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Zin CS, Ab Rahman NS, Mohamed Nazar NI, Kurdi A, Godman B. Trends in the Cost of Medicines, Consultation Fees and Clinic Visits in Malaysia's Private Primary Healthcare System: Employer Health Insurance Coverage. J Multidiscip Healthc 2023; 16:1683-1697. [PMID: 37350986 PMCID: PMC10284298 DOI: 10.2147/jmdh.s403589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/08/2023] [Indexed: 06/24/2023] Open
Abstract
Objective To examine trends in the cost of medicines, consultation fees and clinic visits among the employees covered by the employer health insurance in Malaysia's private primary healthcare system in Malaysia. Designs Retrospective cross-sectional study. Setting PMCare claims database from January 2016 to August 2019. Participants A total of 83,556 outpatient clinic visits involving 10,150 IIUM employees of the International Islamic University Malaysia (IIUM) to private general practitioners (GPs). During the study period, IIUM adopts the incentive structure of capping coverage at Ringgit Malaysia (RM) 45/outpatient visit (USD 10.58) to cover for consultation fees and medicine costs. Main Outcome Measures The monthly percentage change in the number of clinic visits, medicine costs, consultation fees and total costs between January 2016 and August 2019. A simple linear regression using Stata v15.1 was also performed to measure the association between the characteristics of the prescribed medicines and medicine charges. Results The number of clinic visits per patient increased by 17% from January 2016 to August 2019, with consultation fees increasing by 113.9% and total costs by 7.9% per clinic visit per patient. Conversely, the cost of medicines and the number of medicines prescribed per clinic visit per patient decreased by 39.7% and 6.3%, respectively. Conclusion Within the incentive structure of capping the total amount of coverage per clinic visit, medicine costs were reduced by decreasing the number of medicines prescribed, to offset the increased consultation fees. This may create perverse incentives that affect medicine use with negative consequences for the health system and health insurers.
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Affiliation(s)
- Che Suraya Zin
- Big Data Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Norny Syafinaz Ab Rahman
- Big Data Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Nor Ilyani Mohamed Nazar
- Big Data Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region Government, Iraq
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
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Aslam A, Zin CS, Jamshed S, Rahman NSA, Ahmed SI, Pallós P, Gajdács M. Self-Medication with Antibiotics: Prevalence, Practices and Related Factors among the Pakistani Public. Antibiotics (Basel) 2022; 11:antibiotics11060795. [PMID: 35740201 PMCID: PMC9219843 DOI: 10.3390/antibiotics11060795] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Self-medication with antibiotics (SMA) has become considerably common in developing countries, which is a critical factor for driving antibiotic resistance. Individuals involved in SMA generally do not have adequate knowledge regarding the appropriate use, indications and dosage of these drugs. The objective of the present study was to investigate population SMA practices, knowledge and sociodemographic factors associated with SMA in Islamabad, Pakistan. The study adopted a cross-sectional methodology and data collection was performed through an anonymous, structured and pilot-tested questionnaire, which was interview-administered. Inferential statistics and multivariate logistic regression were performed. Out of 480 participants, 55.6% (n = 267) were male with a mean age of 37.1 ± 10.1 years; the total prevalence of SMA was 32.5%. Ciprofloxacin (42.9%) was the most commonly used antibiotic to treat coughs or colds, a runny nose, flu or sore throat, diarrhea or fevers, which were relevant reasons for SMA. Findings from multivariate logistic regression showed that predictors of SMA were: male gender (95% CI: 0.383–1.005), age (95% CI: 0.317–0.953) and highest level of education (95% CI: 0.961–0.649). Despite reasonable access to healthcare facilities, people are still obtaining antibiotics without prescription, bypassing diagnostic and consultative healthcare services. Thus, the government must implement strict healthcare policies to restrict the sale of antibiotics without prescriptions, while at the same time, targeted public awareness campaigns about the proper use of antibiotics are also required.
