PROCEEDINGS of Penang Pharmacists Convention 2023 23rd-24h September 2023

23^rd-24^h September 2023

Venue: Setia SPICE Convention Center, Penang.

Theme: Advancements in Pharmacy Practice

Editors

• NG JING
• TAN BOON SENG
• LEAN QI YING
• NG YEE MEI
• CHAN SIOK YEE

CONTENTS

RESEARCH PRESENTATIONS

P01
Exploring Supplement Usage Among Older Adults in Primary Healthcare Settings in Penang: A Qualitative Interview Study
Christina Christopher*, Ali Blebil, Bhuvan KC, Deepa Alex, Mohamed Izham Mohamed Ibrahim, Norhasimah Ismail, Mark Cheong Wing Loong

P02
Evaluating Pharmacists’ Responses Towards Enquiries on Symptoms of Drug-induced Gastroesophageal Reflux Disease (GORD): A Simulated Client Telephone Call Study in Community Pharmacies
Shin Yi Lim, Kien Sin Tan*

P03

Knowledge, Awareness and Practice of Proper Medication Disposal among the General Public in Malaysia

K.Kumaradev Yuhashinee*, Kien Sin Tan

P04
Lyophilised Rice Starch Sponge as a Potential Buccal Delivery System: Impact of Plasticisers on the Physicochemical Properties and Drug Release Profiles
Jing Yi Lee*, Li Wen Tan, Kay Vien Lee, Choon Fu Goh

P05
Identification of Potential Antibiotic-Producing Microorganism from Soil Sample
Shan Yun Yuk

P01

Exploring Supplement Usage Among Older Adults in Primary Healthcare Settings in Penang: A Qualitative Interview

Christina Christopher¹*, Ali Blebil1, Bhuvan KC², Deepa Alex³, Mohamed Izham Mohamed Ibrahim⁴, Norhasimah Ismail⁵, Mark Cheong Wing Loong¹

¹School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia

 ²School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia

³Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia

⁴Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar

⁵Bayan Lepas Health Clinic, Ministry of Health Malaysia

Email: christina.christopher@monash.edu

Background: Supplementation can potentially improve the overall health and well-being of older adults. However, the utilization of supplements remains questionable in developing countries. Objective: To explore the reasons and awareness of older adults on supplementations. Methods: A semi-structured interview was conducted in Penang, Malaysia, involving 15 participants targeting older adults aged above 60 who visited public health clinics, private clinics, and community pharmacies. Transcription was conducted by one author and was checked for validity by another author, an academician with experience in qualitative data analysis. Categories were then derived from the codes corresponding to emerging themes. NVivo 12 aided the analysis. Results: The median age of participants was 66.48±5.74. Over 70% of the older adults had secondary-level education and stayed with their families. The common healthcare facilities visited were public health clinics and community pharmacies. The majority of the participants reported the consumption of Fish oil, Vitamin C, multivitamins, and Coenyme-Q10 supplements. Three themes emerged from these qualitative findings (i) Reasons for supplementation; (ii) Source of information; and (iii) Integration of supplements with prescription medication. These supplements were primarily taken to promote general health, boost the immune system, enhance physical activity, improve memory, reduce numbness, and replenish essential minerals. Participants expressed that supplements and prescription medication should be utilized to maintain their health. Friends, social media, and recommendations from community pharmacists regarding supplementation often influenced the decision to purchase supplements. However, some participants noted a lack of awareness regarding supplements’ indications and potential side effects. Participants wanted community pharmacists to provide sufficient supplementation information and advice on any interaction with prescription medications. Conclusion: Older adults can understand supplementation usage; nonetheless, it is necessary to provide comprehensive information and recommendations to ensure the safe and high-quality use of supplements.

P02

Evaluating Pharmacists’ Responses Towards Enquiries on Symptoms of Drug-induced Gastroesophageal Reflux Disease (GORD): A Simulated Client Telephone Call Study in Community

Shin Yi Lim, Kien Sin Tan*

Faculty of Pharmacy, SEGi University Kota Damansara, 47810 Selangor, Malaysia.

