Background: Herbal and dietary supplements (HDS) are commonly used for diabetes management and health maintenance due to their perceived safety and benefits. However, HDS can… Read More »Herbal and Dietary Supplement Use among Patients with Type 2 Diabetes Mellitus (T2DM) from a Rural Region in Malaysia: A Cross-Sectional Study
Introduction: The pharmacy drive-through service (P.D.T.S.) is an innovative medication dispensing service that aims to reduce the hurdles of collecting medications. Through the P.D.T.S., patients may have the convenience of getting medication at the drive-through pharmacy counter. By conducting a qualitative study, we explored the user’s experiences of P.D.T.S. in a public specialist hospital in Miri, Sarawak State of Malaysia. Methods: The P.D.T.S. users who consented to participate were invited to a semi-structured phone interview. We go in-depth on the awareness, barriers, application, improvements, and benefits of the P.D.T.S. The interviews lasted, on average, 15 minutes or until achieving data saturation. Audio recordings were transcribed verbatim, and the transcripts were analysed thematically. Result: Participants perceived the P.D.T.S. as convenient and gave them a sense of safety through physical distancing while collecting their medications. On the contrary, they experienced confusion with the instructions on using P.D.T.S. and some degree of inflexibility, especially in the appointment setting. Conclusion: The users of P.D.T.S. had both positive and negative experiences with P.D.T.S. The negative aspect must be improved, especially the user’s instructions and the appointment system.
Introduction: Antibiotic resistance is increasing worldwide. The prevalence of bacterial resistance varies in different geographical areas, and it was correlated with the utilisation of antibiotics in the general population. Objective: This study was conducted to assess public knowledge and attitudes towards antibiotic usage in Perlis, Malaysia. Method: A validated self-administered questionnaire survey was distributed among the public in three main parliament areas of Perlis using the quota sampling method from August to October 2017. The questionnaire from a previous study by Lim et al. was used and the data were analysed using SPSS version 20.0. Result: About half of the respondents (51%) were found to have good knowledge (score ≥6 out of 12), and 45.1% have a good attitude (score ≥6 out of 8). The mean knowledge score was 5.0±2.19 and the mean attitude score was 5.6±3.00. As for knowledge, most respondents still perceived those antibiotics would work on viral infections in the common cold and cough. In terms of attitude, almost three-quarters of the study population (74%) expected antibiotics to treat cough and cold while two-thirds of the respondents (65.1%) expected that taking antibiotics would improve recovery. Half of the respondents (53.6%) will stop taking antibiotics when they start feeling better. Age, education level, and employment sector were found to be significantly associated with knowledge and attitude. There was a positive correlation (r=0.581) between knowledge and attitude scores. Conclusion: This study has identified people with better knowledge would have an appropriate attitude regarding the use of antibiotics. Hence, educational programmes targeting the young generation and public who do not work in the healthcare field are significant to promote the appropriate utilisation of antibiotics among the public in Perlis.
Objective: This study aimed to determine the effectiveness of a pharmacist-led audit-and-feedback intervention in promoting the appropriate prescribing of third-generation cephalosporins and timely culture and sensitivity (C&S) testing in patients admitted to a neurosurgical ward. Method: This quasi-experimental study was conducted from July 2019 to August 2020 in a tertiary public hospital in Malaysia. In the pre-intervention phase, seventy patients who have received treatment with third-generation cephalosporins were examined by a ward pharmacist. The use of a cephalosporin was deemed to be appropriate only if it was in line with either the National Antimicrobial Guidelines 2019 or the recommendations made by the Antimicrobial Stewardship team. The availability of C&S test performed before the first dose of cephalosporin was also studied. As an intervention, the findings were presented and discussed in a 2-hour feedback session. Subsequently, the post-intervention audit was performed in the same manner as in the pre-intervention phase. The primary outcome measures were the proportion of cases with appropriate use of cephalosporin and timely C&S testing. The variables were analysed descriptively. Pearson’s chi-square test was used to assess the differences in appropriateness of antibiotics use and C&S testing, in the pre- and post-intervention cohorts. Result: Seventy cases were studied in the pre- and another seventy in post-intervention phases. The proportion of cases with appropriate use of third-generation cephalosporin increased significantly from 77.1% (54 / 70) to 95.8% (67 / 70) following the intervention (p = 0.001). The proportion of cases with a C&S test performed timely also increased significantly from 38.6% (27 / 70) to 58.6% (41 / 70) (p = 0.018). Conclusion: The pharmacist-led audit-and-feedback intervention was effective in improving the appropriateness of the prescribing of third-generation cephalosporins and timely culture and sensitivity testing, indicating the antimicrobial stewardship strategy had produced a positive outcome.
Chronic pain has a significant impact on sufferers’ quality of life. Furthermore, treatment inadequacies are often reported in the literatures. This study aims to investigate the prevalence of the different dosing behaviors in analgesics use in chronic, non-cancer pain and their correlation to pain control. This is a cross-sectional study and a convenience sampling method was applied. Brief Pain Inventory- Short Form and Pain Management Index was computed to assess pain control. Statistical analysis was performed with Pearson chi-square test and alpha value was set at 0.05. A total of 127 patients were analyzed. 70.9% of the patients reported inadequate pain control with their prescribed analgesic(s). 88.2% patients only took oral analgesics whenever they felt the pain while 11.8% patients took around-the-clock despite the absence of pain. Among them, 11.8-34.7% of patients did not follow their prescriber’s instruction for oral and topical analgesic use respectively. However, no statistically significant result was found between the dosing behaviors and pain control (p>0.95). It was also reported that 98% of patients were not aware of the maximum daily dose of their prescribed analgesic(s). The prevalence of ‘as needed’ dosing is higher than around-the-clock dosing in the management of chronic, non-cancer pain, with deviation from the prescribed instructions between 11.8-34.7%. However, those differences were not significantly associated with the pain control.
The coronavirus disease 2019 (COVID-19) pandemic has hugely affected healthcare services, particularly pharmacy services in a COVID-19 hospital. Before the COVID-19 outbreak, clinical pharmacists routinely reviewed patients’ medications upon ward admission, actively participated in ward rounds and partook in transitional care activities focusing on medication reconciliation and patient education in the wards. However, in order to limit contact with COVID patients, hospital pharmacy department reacted promptly by establishing remote clinical pharmacy services in order to sustain the quality of inpatient pharmaceutical care. This commentary describes the challenges faced by clinical pharmacists in a Malaysian hospital as we continue to provide clinical pharmacy services amidst the new norm.
A cross-sectional study was conducted among pharmacy students to determine factors influencing their choice of work place and to evaluate whether a one-year hospital pre-registration training programme had any effect on these choices. Questionnaires were distributed to graduating students at the School of Pharmaceutical Sciences, Universiti Sains Malaysia. The questionnaires were again sent to the same group of students by post at the end of their pre-registration training year. The response rate during the follow-up stage was 46%. Results indicated that students in the survey were more interested in independent and chain community pharmacies compared to other practice settings. Students’ choices of first place of practice appeared to be influenced by both intrinsic and extrinsic job factors. Our findings did not show major changes in students’ preferences for practice sites before and after the hospital pre-registration period. This information is expected to be useful for pharmacy employers.
Pharmacists in Malaysia practise their profession in rugged terrains which demand both professional skills and pioneering spirits. Many of the current pharmaceutical standards, practices, and legislations need overhauling in order to meet the aspiration of the nation in this new millennium. The Malaysian Pharmaceutical Society has a vital role to play. The profession requires the greatest understanding of the Malaysian Medical Association and the Government in this transition period.