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Affiliation(s)
- Adeel Aslam
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia; (A.A.); (C.S.Z.); (N.S.A.R.)
| | - Che Suraya Zin
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia; (A.A.); (C.S.Z.); (N.S.A.R.)
| | - Shazia Jamshed
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu 20400, Malaysia;
| | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia; (A.A.); (C.S.Z.); (N.S.A.R.)
| | - Syed Imran Ahmed
- School of Pharmacy, College of Science, University of Lincoln, Lincoln LN6 7TS, UK;
| | - Péter Pallós
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6720 Szeged, Hungary;
| | - Márió Gajdács
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6720 Szeged, Hungary;
- Correspondence:
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Rahman NSA, Pakururrazi FA, Zin CS, Halim HA. Trends and patterns of benzodiazepines prescription from 2014 to 2016: A retrospective cross-sectional study in an outpatient setting of tertiary hospital in Malaysia.. [DOI: 10.21203/rs.3.rs-1350508/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background
Despite evidence of their association with adverse drug events and mortality, benzodiazepines are still among the main choice for treating many psychiatric disorders and neurological conditions. To date, there is a meager data on the prescribing trends and patterns of benzodiazepines in Malaysia.
Objective
This study aimed to investigate the trends and patterns of benzodiazepines prescribing at outpatient hospital setting.
Method
A retrospective, cross-sectional study was conducted at outpatient pharmacy of a tertiary hospital in Malaysia. Prescriptions for any of seven benzodiazepines (alprazolam, bromazepam, clobazam, clonazepam, diazepam, lorazepam and midazolam) issued from January 2014 until December 2016 were screened and included in this study. Trends and patterns of prescribed benzodiazepines were examined. Descriptive statistics and association between patient characteristics and prescribing patterns were performed using STATA® SE v.13.1 (Stata Corp LP, Texas, USA).
Results
A total of 5,728 benzodiazepines prescriptions of the seven benzodiazepines were prescribed for 1,943 patients from 2014 to 2016. BZDs were prescribed to 1,013 (52.1%) male with mean age of 46.8 ± 14.1 for the whole study population, in which 26.8% were between 45–54 years old. About 40% of benzodiazepines prescribed were classified as short-acting. About 12.6% reduction in the overall number of benzodiazepine prescriptions from 2014 (n = 1956) to 2016 (n = 1709). Alprazolam was the most frequently prescribed (43.3%) in 2014, followed by (38.9%) 2015 and (36.8%) 2016. Approximately, 69.64% (n = 6,218) of benzodiazepines were prescribed for a duration of 15 to 30 days, while 57.29% (n = 5,115) of benzodiazepines were prescribed with fixed dosing schedule.
Conclusion
Overall benzodiazepine prescription shows a decreasing trend from 2014 to 2016. Alprazolam, the short-acting benzodiazepine was the most frequently prescribed in hospital outpatient setting in Malaysia.
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Shirazi OU, Ab Rahman NS, Zin CS. An overview of the hospitals’ antimicrobial stewardship programs implemented to improve antibiotics’ utilization, cost and resistance patterns. JoP 2022. [DOI: 10.31436/jop.v2i1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction: The high reliance of the physicians and surgeons on the antibiotics since their discovery has led to an irrational antibiotic utilization which not only has raised the incidence of antimicrobial resistance (AMR) but also increased the cost of treatment with antibiotics as high use of antibiotics has been found related to the occurrence of certain nosocomial infections which need extra antibiotic courses to be cured. In order to overcome these antibiotic utilization related problems an antimicrobial stewardship (AMS) program being the set of various persuasive, restrictive and structural interventions is considered an effective tool to rationalize the in-patient antimicrobial utilization worldwide.
Method: The focus of this review is on the interventions that are being implemented during the in-patient AMS programs and have been described effective in controlling the antibiotic utilization, their cost of treatment and an overall infection control. The literature containing the information about various AMS interventions effecting the utilization and cost patterns along with the impact on AMR was searched in various databases such as PubMed, Google Scholar, Science Direct, Ovid (Medline) and Scopus. The categorical sorting of the published data is based on various AMS interventions such as the guideline development, formulary restriction (pre-authorization), educative interventions, clinical pathway development and prospective (post prescription) audit. Considering the objectives of the study such as the goal to curb overutilization of antibiotics, control of their cost of treatment for in-patients and infection control the sorted literature is presented in three different tables describing the AMS impact on the said outcomes.
