatment costs and identify the cost drivers for the treatment of bleeding complications associated with warfarin therapy.

Materials and Methods: This retrospective, cross-sectional study was conducted through a review of medical records at Hospital Tengku Ampuan Afzan in Kuantan, Malaysia. The study included patients aged more than 18 years old who were hospitalized due to overwarfarinisation between January 1, 2022 and December 31, 2023. Purposive sampling was employed to identify eligible cases from various available registries. Cost analysis was conducted from the healthcare provider’s perspective using a bottom-up costing approach. Direct medical costs were estimated by accounting for expenses related to medications, laboratory investigations, medical procedures, personnel, blood transfusions and consumables. All costs were captured in Malaysian Ringgit (MYR). Analysis was performed using descriptive statistics.

Results: A total of 31 patients were included for the costing analysis. The mean age was 57.5 (15.6) years. More than half (51.6%) of them were on warfarin for prevention of stroke in atrial fibrillation. Major bleeding occurred among 17 (54.8%) patients, with 25.8% experiencing gastrointestinal bleed. The total direct medical costs for overwarfarinisation ranged from MYR1,351.91 for minor bleeding to MYR2,642.84 for major bleeding. Total medical cost for managing overwarfarinisation was MYR2291.80. The main cost driver identified was drug therapy (26.2%) in which prothrombin complex concentrate use contributed an average of MYR400.65 per patient.

Conclusion: The average treatment cost for overwarfarinisation was MYR2,291.80 per patient, contributed mainly by drug therapy.

Keywords: warfarin, medical cost, complications.

NMRR ID: NMRR ID-23-02545-IGP

RP-15

Patient Preferences for Inhaler Devices in Chronic Obstructive Pulmonary Disease (COPD) Patients in Hospital Muadzam Shah (HMS): A Qualitative Study

Authors: Ahmad, Nur Syafiqah1*; Sabri, Muhammad Afiq1; W Mustappa, W Muhammad Syahir1; Mazuki, Khairun Nisa1, Teng, Chin Siew1; Che Wan Ahmad, Che Wan Mohd Hafidz1

• 1Department of Pharmacy, Hospital Muadzam Shah, Muadzam Shah 26700, Pahang

*Corresponding author: nur_syafiqah@moh.gov.my

Abstract

Introduction: Various inhaler devices are available for treatment of chronic obstructive pulmonary disease (COPD) including pressurised metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and soft mist inhalers (SMIs). The technical effectiveness and safety of inhalers are the main subjects of research, but aspects like comfort, convenience of use, and personal preferences receive less attention.

Objectives: This study aimed to explore the factors affecting patient preferences toward inhalers and the most preferred types of inhalers among COPD patients in Hospital Muadzam Shah.

Materials and Methods: A semi-structured in-depth interview was conducted with COPD patients who had experience using more than one type of inhaler device, continuing until data saturation was reached. Participants were selected through purposive sampling. All interviews were audio-recorded and transcribed verbatim. Thematic analysis was applied to identify recurring themes and subthemes.

Results: A total of 12 participants were recruited for this study. Six major themes emerged: (1) treatment effectiveness; (2) ease of use and practicality; (3) emotional and psychological factors; (4) healthcare interaction; (5) adherence and routine use; and (6) practical and environmental barriers, with treatment effectiveness identified as the most influential factor. Participants in this study demonstrated a preference for DPIs over other types of inhalers.

Conclusion: Patients’ experiences and preferences play a central role in the successful use of inhalers. A patient-centered approach, incorporating device training and shared decision-making, can improve adherence and disease outcomes.

Keywords: Inhaler; COPD; qualitative study; patient preferences.

NMRR ID: NMRR ID-24-03375-REI

RP-16

Knowledge, Attitude and Practice Regarding Disposal of Unused and Expired Medicines Among Patients in Outpatient Pharmacy in PKD Tanah Merah, Kelantan

Authors: Mukhtar, Suzita¹*; Salleh, Amanina¹; Abd Rahman, Syaheerah¹; Pauzi, Fatin Husna²; Shaari, Syuhada²; Zahari, Amalina Zaiza³; Che Khalid, Akmal³; Shukri, Amalin Aisyah⁴; Rosedi, Anas⁵; Adib, Aida⁵

• 1 Pharmacy Department, Klinik Kesihatan Tanah Merah,
• 2 Pharmacy Department, Klinik Kesihatan Kemahang,
• 3 Pharmacy Department, Klinik Kesihatan Gual Ipoh,
• 4 Pharmacy Department, Klinik Kesihatan Belimbing,
• 5 Tanah Merah District Health Office

*Corresponding author: suzita.mukhtar@moh.gov.my

Abstract

Introduction: Improper disposal of medicines can harm the environment, endanger health, and raise healthcare costs through water contamination and accidental ingestion. Public awareness is crucial for proper waste management, but data on patient KAP in PKD Tanah Merah remains limited, highlighting the need for local research.

Objective: This study aims to assess the knowledge, attitudes, and practices (KAP) related to the disposal of unused and expired medications among patients at the outpatient pharmacy of PKD Tanah Merah, Kelantan.

