Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy


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Published: October 2011

In this issue:

  • STARZ-DRP: A Step-by-step Approach for Pharmacy Triage Services
  • Predictors of Herbal Utilization by Multiethnic Secondary Care Patients in Malaysia: a Cross Sectional Survey
  • Calculated 10 Years Risk of CHD: Primary Preventive Measures in Medical Ward PPUKM (University Kebangsaan Malaysia Medical Centre)
  • Study of Aminoglycosides Use among In-patients at Hospital Kuala Lumpur

Supplement

  • Proceedings of the Malaysian Pharmaceutical Society
    Pharmacy Scientific Conference 2011

STARZ-DRP: A Step-by-step Approach for Pharmacy Triage Services

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    Abstract

    This article highlights the importance of structured and systematic processes in triaging patients with minor illnesses. The main aim is to describe a model or protocol for organizing a community pharmacist’s knowledge in a manner that allows him/her to begin identifying the actual and potential drug-related problems (DRPs). We consulted standard reference textbooks and key pharmacy journals looking for common mnemonics which has been promoted as a decision aids for the supply of non-prescription medicines. Our focus was to examine each method in terms of the collecting relevant information with respect to detection of DRPs associated with self-medicating patients. The positives and negatives attributes of each method were assessed. We noticed that each of the mnemonics examine were incomplete in some area. Even for an established and popular aide-memoire, WWHAM, which is an easily remembered mnemonic to obtain a general picture of the patient’s presenting compliant does not provides adequate information for triage and recognize patient-specific medication related problems. Although other mnemonics are more comprehensive than WWHAM, they are still limited. Moreover, by no means these methods were universally use and apply in the community pharmacy practice. Alternatively, the proposed approach provides a platform for triaging a self-medication patient as well as identifying DRPs for collaborating with other health care professionals. Therefore, the STARZ-DRP is an alternative approach for conducting self-care consultation. In depth study is needed to determinate whether it is more effective than other methods for pharmacy triage service when studied in a controlled, systematic manner.

    Predictors of Herbal Utilization by Multiethnic Secondary Care Patients in Malaysia: a Cross Sectional Survey

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      Abstract

      This study was carried out to determine the extent to which demographic characteristic and disease variables are significantly associated with herbal use. This study was a cross sectional survey conducted by structured interview using a validated questionnaire. The subjects were selected using a convenience sampling of 250 patients attending medical wards in Penang Hospital. Univariate and multivariate analysis were performed to examine the predictors of herbal use. The result found 42.4% of participants (n=106) used herbal medicines, with more than one third used herbs and conventional treatments concomitantly (67.9%). A total of 76 patients (30.4%) used herbal medicines in the past 12 months, and 37 (14.8%) patients had ever been used herbs. Multiple stepwise selection logistic regression modelling identified two significant determinants (P<0.05) of herbal use. These were demographic factor, education attainment and disease variable, kidney problem. Study findings indicate that patients with higher education attainment are more likely to use herbal medicines. In contrast, those who suffer from kidney problems are associated with more than three times decreased odds.

      Calculated 10 Years Risk of CHD: Primary Preventive Measures in Medical Ward PPUKM (University Kebangsaan Malaysia Medical Centre)

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        Abstract

        Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. Identification of common risk factors and risk stratification helps to prioritize primary preventive measures and hence can reduce this epidemic. This retrospective cross sectional study was carried out to assess the primary preventive measures according to 10 years CHD risk stratification. One hundred thirty (67 female and 63 female) middle aged (40-65 years) patients admitted to PPUKM’s medical ward with no prior diagnosis of CHD were selected. Patient diagnosed with diabetes or hypertension related to pregnancy was excluded. The patients’ medical record and order management system (OMS) were screened to obtain relevant demographic information, medical and medication history and related laboratory results. The Joint British Societies CHD risk prediction chart was used to calculate the 10 years CHD risk. Gender specific differences of 10 years calculated CHD risk, baseline measure of BP, cholesterol, weight, BMI, HbA1C level and number of patients who received primary preventive measures were used as outcome measures. Results showed that male patients had a significantly higher 10 years CHD risk than female (P < 0.05). Hypertension was the most prevalent risk factor followed by diabetes and dyslipidemia. About10% (n=6) of hypertensive patients with SBP≥160 mmHg and 32 (37%) diabetic patients did not receive antihypertensive therapy and lipid lowering therapy respectively. Hence, there is a need for further improvement in primary preventive measures for CHD.

        Study of Aminoglycosides Use among In-patients at Hospital Kuala Lumpur

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          Abstract

          Aminoglycosides are a group of antibiotics that have been widely used in treatment of infections especially caused by gram negative bacteria. The purpose of this research was to study the aminoglycosides use among in-patients. This study was carried out retrospectively which included the patients 18 years and above who had received aminoglycosides therapy from July 2008 until December 2008. Patients with incomplete data were excluded. A total of 104 patients were included in this study based on the inclusion criteria. The aminoglycosides were used in patients who had normal renal function and also in patients who were in end stage renal failure. Gentamicin was the most frequently used (44.2%), followed by amikacin (33.7%), netilmicin (13.4%) and the least frequently used was streptomycin (8.7%). The culture and sensitivity test had been performed only to 62% of patients. Indication was appropriate in 95.2% patients and was inappropriate in 4.8% patients (p<0.001). Appropriate doses were given to 59.6% patients and 37.4% patients had received inappropriate doses (p>0.05) and 5.8% patients were not assessable. Duration of therapy was appropriate in 87.5% patients and there were 12.5% patients did not received therapy in appropriate duration (p<0.001). A total of 77(89.5%) cases of pharmacodynamic and 9(10.4%) cases of pharmacokinetic potential drug-drug interactions between aminoglycosides and other drugs were identified. There were 3 cases had minor severity and the rest had moderate severity. Conclusion: The appropriateness of aminoglycosides use still needs to be improved in order to ensure their effectiveness and safety in clinical setting.