Results: The post AMS changes in utilization patterns are described as fall of antibiotics defined daily doses (DDD) and days of therapy (DOT) which resulted in the reduction of the cost of treatment with antibiotics. The reduction of the cost of treatment with antibiotics also resulted due to the AMS impact on the control of various nosocomial and multi-drug resistant (MDR) infections.
Conclusion: It has been concluded that the AMS program if implemented under the supervision of an expert AMS team mainly comprising of an infectious disease (ID) physician, clinical pharmacists and microbiologists with considerable support by the hospital authorities could be a highly efficient tool of the pharmacovigilance for rationalizing the in-patient antimicrobial practice.
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Wee LH, Tee GH, Chan CMH, Draman S, Jamalludin AR, Ho BK, Yn Ling JM, Lim KH, Mohd Yusoff MF, Baharom N, Robson N, Kartiwi M, Ab Rahman NS, Siau CS, Nik Mohamed MH. The Role of Media and Retailer Message Recall on Malaysian Male Perceptions of E-Cigarette Use: The 2016 National Study of E-Cigarettes Prevalence. INQUIRY 2022; 59:469580221079683. [PMID: 35225040 PMCID: PMC8891842 DOI: 10.1177/00469580221079683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceptions of current smokers on electronic cigarette (EC) use, after exposure to information on EC use and its potential harms from various media and retail outlets. This cross-sectional study is a sub-analysis of the National Study of Electronic Cigarettes Prevalence (N = 4289) using the multi-stage stratified sampling method. Respondents were interviewed face-to-face by a trained data collector using a structured questionnaire printed in both Bahasa Malaysia and English. The analysis included 376 males who smoked conventional cigarettes and/or used ECs and reported ever seeing messages on ECs/vape in various platforms were analyzed using weighted simple and multiple logistic regression. Our findings showed different media types resulted in differing perceptions among smokers towards EC use especially between social media and conventional media. Those exposed to messages promoting EC in social media had higher odds of believing that ECs help people quit smoking (OR: 2.28), the urge to smoke is reduced by ECs (OR: 1.86), ECs are more effective than medication for quitting smoking (OR: 1.96), breathing is improved after using ECs (OR: 2.85), the smell of EC is better than a tobacco cigarette (OR: 2.73), and ECs should be regulated rather than banned completely (OR: 3.08). Vape shops, social, and conventional media provided very different perceptions among smokers towards EC use. Beyond using traditional communication channels, EC promoters have successfully utilized social media to promote ECs among smokers.
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Affiliation(s)
- Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Samsul Draman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ab Rahman Jamalludin
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Jane Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Noorzurani Robson
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mira Kartiwi
- Kulliyyah of ICT, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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Aslam A, Zin CS, Ab Rahman NS, Gajdács M, Ahmed SI, Jamshed S. Self-Medication Practices with Antibiotics and Associated Factors among the Public of Malaysia: A Cross-Sectional Study. Drug Healthc Patient Saf 2021; 13:171-181. [PMID: 34737648 PMCID: PMC8560071 DOI: 10.2147/dhps.s331427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/06/2021] [Indexed: 12/28/2022]
Abstract
Background Self-medication with antibiotics (SMA) is an important public health issue, which can result in the facilitated development of antibiotic resistance, and may increase the risk of inappropriate utilization of antibiotics. So, the objective of the present study was to estimate the prevalence rate of SMA and to also explore SMA practices among the lay population of Kuala Lumpur (Malaysia). Methods The current study was cross-sectional population-based and used a convenient sampling technique. Moreover, Lorenz’s formula was used to calculate the sample size and the required sample size was 480. Data were collected through face-to-face interviews with a pre-validated questionnaire and the study was conducted in Kuala Lumpur (Malaysia). Descriptive statistics, cross-tabulation, and logistic regression were executed by using SPSS version 24. Results Out of 480 participants, 45.8% were polled male and the prevalence of SMA in this study was found to be 15.1%. The majority of participants 23.1% indicated that they practiced antibiotics at least once in the last six months. The commonly self-medicated antibiotics were amoxicillin-clavulanate 20.6%, ampicillin/cloxacillin 14.2%, and levofloxacin 8.3%. Moreover, 64.8% of participants indicated that they bought their antibiotics from pharmacies. Whereas, most of the participants practice antibiotics to save money 19.2% and time 23.1%. Findings from multivariate logistic regressions showed that predictors of SMA were male gender, (95% CI: 0.300–0.877) occupation (95% CI: 0.122–10.797), health insurance (95% CI: 0.025–0.472), and education (95% CI: 0.084–0.800). Conclusion The results of this study indicate that SMA persists among the community and education level has a significant impact on this behavior. Thus, concerning health management authorities should step in with developing legislation to stop this practice, and by implementing such interventions and policies to educate and to raise awareness about the risk of SMA for the future.