Materials and Methods: A cross-sectional study was conducted among 460 adult patients at seven outpatient pharmacies under PKD Tanah Merah. A validated questionnaire by Nur Feazira Abdul Kadir et al. (2021) was administered digitally via QR code. Systematic sampling was employed by selecting patients with odd queue numbers from the outpatient register. Descriptive statistics were used to summarize variables, while bivariate and multivariable logistic regression analyses assessed associations, with significance set at p < 0.05. Adjusted odds ratios (AOR) was reported.

Results: Of the 460 respondents, most were female (63.7%), aged 18–35 (40.4%), Malay (95.7%), with 47.0% holding tertiary education, 61.3% employed, and 70% married. While 72.6% showed good knowledge and 63.0% had a positive attitude, only 51.7% practiced proper medicine disposal. Older adults (55–88 years) were more likely to have good knowledge (AOR = 2.12; 95% CI: 1.03–4.37; p = 0.042). Good knowledge significantly increased the likelihood of a positive attitude (AOR = 2.70; 95% CI: 1.67–4.38; p <0.001) and appropriate disposal practices (AOR = 5.23; 95% CI: 3.15–8.69; p <0.001). A positive attitude also predicted better disposal practices (AOR = 2.13; 95% CI: 1.36–3.35; p <0.001).

Conclusion: Knowledge and attitude are key to encouraging proper medicine disposal. Targeted education and awareness campaigns by healthcare providers are vital to foster responsible behaviour and support environmental sustainability.

Keywords: Knowledge, Attitude, Practice, Disposal Practice

NMRR ID: NMRR ID-22-01370-6DZ

RP-17

Impact of Educational Intervention Towards knowledge and Practice of Sublingual Glyceryl Trinitrate among Acute Coronary Syndrome Patients in Dungun Hospital

Authors: Ruslan, Noor Faeza1*; Alias, Siti Kamsida1; Raja Musa, Puteri Aimi Athira1; Taib, Nur Alya Syahirah1; Ab Supian, Muhammad Yusuf Hakim1

• 1Department of Pharmacy, Hospital Dungun, Dungun, 23000, Terengganu

*Corresponding author: noor.faeza@moh.gov.my

Abstract

Introduction: Acute Coronary Syndrome (ACS) is highly prevalent worldwide and remains the top cause of death. The treatment can be self-managed with Sublingual Glyceryl Trinitrate (GTN) tablets and remain first-line therapy for many patients. However, there is limited local data reported on the knowledge and practice among patients.

Objectives: This study aimed to determine the difference in mean scores of knowledge and practice on Sublingual GTN among control and intervention groups, to compare patient’s knowledge and practice between both groups over-time and to identify association between demographic characteristics with patients’ knowledge and practice.

Materials and Methods: This was an interventional study involved ACS patients with Sublingual GTN at Dungun Hospital. Data was collected from September 2024 to January 2025. They were randomized into 2 groups; control (received counselling) and intervention group (received educational intervention comprising counselling, pamphlets and video of Sublingual GTN usage). Patients were interviewed pre and post intervention with one month interval using validated questionnaires (part 1: demography; part 2: 8 items on knowledge, 7-8 scores=good knowledge; part 3: 6 items on practice, 5-6 scores=good practice). Data was analyzed using SPSS v.29, employing descriptive statistics and parametric tests.

Results: A total of 61 patients were recruited [control group=35 (57.4%); intervention group=26 (42.6%)] with mean age=57 (±12.8) years old; male=48 (78.7%); Malay=59 (96.7%). Within group comparison, there were significant differences of knowledge and practice after intervention for both control and intervention groups (p<0.001). However, no significant difference was detected for knowledge and practice in neither intervention nor control group post intervention (p>0.05). There also no significant association was found between knowledge and practice in different sociodemographic characteristics.

Conclusion: There were improvements in knowledge and practice of Sublingual GTN pre and post study among intervention group indicating the importance of repeated education and counselling. Larger samples should be taken for more promising results.

Keywords: Acute Coronary Syndrome, Sublingual Glyceryl Trinitrate, Knowledge, Practice Educational Intervention

NMRR ID: NMRR ID-24-02629-I2R

RP-18

Pain as 5th Vital Sign: An Evaluation of Knowledge Among Healthcare Workers in Hospital Tanah Merah, Kelantan

Authors: Mahmood, Malihah Hanani1; Ku Jaya, Tengku Nur Eqhwana1 *

• 1Pharmacy Department, Hospital Tanah Merah, Ministry of Health Malaysia, 17500 Tanah Merah, Kelantan, Malaysia.

*Corresponding author: t.eqhwana@moh.gov.my

Abstract

Introduction: In 2008, Malaysia implemented the “Pain as the 5th Vital Sign” initiative, introducing the Pain Free Hospital concept across healthcare institutions. In line with this national effort, Hospital Tanah Merah (HTM) will undergo an audit in 2025 as part of the process to obtain certification as a Pain-Free Hospital. The findings of this research can support the development of more effective training programs and inform policy makers about the need for targeted pain management workshops. Ultimately, this will help address knowledge gaps and improve the quality of patient care.