Email: tankiensin@segi.edu.my

Background: A comprehensive and systematic assessment of patients presenting with symptoms of common ailments in community pharmacy setting is imperative. Negligence in doing so often results in failures to identify underlying drug-related problems as the primary causative factor of any illness. Little is known about the performance of community pharmacists in providing remote consultation services via telephone during the pandemic period. Objectives: This study primarily explored how pharmacists addressed the enquiries regarding symptoms of non-steroidal anti-inflammatory drugs (NSAID)-induced GORD presented by a client remotely via phone and their readiness in adopting telepharmacy interventions. Methods: A cross-sectional simulated client telephone call study was conducted among community pharmacists in Malaysia between September – October 2020. A simulated client was trained to present a standardised case scenario featuring a patient with symptoms of heartburn to the respondents via telephone. Out of a total of 339 attempts made, 295 telephone encounters were included in this study for analysis. The approaches taken by the pharmacists in response to the enquiries were examined. Results: The simulated client managed to consult a pharmacist in 87% of the telephone encounters (n=295). The call durations ranged between 1 to 8 minutes (median=3.5 minutes). Most pharmacists asked questions to investigate the duration of symptoms (96%, n=284) and co-morbidities (85%, n=252). A minor fraction of them explored and enquired about medication history (37%, n=109), potential triggering factors (14%, n=40), as well as any action taken to relieve symptoms (10%, n=30). Up to 37% pharmacists (n=109) were able to detect the underlying NSAID-induced GORD in the case scenario spontaneously. Conclusion: A positive response rate in this phone-based survey implies favourable readiness for tele-interventions in community pharmacy. Appropriate guidelines and training resources may be instituted to optimise providers’ competency in the delivery of minor ailments services on telehealth platforms.

P03

Knowledge, Awareness and Practice of Proper Medication Disposal among the General Public in Malaysia

K.Kumaradev Yuhashinee*, Kien Sin Tan

Faculty of Pharmacy, SEGi University, Selangor, 47810, Malaysia.

Email: yuhakumar3105@gmail.com

Background: Inappropriate medication disposal could negatively impact the environment, healthcare, and community. However, knowledge on proper medication disposal among the general public remains inadequate. Despite ongoing initiatives to encourage the use of the Medication Return Programme (MRP), awareness and utilisation of the service remain unsatisfactory. Objectives: The aim of this research was to analyse the respondents’ knowledge towards proper medication disposal and their medication disposal practice. The study also examined the awareness and utilisation of the MRP. Methods: A questionnaire was disseminated to the public between September to November 2022. The target population was the public above 18 years old throughout Malaysia. The collected data was analysed using the Statistical Package for Social Sciences (SPSS) version 28, applying both descriptive and inferential statistics. Results: The study involved 341 respondents. The median score for knowledge towards proper medication disposal was 58.3%. The respondents had basic knowledge on the subject but misunderstood that wastewater treatment plants are able to remove medicinal residues (n = 63, 18.5%). The majority of the respondents disposed their medications in the rubbish as it was convenient (n = 215, 63.0%). Less than 50% of the respondents were aware of MRP, and only 31.1% (n = 106) of the respondents have utilised the service. The mean satisfaction score for health facilities offering MRP was average (3.21/5.00). The lack of awareness towards MRP was identified as a primary barrier, and respondents urged for better accessibility to MRP. A correlation was established between the level of knowledge and the respondents’ disposal practices. Conclusion: The findings highlighted the mediocre knowledge towards proper medication disposal and the lack of awareness towards MRP. Proactive strategies by the Ministry of Health and stakeholders are required to enforce safe and convenient medication disposal practice.