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Affiliation(s)
- Adeel Aslam
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Che Suraya Zin
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, 6720, Hungary
| | - Syed Imran Ahmed
- School of Pharmacy, College of Science, University of Lincoln, Lincoln, UK
| | - Shazia Jamshed
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Besut, Terengganu, 22200, Malaysia
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Elnaem MH, Mohd Taufek NH, Ab Rahman NS, Mohd Nazar NI, Zin CS, Nuffer W, Turner CJ. COVID-19 Vaccination Attitudes, Perceptions, and Side Effect Experiences in Malaysia: Do Age, Gender, and Vaccine Type Matter? Vaccines (Basel) 2021; 9:1156. [PMID: 34696264 PMCID: PMC8539146 DOI: 10.3390/vaccines9101156] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate the attitudes, perceptions, and experiences of side effects with the COVID-19 vaccines in Malaysia among participants in the National Vaccination Program. A cross-sectional survey was conducted among a sample of vaccine-eligible and vaccinated individuals in Malaysia between May and July 2021. A total of 428 respondents completed the survey. A vast majority (98.6%) of the respondents had registered to be vaccinated. Twenty participants (4.7%) expressed concerns about either registering or receiving the COVID-19 vaccination, mainly due to their uncertainty of vaccine safety. Approximately 77.5% received their vaccinations. Of them, 76.8% had experienced vaccine-related side effects. About 40% of the side effects occurred more with the second dose, particularly those who received the Pfizer-BioNTech vaccine (p < 0.001). Pain at the injection site (61.1%) and tiredness (48.8%) were the most reported side effects. Compared to those aged ≥60 years, all age groups were more likely to exhibit vaccine-related side effects; meanwhile, males (OR: 0.51, 95% CI: 0.27-0.93) were less likely to experience side effects than females. Those who received the Sinovac vaccine were at lower risk of experiencing side effects (OR: 0.08, 95% CI: 0.03-0.22) and were more likely to report fewer side effects than Pfizer-BioNTech (p = 0.012) and Oxford-AstraZeneca groups (p= 0.001). The overall attitudes toward the COVID-19 vaccination program were positive. Several differences in the experiences of vaccine-related side effects, in terms of prevalence and numbers, were attributed to age, gender, and received vaccine type.
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Affiliation(s)
- Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (N.H.M.T.); (N.S.A.R.); (N.I.M.N.); (C.S.Z.)
| | - Nor Hidayah Mohd Taufek
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (N.H.M.T.); (N.S.A.R.); (N.I.M.N.); (C.S.Z.)
| | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (N.H.M.T.); (N.S.A.R.); (N.I.M.N.); (C.S.Z.)
| | - Nor Ilyani Mohd Nazar
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (N.H.M.T.); (N.S.A.R.); (N.I.M.N.); (C.S.Z.)
| | - Che Suraya Zin
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (N.H.M.T.); (N.S.A.R.); (N.I.M.N.); (C.S.Z.)
| | - Wesley Nuffer
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Christopher John Turner
- Retired but Formerly with Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
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Mohd Taufek NH, Halimi SN, Ab Rahman NS, Zin CS, Turner CJ. Reflections of pharmacy students on experiential education in providing health services to people with history of substance use disorders in Malaysia. JoP 2021. [DOI: 10.31436/jop.v1i2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Accreditation standards for pharmacy students’ education include the requirement for experiential education (EE) and acknowledge, in building life-long learning skills, the need to develop students’ skills in analysing their practice-based performance. The goal of this qualitative study was to assess students’ ability to reflect on their experience providing face-to-face care to patients with a history of substance use disorders (PHSUDs).