Objectives: This study aims to assess the level of knowledge regarding P5VS among healthcare workers in HTM and to determine the relationship between their knowledge levels and socio-demographic factors including gender, age, job role, and years of service.

Materials and Methods: A quantitative cross-sectional study was conducted between 20 August 2024 to 20 November 2024 involving 384 full-time healthcare workers at HTM. A validated questionnaire adapted from the Ministry of Health’s Pain-Free Hospital Manual (3rd Edition) was distributed online. A knowledge score of ≥80% was considered passed. Descriptive statistics and one-way ANOVA were used to explore associations between variables.

Results: A total of 80.5% of respondents scored ≥80%, indicating an overall good level of knowledge. Doctors, pharmacists, and nurses recorded the highest pass rates, while allied health and dental staff showed lower performance. Among the socio-demographic variables, only professional role was significantly associated with knowledge scores (p < 0.001). No significant correlation was found with gender, age, or years of service.

Conclusion: While most healthcare workers at HTM demonstrated good knowledge of P5VS, disparities between professional groups indicate a need for targeted, role-specific training. Continued education and structured reinforcement are vital to ensure consistent, effective pain assessment practices across all departments.

Keywords: Pain, Fifth Vital Sign, Knowledge, Healthcare Workers, Hospital Tanah Merah

NMRR ID: NMRR ID-24-01504-FYR

RP-19

Investigating Decline in Estimated Glomerular Filtration Rate in Atrial Fibrillation Patients Treated with Warfarin vs Novel Oral Anticoagulants (IDEAL-AF)

Authors: Khamar Ludin, Norhidayah1*; Ramlan, Aida Roziana1; Abdul Majid, Nadiah1; Azmi, Nur Amalina1; Mohd Kaman, Nur Najihah1; Mohamed Dhalan, Nurul Hidayah1; Nadzmi, Nurul Afina1

• 1Department of Pharmacy, Hospital Pekan, Pekan 26600, Pahang

*Corresponding author: norhidayahkl@moh.gov.my

Abstract

Introduction: Renal function decline is a concern in atrial fibrillation (AF) patients on long-term anticoagulation. Warfarin may promote nephropathy through vascular calcification, but comparative data with novel oral anticoagulants (NOACs) remain limited.

Objective: To evaluate the reduction in estimated glomerular filtration rate (eGFR) in patients with AF treated with warfarin versus NOACs. Methods: This retrospective cohort study included 86 AF patients from Hospital Pekan. eGFR was calculated using the CKD-EPI formula at baseline and follow-up. The primary outcome was the mean annual eGFR change in patients on warfarin (n=46) versus NOACs (n=40: rivaroxaban and dabigatran). The secondary outcome was the incidence of eGFR <50 mL/min/1.73m². Multivariate logistic regression was used to determine adjusted odds ratios (ORs).

Results: Mean age was 69.88 ± 10.97 years and 51.16% were women. The mean annual eGFR change was −2.61 ± 5.44 for warfarin, −3.37 ± 4.99 for rivaroxaban (p=0.798 vs. warfarin), and 0.06 ± 4.67 for dabigatran (p=0.422 vs. warfarin), with no statistically significant differences (p=0.289 overall). Although the differences did not reach statistical significance, dabigatran demonstrated a numerically favourable renal profile. Patients with baseline eGFR <50mL/min/1.73m² had higher rates of heart failure (p=0.034) and stroke/TIA (p=0.011). The adjusted OR for developing eGFR <50mL/min/1.73m² with NOACs versus warfarin was 3.28 (95% CI: 1.08–9.96, p=0.036), indicating increased odds in the NOAC group.

Conclusion: Although not statistically significant, dabigatran demonstrated a trend toward renal preservation. Findings underscore the need for individualized anticoagulant choice in AF patients, especially those at risk of renal impairment. Cost-effectiveness considerations, including budget impact, are essential in guiding optimal therapy.

Keywords: atrial fibrillation, warfarin, novel oral anticoagulants, anticoagulant, chronic kidney disease

NMRR ID: NMRR ID-25-00651-YB4

RP-20

Knowledge, Attitude, and Practice of Community Pharmacy Professionals on Generic Medicines in Pahang

Authors: Khairul Hafidz, Muhammad Hafizul Aniq1*; Izuddin, Muhammad Azzim1

• 1Pharmacy Services Department, Pahang Health State Department, Kuantan, Pahang

*Corresponding author: hafizul.aniq@moh.gov.my

Abstract

Introduction: Generic medicines are crucial for sustainable healthcare, offering affordable yet effective treatment alternatives. Community pharmacy personnel are key advocates, but their knowledge, attitudes, practices influence integration of generics into practice remains unclear.

Objectives: To assess the level of knowledge, attitude, and dispensing practices regarding generic medicines, identify factors associated with knowledge and attitude scores and factors influencing selection and dispensing them among community pharmacy personnel in Pahang.

