Positioning and Utilization of Information and Communication Technology in Community Pharmacies of Selangor, Malaysia: Cross-Sectional Study

A survey of the adoption and perception of mobile health applications among community pharmacists in Malaysia

OBJECTIVES

To determine the adoption and perception of mobile health (mHealth) applications among community pharmacists in Malaysia.

METHODS

A cross-sectional survey using a self-administered questionnaire was conducted with 300 community pharmacists in the Klang Valley, Malaysia using a stratified sampling approach. The questionnaire consisted of 36 questions with three sections: demographic data, adoption of mHealth applications and perception towards mHealth applications. Descriptive and inferential tests as well as exploratory factor analysis were used to analyse the data.

KEY FINDINGS

Adoption of mHealth applications by community pharmacists for both professional and personal use was relatively high at 79.7%. Utilised mHealth applications were primarily from the medical references category, while applications for patient monitoring, personal care and fitness were used to a lesser degree. Among mHealth application users, only 65.7% recommended them to their patients. Overall perception towards mHealth applications was positive, but perception towards the benefits and favour of mHealth applications for their patients was lower. This was corroborated by the factor analysis, which identified four main factors explaining 59.9% of variance in the dataset. These factors were perception towards use in their own professional practice, perception on benefits and use in their patients, perception on specific features of mHealth applications, and reliability of mHealth applications.

CONCLUSIONS

Adoption of mHealth applications among community pharmacists in Malaysia is high. Community pharmacists are more likely to use mHealth applications professionally and personally but less likely to recommend them to patients due to less favourable perceptions on how patients will benefit from mHealth applications.

Using the Simulated Patient Methodology in the Form of Mystery Calls in Community Pharmacy Practice Research: A Scoping Review Protocol

Community pharmacies (CPs) play a major role in health care delivery. The simulated patient methodology (SPM), which is considered the "gold standard", is recommended for studying CP practice. SPM can be applied in different forms, which include visits and also calls ("mystery calls"). So far, only the role of visits in the investigation of CP practice is known. As the first study worldwide, a systematic map of such reports will be provided, which applies calls in the context of the SPM for the study of CP practice. Reports with the pharmacy staff as the population under study should be included. Reports should be included that conduct an investigation using the SPM in the form of calls to simulate patients and other customers. Reports should be included that examine CP practice as defined by the International Pharmaceutical Federation and the World Health Organization (FIP/WHO). The scoping review methodology will be applied using the associated guidelines from Joanna Briggs Institute (JBI) and PRISMA extension for Scoping Review (PRISMA-ScR). The search will be for both published and unpublished original research in English with transparent information on SPM until the end of 2022. The plan is to search Embase, MEDLINE via PubMed, and Web of Science. Directly afterward, the respective literature collection of the reviewers and the reference lists of suitable international reviews will be searched. This will be followed by a forward and backward snowballing in Google Scholar. For the inclusion of reports, a selection process and for the data extraction a data charting process with the help of variables derived from related reviews and from two SPM-form spanning international guidelines will be performed. The data extracted from the included reports should be synthesized and presented in MS Excel tabular form using the previously determined variables.

Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low- and middle-income countries

Background

Digital health can support health care in low- and middle-income countries (LMICs) by overcoming problems of distance, poor infrastructure and the need to provide community practitioners with specialist support. We used five RESPIRE countries as exemplars (Bangladesh, India, Indonesia, Malaysia, Pakistan) to identify the digital health solutions that are valuable in their local setting, worked together with local clinicians and researchers to explore digital health policy, electricity/ICT infrastructure, and socio-cultural factors influencing users' ability to access, adopt and utilise digital health.

Methods

We adopted the Joanna Briggs Institute's scoping review protocol and followed the Cochrane Rapid Review method to accelerate the review process, using the Implementation and Operation of Mobile Health projects framework and The Extended Technology Acceptance Model of Mobile Telephony to categorise the results. We conducted the review in four stages: (1) establishing value, (2) identifying digital health policy, (3) searching for evidence of infrastructure, design, and end-user adoption, (4) local input to interpret relevance and adoption factors. We used open-source national/international statistics such as the World Health Organization, International Telecommunication Union, Groupe Speciale Mobile, and local news/articles/government statistics to scope the current status, and systematically searched five databases for locally relevant exemplars.

Results

We found 118 studies (2015-2021) and 114 supplementary online news articles and national statistics. Digital health policy was available in all countries, but scarce skilled labour, lack of legislation/interoperability support, and interrupted electricity and internet services were limitations. Older patients, women and those living in rural areas were least likely to have access to ICT infrastructure. Renewable energy has potential in enabling digital health care. Low usage mobile data and voice service packages are relatively affordable options for mHealth in the five countries.

Conclusions

Effective implementation of digital health technologies requires a supportive policy, stable electricity infrastructures, affordable mobile internet service, and good understanding of the socio-economic context in order to tailor the intervention such that it functional, accessible, feasible, user-friendly and trusted by the target users. We suggest a checklist of contextual factors that developers of digital health initiatives in LMICs should consider at an early stage in the development process.

Assessing E-Health adoption readiness using diffusion of innovation theory and the role mediated by each adopter's category in a Mauritian context

BACKGROUND

The preparedness of healthcare institutes for the foreseen changes expected to arise through the implementation of E-Health is a significant turning point in determining its success. This should be evaluated through the awareness and readiness of healthcare workers to adopt E-Health technology to reduce health information technology failures.

METHODS

This study investigated the relationship between the perceived attributes of innovation and E-Health adoption decisions of healthcare workers as part of a preimplementation process. Using a cross-sectional quantitative approach, the dimensions of the diffusion of innovation (DOI) theory were used to assess the E-Health readiness of 110 healthcare workers in a Mauritian specialized hospital.

RESULTS

A strong inclination towards E-Health adoption was observed, where the prime stimulators were perceived as modernization of healthcare management (84.1%, ẋ=4.19), increased work efficiency through reduction of duplication (77.6%, ẋ=4.10) and faster generation of results (71.1%, ẋ=4.07). The findings of this study also validated the use of five DOI dimensions (i.e. relative advantage, compatibility, complexity, trialability and observability) in a predictability model (F(5, 101)=17.067, p<0.001) towards E-Health adoption. A significant association between 'adopter category' and 'willingness to recommend E-Health adoption' (χ2(8)=74.89, p<0.001) endorsed the fact that physicians and nursing managers have central roles within a social ecosystem to facilitate the diffusion of technology and influence the adoption of innovation.

CONCLUSION

This is the first study of its kind in Mauritius to successfully characterize each adopter's profile and demonstrate the applicability of the DOI framework to predict the diffusion rate of E-Health platforms, while also highlighting the importance of identifying key opinion leaders who can be primed by innovators regarding the benefits of E-Health platforms, thus ensuring non-disruptive evolutionary innovation in the Mauritian healthcare sector.