Materials and methods: Interviews were conducted with undergraduate pharmacy students who provided care to PHSUDs in an EE programme. An interview guide was used to explore students’ experiences and their perceptions regarding the challenges they encountered, changes in their attitude towards PHSUDs and ways to improve their ability to care for PHSUDs. Data relevant to the study was extracted from interview transcripts, manually sorted and coded using Microsoft Excel and subjected to thematic analysis.
Results: The themes identified were 1) Increased self-confidence in face-to-face interactions with PHSUDs 2) Increased empathy towards PHSUDS 3) Reduction in stigmatised attitudes towards PHSUDs 4) Positive nature of the interactions with PHSUDs 5) Appreciation for the opportunity to apply knowledge in practice 6) Recognition of the need for improved communication skill training 7) Recognition of the need to improve training for dealing with unexpected questions and situations.
Conclusion: Pharmacy students demonstrated reflective skills in identifying multiple positive learning outcomes stemming from a one-day EE programme involving PHSUDs. In addition, they provided insights useful to faculty in curriculum planning.
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Elnaem MH, Akkawi ME, Nazar NIM, Ab Rahman NS, Mohamed MHN. Malaysian pharmacy students' perspectives on the virtual objective structured clinical examination during the coronavirus disease 2019 pandemic. J Educ Eval Health Prof 2021; 18:6. [PMID: 33910270 PMCID: PMC8089464 DOI: 10.3352/jeehp.2021.18.6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/23/2021] [Indexed: 05/21/2023]
Abstract
PURPOSE This study investigated pharmacy students' perceptions of various aspects of virtual objective structured clinical examinations (vOSCEs) conducted during the coronavirus disease 2019 pandemic in Malaysia. METHODS This cross-sectional study involved third- and fourth-year pharmacy students at the International Islamic University Malaysia. A validated self-administered questionnaire was distributed to students who had taken a vOSCE a week before. RESULTS Out of the 253 students who were approached, 231 (91.3%) completed the questionnaire. More than 75% of the participants agreed that the instructions and preparations were clear and helpful in familiarizing them with the vOSCE flow. It was found that 53.2% of the respondents were satisfied with the flow and conduct of the vOSCE. However, only approximately one-third of the respondents believed that the tasks provided in the vOSCE were more convenient, less stressful, and easier to perform than those in the conventional OSCE. Furthermore, 49.7% of the students favored not having a vOSCE in the future when conducting a conventional OSCE becomes feasible again. Internet connection was reported as a problem hindering the performance of the vOSCE by 51.9% of the participants. Students who were interested in clinical pharmacy courses were more satisfied than other students with the preparation and operation of the vOSCE, the faculty support, and the allocated time. CONCLUSION Students were satisfied with the organization and operation of the vOSCE. However, they still preferred the conventional OSCE over the vOSCE. These findings might indicate a further need to expose students to telehealthcare models.
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Affiliation(s)
- Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Muhammad Eid Akkawi
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Nor Ilyani Mohamed Nazar
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
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Mohd Taufek NH, Halimi SN, Ab Rahman NS, Zin CS, Che Mohamad CA, Turner CJ. Experiential education as a strategy to preserve Maqasid Al-Shariah by identifying and addressing stigmatic views held by pharmacy students of patients with substance use disorders. JoP 2021. [DOI: 10.31436/jop.v1i1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Stigmatising people with a history of substance use disorders (PHSUDs) is discriminatory, causes harm by hindering access to health services and promotes relapse. It jeopardises the preservation of Maqasid Al-Shariah, particularly the protection of life and well-being. Experiential education (EE) is a potential strategy to overcome stigma through direct experience with PHSUDs. This study aimed to identify stigmatised views of PHSUD's held by pharmacy students and, in accord with Maqasid Al-Shariah, the effectiveness of EE in changing those views.