Materials and Methods: This cross-sectional study surveyed 91 Pahang community pharmacy personnel using an adopted self-administered online questionnaire (Jan-Mar 2025). The questionnaire assessed socio-demographics, knowledge, attitudes, practices and views on generics, as well as selection and dispensing influences. Knowledge scores of ≥35/40 defined strong knowledge, attitude score ≥30/45 defined positive attitude and practice scores of ≥30/40 indicated a higher level of generic medicine use. Data analysis involved descriptive statistics, and multiple linear regression.

Results: Mean scores for knowledge are high (35.79±2.885), mean scores for attitude are positive (35.15±4.379), mean scores for practice show strong orientation toward the use of generic medicine (30.96±3.812). MLR identified female gender (b=-1.834; 95% CI: -3.021, -0.646; p=0.003), Chinese ethnicity (b=-1.622; 95% CI: -2.978, -0.266; p=0.020), and 6-10 years’ experience (b=1.312; 95% CI: 0.080, 2.544; p=0.037) as significant knowledge predictors. Over 10 years’ experience showed significantly lower practice scores favouring generic medicine (b=-3.034; 95% CI: -5.276, -0.791; p=0.009). No significant predictors of attitude score were identified. Consumer preference (98.9%), cost-effectiveness (96.7%), and affordability (95.6%) were found to influence the selection and dispensing of generic medicines.

Conclusion: Community pharmacy personnel in Pahang show strong knowledge, positive attitudes and highly favourable practice towards generic medicines. Dispensing practices are heavily driven by consumer demand and cost factors, with notable concerns about manufacturer credibility.

Keywords: Generic medicines; knowledge; attitude; practice; barriers; community pharmacy; Pahang

NMRR ID: NMRR ID-24-03510-BOY

RP-21

Exploring Perceptions of Hemodialysis Patients towards Medication Therapy Adherence Clinic Services

Authors: Chase-Currier, Alyson1*; Kwong, Kien Seang1; Ibrahim, Rosmaisarah1; Lee, Chen Yuan2; Chen, Tze Seong3

• 1Department of Pharmacy, Hospital Raub, Raub 27600, Pahang
• 2Department of Pharmacy, Pejabat Kesihatan Daerah Raub, Raub 27600, Pahang
• 3Department of Pharmacy, Klinik Kesihatan Bandar Bentong, Bentong 28700, Pahang

*Corresponding author: alyson.chase@moh.gov.my

Abstract

Introduction: Pharmacists conduct Medication Therapy Adherence Clinic (MTAC) services to improve patient knowledge and adherence to medications, as the patients undergoing hemodialysis (HD) are at high risk of healthcare and pharmaceutical care issues. Hospital Raub and Hospital Jerantut are the only hospitals in Pahang, Malaysia providing MTAC services for HD patients.

Objective: To explore the perceptions of HD patients towards MTAC services.

Materials and Methods: A qualitative study with health belief model and grounded theory approach was used as a framework for this study. In-depth face-to-face interviews with semi-structured topic guide were conducted among eleven patients from Hospital Raub, Pahang, Malaysia. Data were collected using purposive sampling until data saturation. All the interviews were audio recorded, transcribed verbatim and then thematically analysed using NVivo 13.

Results: Six major themes were identified: (1) Initial diagnosis and emotional impact, (2) perceived importance of medications, (3) medication adherence, (4) satisfaction with pharmacy service, (5) family support, and (6) impact on quality of life. The patients reported high satisfaction with pharmacy services, particularly valuing the expertise and support of MTAC pharmacists. They felt that having strong family involvement was essential in supporting medication adherence and overall treatment plans. This study suggests that strengthening family support and providing continuous and personalized care are vital to improving the patient’s outcomes.

Conclusion: HD patients had positive perceptions towards MTAC services in improving disease understanding and medication compliance for optimal health outcomes. These findings underscore the importance of MTAC services in enhancing medication adherence for HD patients prescribed with complex pharmacotherapy. HD MTAC should be expanded to other facilities to help HD patients better understand their medications. Further research should explore long-term impacts and strategies to enhance MTAC services.

Keywords: Medication Therapy Adherence Clinic (MTAC), haemodialysis (HD), qualitative study, pharmacists, Malaysia

NMRR ID: NMRR ID-22-01473-5NE

RP-22

A Study of High Dose Versus Moderate Dose Methadone Maintenance: Evaluating Outcome in Controlling Illicit Substance Use

Authors: Kwek, Cheng Hau1*; Muzafar Shah, Najihah Mohd2; Wahairi, Nurfarahaneem3

• 1Pharmacy Unit, Klinik Kesihatan Kuala Kemaman, Pejabat Kesihatan Daerah Kemaman, Terengganu
• 2Pharmacy Unit, Klinik Kesihatan Kerteh, Pejabat Kesihatan Daerah Kemaman, Terengganu
• 3Pharmacy Unit, Klinik Kesihatan Kemasik, Pejabat Kesihatan Daerah Kemaman, Terengganu

*Corresponding author: kwek.chenghau@moh.gov.my

Abstract

Introduction: Methadone dosing has long been a topic of debate among clinicians. In the government-run Methadone Maintenance Treatment (MMT) programs, the average daily dose remains below 40mg. Multiple studies have suggested that a daily methadone dosage of 60 to 100mg is necessary for effective treatment and the reduction of opiate use. Typical methadone doses have increased over time, supported by evidence that doses below 60mg/day are insufficient, while doses near to 100mg/day yield superior outcomes.