P04

Lyophilised Rice Starch Sponge as a Potential Buccal Delivery System: Impact of Plasticisers on the Physicochemical

Jing Yi Lee*, Li Wen Tan, Kay Vien Lee, Choon Fu Goh

Discipline of Pharmaceutical Technology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia

Email: esteeljy@gmail.com

Background: Rice starch is a promising mucoadhesive biopolymer for formulation development in buccal drug delivery. Lyophilisation of starch mixture can improve formulation stability by reducing starch retrogradation.  Objectives: This study aims to compare the effects of plasticisers (sorbitol and Tween® 80, T80) on the physiochemical properties and drug release profiles of lyophilised rice sponges (RS) incorporated with propranolol hydrochloride (PPN). Methods: RS were prepared by lyophilising rice starch mixture (5%w/v) added with sorbitol or T80 (0.2 and 0.3 g/g rice starch) and PPN (10, 20, 30%w/w). The RS were characterised for mechanical, water absorption capacity (WAC), and drug release profiles. Results: Control RS exhibited a rough wrinkled surface with loose layers. Sorbitol resulted in a compact structure with a higher puncture strength (PS) but a lower WAC while T80 loosened the flakes which reduced PS and increased WAC. The modified PS and WAC properties were evidenced in the disturbance of plasticiser-starch interactions in ATR-FTIR and DSC analyses. PPN incorporation increased PS and decreased WAC in plasticised RS but T80-RS has a lower PS than sorbitol-RS. Particularly, T80-RS achieved outstandingly high PS and the lowest WAC with 30%w/w PPN due to PPN-starch interaction via hydrogen bonding. Drug dissolution of control RS reduced with drug loading due to drug crystallinity. Control RS with 10%w/w PPN achieved complete drug release owing to drug amorphicity but plasticiser reduced drug release because of a compact structure. Complete drug dissolution achieved at lower sorbitol or higher T80 contents for 20%w/w PPN may be contributed by partial drug crystallinity and high WAC. Nevertheless, the negative effects of drug crystallinity and poor WAC reduced drug release at 30%w/w PPN despite the inclusion of plasticiser. Conclusion: In conclusion, this study highlights the influence of plasticisers on physicochemical properties and drug release profiles of RS at different drug loadings.

P05

Identification of Potential Antibiotic-Producing Microorganism

Shan Yun Yuk

Faculty of Pharmacy, AIMST University, 08100 Bedong, Kedah, Malaysia.

Email: yuns98565@gmail.com

Background: To explore the soil microbial diversity that has the greatest potential to secrete clinically important antibiotics, this research focuses on the isolation, cultivation and identification of the microorganisms in the samples. Objective: To analyze the antibiotic producing capabilities of microbes obtained from various soil samples. Methods: Soil was collected from AIMST University. The liquid nutrient agar medium was autoclaved before preparation. After that, a four-fold soil sample serial dilution was initiated. The soil solution was incubated for 24 hours. Colonies of microbes with the inhibitory zone were isolated into the nutrient broth. Subsequently, the nutrient broths with the desired microorganisms had been incubated for 24 hours. The cultivated unknown microbes were spread at the center against the test microorganisms, Klebsiella Pneumonia (ATCC 10031), Escherichia coli (ATCC 8739), Staphylococcus Aureus (ATCC 29737) and Bacillus Subtilis (ATCC 6633). Next, gram staining and soft agar stabbing techniques were carried out. Results: The microorganisms in sample A, B and C appeared in pink or red color under the microscope after gram staining. The soil isolates in sample A were comprised of the coccobacillus and diplobacillus. The soil in sample B consists of cocci and streptococci bacteria while sample C were comprised of vibrio, cocci, diplococci, and streptococci bacteria. Diffusion edges were observed in the motility agar of sample A and sample B. Sharp edge was also detected in the motility agar of sample C. Conclusion: Gram staining proved that the soil isolates of sample A, B and C were gram negative. Lastly, with the soft agar stabbing test, the unknown microorganisms in sample A and B were concluded to be motile while the movement of microorganisms in sample C was deduced as non-motile.