BPharm, PhD
Discipline of Social and Administrative Pharmacy
School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
Abstract
Objectives: The objectives of this study were to determine the cost of a behavioral risk factor reduction program at the worksite and to compare the cost-effectiveness of the program with a control group. Methodology: This was a quasi-experimental study conducted among employees of Universiti Sains Malaysia. The program targeted five primary risk factors (RF). Participants in the intervention program were subjected to schedule individualized counseling and seminars during the 6- month follow-up. Participants in the control group underwent health screening. Cost-effectiveness analysis was conducted from the payer’s perspective to determine the cost of 1% increase in proportion of participants who reach ideal targets for the RF. One-way sensitivity analysis was also conducted. Results: A total 136 participants were recruited in this study. At 6-month follow-up, significantly higher proportion of participants in the intervention group reached target for fruit and vegetable intake (P < 0.001) and physical activity (P = 0.017). The costs of the intervention program and control group were estimated to be MYR304.52 (USD92.28) and MYR169.90 (USD51.48) per participant respectively. The incremental cost-effectiveness ratio (ICER) of all the RF were lower than the World Health Organization recommendation based on the CHOICE analyses for relative cost-effectiveness of an intervention. Body mass index and alcohol consumption reported negative ICER which indicated control dominant. Sensitivity analyses showed that ICER was reported to be most sensitive to the change in participants’ salary. Conclusion: The proposed health promotion program was shown to be cost-effective in modifying most of the behavioral RF.
Abstract
Tablet splitting practices have been shown to reduce the medication cost in many countries. This study was aimed to evaluate the tablet splitting practices among community pharmacists in Penang, Malaysia. A two-month cross-sectional descriptive survey was carried out in forty randomly chosen community pharmacies in Penang. The pharmacists were required to document all their tablet splitting recommendations during the study period. The data collected includes the appropriateness of the tablet splitting recommendations by pharmacists; the extent of communication between pharmacists and physicians when recommending tablet splitting; the physicians‟ and patients‟ acceptance towards the tablet splitting; and the documentation of cost-saving achieved from the tablet splitting. The result showed that the tablet splitting was recommended by 31.0% of the pharmacists who receives prescriptions eligible for this practice. Tablets of patent- protected innovator brands were more likely to be recommended for splitting. Majority (92.9%) of the splitting recommendations were appropriate except two cases which involve unscored combination tablet. The pharmacists requested consent from the physicians for 42.9% of the splitting recommendations and majority (91.7%) of the requests were accepted. Meanwhile, the patients‟ acceptance rate for splitting recommendation was 82.1%. Through acceptance of tablet-splitting, the patients‟ monthly expenses on drugs reduced by 36.5% and this correspond to a monthly saving of RM39.05 (US$10.30, US$1.00 = RM 3.80) per patient. The study concluded that the tablet splitting is not a common practice among the community pharmacists, however both the physicians and patients highly accept pharmacists‟ suggestion on splitting. The findings also revealed that tablet splitting can be used as a cost-containment measure for patient as well.
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.