Objectives: This study aimed to compare the percentage of patients taking illicit drug between high-dose and moderate-dose methadone groups and to determine patient compliance with the MMT program.

Materials and Methods: A retrospective chart review was conducted on patients receiving MMT at 8 health clinics in Kemaman from January to December 2023. Patients were divided into two groups based on their daily methadone doses: moderate dose (60 to 79mg) and high dose (≥ 80mg). The groups were compared using urine drug screens for illicit substances at the first month and again at the 12th months of the study duration. A structured form was used for data collection and was analyzed using descriptive statistic and chi-square tests with p<0.05 considered statistical significant (SPSSv.26).

Results: A total of 100 Malay male patients included (mean age=46.95±6.90 years; married=43%; employed =87%; ≤ secondary education=76%; mean methadone dose= 82.3±22.42 mg). About 51 patients received moderate doses and the others received higher doses. Urine drug screen showed a reduction in illicit drug use in both groups. In the moderate-dose group, 23.5% tested positive at baseline and 13.7% at follow-up, while in the high-dose group, rates were lower at both time points (18.4% and 6.1%, respectively). All patients demonstrated good compliance with the MMT program.

Conclusion: Higher methadone doses were resulted in reduced opiate and illicit substance use compared to moderate doses as indicated by lower percentage of positive urine drug screens.

Keywords: MMT; Methadone dose, illicit substance, opiates

NMRR ID: NMRR ID-24-01069-3ZH

RP-23

Stroke Risk and Behaviour Change of Working-Age Adults (18–64 Years) with Hypertension in a Malaysian Setting

Authors: Ibrahim, Yasmin1*; Yahya, Abqariyah2

• 1Cawangan Amalan dan Perkembangan Farmasi, Bahagian Perkhidmatan Farmasi, Jabatan Kesihatan Negeri Pahang, Kuantan 25582, Pahang
• 2Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Kuala Lumpur

*Corresponding author: yasmin.ibrahim@moh.gov.my

Abstract

Introduction: Hypertension is a significant risk factor for stroke among adults aged <65 years in Malaysia. While research has identified various factors influencing hypertension management, studies on psychosocial factors are limited. This study seeks to inform targeted public health interventions to enhance hypertension management and lower stroke risk in working-age adults.

Objectives: This study examined the association between the accuracy of perceived stroke risk and the readiness for behaviour change, with blood pressure control status, among working age adults with hypertension in a Malaysian setting.

Materials and Methods: A cross-sectional study was conducted across six health clinics in Kuantan district, involving 158 patients aged 18–64 years who were on at least one antihypertensive medication. Participants completed a validated questionnaire assessing their perceptions, lifestyle, medication adherence and stroke knowledge. Blood pressure data were retrieved from participant’s medical records. Binary logistic regression was employed to determine the associations between perceived stroke risk accuracy and readiness for behaviour change, towards blood pressure control.

Results: Among 134 participants analysed, the majority were married (82.8%), Malay (90.3%), with a mean age of 48.87 ± 9.25 years. Approximately 60.4% were women, 73.1% had secondary education or lower, and 79.8% were from low-income backgrounds. Only 33.6% accurately assessed their stroke risk, while 58.2% were not ready for behaviour change. Accurate perceived stroke risk was positively associated with controlled blood pressure (aOR = 3.084, 95% CI: 1.006–9.458, p = 0.049). Being ready for behaviour change was negatively associated with controlled blood pressure (aOR = 0.455, 95% CI: 0.144–1.436, p = 0.180).

Conclusion: Accurate perception of stroke risk is crucial for effective hypertension management. Targeted educational strategies and technology can enhance awareness and promote healthy lifestyle choices among at-risk working-age adults. Further research is needed to deepen the understanding of the relationship between behavioural readiness and hypertension control in this demographic.

Keywords: Stroke; hypertension; risk perception; behaviour change

NMRR ID: NMRR ID-24-01026-5IS

RP-24

Evaluation of Meropenem Dosing Adequacy and Clinical Outcomes in ICU Patients: A Model-Informed Retrospective Study

Authors: Md Rosly, Nurul Aida1; Abdullah, Mursyida1*; Mat Sulaiman, Farhana Nabilla1; Ali, Mohd Nazri2; Zakaria, Fazilawati2; Mustafa, Suzana1

• 1Pharmacy Department, Hospital Raja Perempuan Zainab II Hospital, Kelantan
• 2Anesthesiology Department, Hospital Raja Perempuan Zainab II, Kelantan

*Corresponding author: aidarosly017@gmail.com

Abstract

Introduction: Critically ill patients often experience altered pharmacokinetics (PK), making standard meropenem dosing suboptimal and potentially compromising therapeutic outcomes. Model-informed precision dosing (MIPD) offers a strategy to individualize dosing and optimize drug exposure. For meropenem, a pharmacodynamic target of 100% time above the minimum inhibitory concentration (100% T>MIC) is recommended to maximize efficacy. Based on the EUCAST breakpoint (MIC of 2 mg/L), a steady-state concentration above 8 mg/L is suggested for optimal bacterial killing. In Malaysia, however, therapeutic drug monitoring (TDM) for meropenem is not routinely available, limiting individualized dosing.

Objectives: This study aimed to evaluate the adequacy of meropenem dosing in ICU patients and explore its association with bacterial resistance and mortality.

Materials and Methods: A retrospective study was conducted in ICU patients treated with meropenem at Hospital Raja Perempuan Zainab II (HRPZ II). Patient demographics, renal function (creatinine clearance), dosing regimens, microbiological data, and clinical outcomes were collected. Dosing adequacy was assessed using a published MIPD simulation based on creatinine clearance, targeting a 24-hour meropenem concentration >8 mg/L. Statistical analysis was performed to evaluate associations between dosing adequacy, bacterial resistance, and mortality.

Results: Among 253 patients included, mortality was 56.5% (n=143). Inadequate dosing was observed in 79.1% (n=200), and 46.2% (n=117) developed bacterial resistance. Serum creatinine at meropenem initiation was significantly associated with dosing adequacy. Inadequate dosing increased mortality risk (OR = 4.94; 95% CI 2.20–11.10) and prolonged ICU stay by about four days but was not significantly linked to resistance. Older age reduced mortality risk (OR = 0.965/year), while higher body weight increased it (OR = 1.025/kg).

Conclusion: Standard meropenem dosing often results in suboptimal exposure. Integrating MIPD into routine care may improve meropenem adequacy and clinical outcomes in critically ill patients.

Keywords: Meropenem, Model-Informed Precision Dosing (MIPD), Critically Ill Patients, Pharmacokinetics, Mortality

NMRR ID: NMRR ID-24-03287-ASZ

RP-25

Evaluation of Healthcare Providers’ Knowledge and Attitude about the Handling of Chemotherapy Drugs at Hospital Setiu, Terengganu

Authors: Sulaiman, Saiful Hazim1*; Mohd Rahim1, Nur Fahimah; MD Husin1, Nur Najwa Hasnifalina1

• 1Department of Pharmacy, Hospital Setiu, 22100, Permaisuri, Terengganu

*Corresponding author: saifulhazim.sulaiman@moh.gov.my

Abstract

Introduction: Chemotherapy treatment started at Hospital Setiu in June 2023. Safe handling is essential to reduce health risks like cancer, infertility and birth defects with prolonged exposure. Healthcare providers face potential exposure to cytotoxic drugs, making good knowledge and proper attitude crucial. Currently, no local data has been reported on this issue.

Objectives: This study aimed to assess knowledge and attitude on chemotherapy drugs handling among healthcare providers in Hospital Setiu and to identify the association of knowledge and attitude with demographic characteristics.

Materials and Methods: A cross-sectional was conducted from May 2024 to February 2025. An anonymous online survey was distributed among healthcare providers involved in chemotherapy drug handling with consent obtained prior to participation. Study tools were validated questionnaire on knowledge comprising 40 questions (four domains; 2.5 scores per correct response; total score=100) and 5 closed-ended questions on attitude of chemotherapy drugs handling. Data were analyzed using descriptive and parametric test (SPSSv.27).

Results: A total of 98 healthcare workers participated, with a mean age of 37±8.18 years. Majority were female (81.6%) and 54.1% involving nurses. They had an average of 14±8.22 years of working duration and 2±1.90 years of experience in handling chemotherapy. The mean knowledge score was 66.82±16.85. Most staff were disapproved of improper practices either among peers (83.7%) or during hectic time (90.8%). About 81.6% of them were worried about long-term side effects from occupational exposure. Significant negative associations were found between age and working duration with all knowledge domains, except for knowledge on chemotherapy exposure, which correlated positively. Only attitude of applying safety measures showed statistically significant with age and working duration (p<0.05).

Conclusion: Findings revealed that study participants had moderate knowledge and attitudes on handling chemotherapy drugs, highlighting an urgent need for additional training, establishing institution guidelines, emphasize good attitude and safety practice.

Keywords: Chemotherapy drugs, Knowledge, Attitude, Healthcare providers, Setiu

NMRR ID: NMRR ID-24-01593-NWD

RP-26

Knowledge, Attitude, Practice and Complication Awareness Among Type 2 Diabetes Mellitus Patients in Health Clinics, PKD Bachok

Authors: Md Adnani, Nur Thaqifah1*; Nik Mustapha, Nik Suraima2

• 1Department of Pharmacy, Klinik Kesihatan Mahligai, Bachok 16300, Kelantan
• 2Department of Pharmacy, Klinik Kesihatan Balai, Bachok 16300, Kelantan

*Corresponding author: thaqifahadnani@gmail.com

Abstract

Introduction: There was a decreasing trend on the achievement of HbA1c at PKD Bachok from 32.54% (2022) to 30.95% (2023) and it is worrying as it could affect glycaemic control and diabetic complications. This study is conducted since a very limited study regarding diabetes knowledge, attitudes, practice and complications awareness among Type 2 diabetic patients in Bachok district.

Objectives: To evaluate the knowledge, attitude, practice and complication awareness among Type 2 Diabetes Mellitus (T2DM) patients in Health Clinics, PKD Bachok.

Materials and Methods: A cross-sectional study using a validated questionnaire conducted in 8 Health Clinics from 1st July till 31st August 2024. The inclusion criteria was adult patients aged ≥18 years old, diagnosed with T2DM, able to read and understand Malay language. The sampling method was systematic random sampling, sample size was calculated using Raosoft (MOE:5%, CI:95%, PS:29942, RD:50%) and association analysis was tested using Independent t-test and Chi-square test.

Results: 380 respondents participating in this research were mostly Malay female (67.6%, n=257) with the mean age of 49 years old. 59.7% (n=227) respondents graduated secondary school and 72.6% (n=276) had family history of Diabetes. Findings showed respondents had good knowledge (64.2%, n=244), good attitude (49.2%, n=187), good practice (82.6%, n=314) and good complication awareness (61.6%, n=234). There was significant association between family history of diabetes with knowledge (p=0.035) and attitude (p=0.001). Also, educational status was significantly associated with attitude (p<0.001), practice (p=0.009) and complication awareness (p=0.001). A significant association was found between attitude (p=0.001) and practice (p=0.003) with complication awareness.

Conclusion: Family history of diabetes and educational status were the most significant factors, while practice and attitude were significantly associated with complication awareness of diabetes. This study highlights the need for well-organized health education and counselling to improve patients’ attitude and practice regarding diabetes.

Keywords: Type 2 Diabetes Mellitus, Knowledge, Attitude, Practice, Complication Awareness

NMRR ID: NMRR ID-24-02973-CDR

RP-27

The Appropriateness of Intravenous Proton Pump Inhibitors Usage and Its Direct Costs In Hospital Tengku Ampuan Afzan

Authors: Fazil, Azra Farzana1*; Ahmad, Mastura1; Nik Mohd Sabri, Nik Nur Naseela Fathin1; Mohd Zain, Mimi Nurul Syafilla1; Rosli, Nur Amalina2; Tengku Mokhtar, Tengku Hanim Syahmina3; Goh, Suzanne4; Wan Nasruddin, Wan Anwar1; Yousry, Nur Ain Atiqah5

• 1Department of Pharmacy, Hospital Tengku Ampuan Afzan, Kuantan, Pahang
• 2Balok Health Clinic, Kuantan, Pahang
• 3 Bandar Kuantan Health Clinic, Kuantan, Pahang
• 4 Karak Health Clinic, Bentong, Pahang
• 5 Padang Luas Health Clinic, Bera, Pahang,

*Corresponding author: syafilla@moh.gov.my

Abstract

Introduction: The lack of national guidelines for proton pump inhibitor (PPI) use has led to variability in prescribing practices, which may result in unnecessary healthcare costs and potential adverse effects, particularly in hospitalized settings. Intravenous (IV) PPI is commonly prescribed in Hospital Tengku Ampuan Afzan (HTAA) among non-critically ill patients. This raise concerns over the possibility of inappropriate use of IV PPIs in the local setting.

Objectives: This study aimed to assess the appropriateness of the prescribed IV PPI utilization in adult patients admitted in medical wards based on established guidelines and to determine the direct cost associated with inappropriate use of IV PPIs.

Materials and Methods: A prospective cohort study was conducted at HTAA from December 2023 to January 2024. The study population consisted of adult patients who were admitted to medical wards and received IV PPIs. The appropriateness was assessed using American College of Gastroenterology (ACG) guidelines and American Society of Health-System Pharmacist (ASHP) Therapeutic Guidelines On Stress Ulcer Prophylaxis. The direct cost of IV PPI therapy included the drug, consumables, personnel and admission costs. Descriptive analysis was performed using SPSS version 21.0.

Results: Of the 150 patients included, the most common indication for IV PPI was for prophylaxis use (76%). Overall, 84% of IV PPI prescriptions were appropriate based on clinical guidelines, while 16% were deemed inappropriate. Among the inappropriate cases, 91.7% were due to unclear indications. The inappropriate use of IV PPIs resulted in an avoidable direct cost of RM586.30 with an average of RM24.42 per patient. Assuming that the rate of inappropriate use is constant, estimated cost incurred will be RM3517.80 per year.

Conclusion: The prevalence of inappropriate use of IV PPIs in HTAA was 16%, which is similar across other studies. This leads to an estimated avoidable cost of RM3517.80 per year.

Keywords: PPI, proton pump inhibitors, appropriateness, direct cost

NMRR ID: NMRR ID-23-03388-FWD

RP-28

The Impact of Medication Therapy Adherence Clinic (MTAC) on the Understanding of Medication Knowledge, Adherence and Clinical Outcomes for Dialysis Patients in Kelantan: A Multicentre Study

Authors: Zulkiflee, Natasha Amanina1*; Muhammad Faiz, Muhammad Jibril1; Mohamad Zalik, Noraniza1; Yacob, Aziani2; Kamarusulaimi, Nurul Idayu3

• 1Pharmacy Department, Hospital Pasir Mas, Ministry of Health Malaysia
• 2 Pharmacy Department, Hospital Raja Perempuan Zainab II, Ministry of Health Malaysia
• 3Pharmacy Department, Hospital Tanah Merah, Ministry of Health Malaysia

*Corresponding author: natasha_amaninaz@moh.gov.my

Abstract

Introduction: Pharmacist-led Medication Therapy Adherence Clinic (MTAC) has been implemented to manage complex medication regimens and high pill burdens of ESRD patients undergoing dialysis. However, the effectiveness of MTAC among dialysis patients in Kelantan remains limited in evidence.

Objectives: To evaluate the impact of MTAC on medication knowledge, adherence, and selected clinical outcomes (potassium, phosphate, calcium, and hemoglobin levels) among dialysis patients. It also examines the relationship between knowledge and adherence and identifies sociodemographic predictors influencing both.

Materials and Methods: This retrospective cohort study involves conveniently sampling 91 adult dialysis patients who completed three MTAC visits at three public hospitals in Kelantan between January 2022 to May 2024. Medication knowledge was assessed using DFIT tool, adherence via MyMAAT and clinical outcomes through laboratory parameters. Repeated measures ANOVA, correlation and regression analyses were employed.

Results: There were statistically significant improvements in both medication knowledge (mean DFIT: 94.56 to 99.05, p < 0.001) and self-reported adherence (MyMAAT >50%: 57.1% to 78.0%, p < 0.001) across the three MTAC visits. No significant changes were observed in clinical outcomes, although modest improvements in potassium and calcium levels were noted. Correlation between knowledge and adherence was weak, with significance only at the second visit (r = +0.261, p < 0.05). Sociodemographic factors showed limited predictive value, except for gender at first visit, where females had significantly better adherence compared to males (p < 0.05).

Conclusion: MTAC has been proven effective in enhancing medication knowledge and adherence among dialysis patients in Kelantan. Although the short-term effect on biochemical outcomes was limited, behavioral improvements were evident in this study. The research data portrays the requisition for this study to be done as baseline to assess longer-term effects of MTAC implementation for dialysis patients in Kelantan, entailing broader population and robust study models integrating multidisciplinary elements.

Keywords: Medication Therapy Adherence Clinic, Dialysis, Pharmacist Intervention, Medication Knowledge, Adherence, Clinical Outcomes, Kelantan

NMRR ID: NMRR-24-3178-VY8

RP-29

The Impact of Medication Regimen Complexity Level on Glycemic Control in Older Adults with Type 2 Diabetes Mellitus (T2DM) in a Primary Health Care, Pasir Mas, Kelantan

Authors: Zammari, Nur Farahiah1*; Tuan Aziz, Wan Hazni1; Hamil, Nor Liyana Izzati1; Ab Rahman, Fatin Nabila1; Wan Nazman,Wan Nazmin1; Mazlan, Marsya Aida1

• 1Pejabat Kesihatan Daerah Pasir Mas, Pasir Mas 17000, Kelantan

*Corresponding author: farahiahzamri@gmail.com

Abstract

Introduction: The higher the complexity of the medication regimens, the more challenging for patients to maintain consistent adherence, leading to poorer glycemic control and higher HbA1c levels.

Objectives: To assess the impact of medication regimen complexity level on glycemic control in older adults with Type 2 Diabetes Mellitus.

Materials and Methods: Retrospective record research was conducted in the outpatient health clinic in Pasir Mas district. Demographic, clinical characteristics, and medication-related characteristics of older adults from January to June 2024 were collected from Advanced Clinic Management (ACM). The complexity of the patients’ medication regimens was assessed using the Medication Regimen Complexity Index (MRCI) tool. Logistic regression analyses were used to identify the factors influencing glycemic control.

Results: A total of 284 older adults were included in the study, of whom 40.5% had poor glycaemic control as indicated by elevated HbA1c levels (>8%). The mean number of medications prescribed for diabetes management was 1.5 (SD = 0.7). Additionally, 34.5% of the patients were found to have a high diabetes-specific medication regimen complexity index (MRCI). Meanwhile, multiple linear regression analysis showed young-old (60-74) age (Adjusted β = 0.723, 95% CI: 1.092-3.885, p = 0.026), presence of polypharmacy (Adjusted β = 0.713, 95% CI: 1.028-4.049, p = 0.041), high medication regimen complexity (Adjusted β = 2.130, 95% CI: 1.702-41.597, p = 0.009) and injectable dosage form (Adjusted β = 1.513, 95% CI: 1.274-16.176, p = 0.020) are the significant factors of poor glycaemic control.

Conclusion: The findings addressed the importance of reducing medication complexity to improve glycaemic control, particularly among individuals at greater risk such as those with polypharmacy and long-standing T2DM. Strategies such as regimen simplification should be considered to reduce MRC and enhance treatment outcomes.

Keywords: Type 2 diabetes mellitus (T2DM), Older adults, MRC index level, HbA1c levels

NMRR ID: NMRR ID-24-03019-G