Materials and methods: Interviews were conducted with seven undergraduate pharmacy students who provided care to PHSUDs through an EE programme. A semi-structured interview guide was used to explore students' perceptions on stigma. Each interview was audio-taped, transcribed verbatim and translated into English. Data were manually sorted and coded using Microsoft Excel 2016 and subjected to thematic analysis.
Results: The following themes related to stigma were identified: 1) individuals are to blame 2) moral versus biological views of addiction 3) stereotypes of unpredictability and dangerousness 4) lack of didactic education/training for pharmacy students regarding PHSUDs and 5) lack of face-to-face experiential education with PHSUDs. Less stigma and greater empathy towards PHSUDs were reported post-intervention attributable to increased knowledge about substance abuse and face-to-face interactions with PHSUDs.
Conclusion: Pharmacy students have pre-conceived stigmatic views regarding PHSUDs modifiable through experiential education. Contact by pharmacy students with stigmatised patients promotes health care without discrimination as advocated in the teaching of Islam. Future interventions to reduce stigma are required to preserve Maqasid Al-Shariah.
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Ismail FF, Mohamed Noor Z, Muda SM, Ab Rahman NS. Healthcare Professional Attitude and Social Support: How Do They Affect the Self-esteem of Physically Disabled People? J Pharm Bioallied Sci 2020; 12:S681-S690. [PMID: 33828361 PMCID: PMC8021065 DOI: 10.4103/jpbs.jpbs_383_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/20/2020] [Accepted: 05/18/2020] [Indexed: 11/11/2022] Open
Abstract
Context: The attitude of healthcare professionals and social supports give big influence toward self-esteem of physically disabled people. Aims: To explore how impairments could affect the self-esteem of physically disabled people and how healthcare professionals and social support boost their self-esteem. Materials and Methods: This study was conducted qualitatively whereby face-to-face interviews were conducted among 10 participants with physical disabilities. Participants were recruited from two rehabilitation centres in Kuantan, namely Community-based rehabilitation and rehabilitation, occupational therapy, and physiotherapy of public hospital in Kuantan. Interviews were conducted using the developed interview guide that explored on the disabled peoples’ self-esteem and motivation, feelings toward attitude of the healthcare professionals, and satisfaction toward the physical, services, and social support from the healthcare professionals. Thematic analysis was done to identify the themes emerged from the interview transcripts. Results: Five males and five females with age ranging from 31 to 58 years were interviewed. Five are still working or studying post impairments. Participants claimed being low self-esteem resulted from negative perception from the society, issue of rejection, being discriminated, and difficulty in getting support from the society. Most of the participants asserted that they gained their motivation and self-esteem due to the continuous support from various groups, such as their spouses, family members, colleagues, employers, and healthcare professionals. Conclusions: Despite heavy workload and stressful working environment, positive attitude showed by the healthcare professionals is highly praised. Hence, this will indirectly improve the self-esteem, motivation, and rehabilitation progress of physically disabled people.
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Affiliation(s)
| | - Zaswiza Mohamed Noor
- Faculty of Pharmacy and Health Sciences, UniKL Royal College of Medicine Perak, Pahang, Malaysia
| | | | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, IIUM Kuantan, Pahang, Malaysia.,Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
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12
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Ramlan AR, Mohamed Nazar NI, Tumian A, Ab Rahman NS, Mohamad D, Abdul Talib MS, Zakaria KFM, Izuddin MA, Zainal Abidin NA, T Syed Manso SS, Wan Hassan WNK. Time to Treatment Initiation and Retrospective Analysis of Antiretroviral Therapy Outcomes among HIV-positive Methadone Maintenance Therapy Clients in Primary Health-care Centers, Kuantan, Pahang. J Pharm Bioallied Sci 2020; 12:S810-S815. [PMID: 33828381 PMCID: PMC8021067 DOI: 10.4103/jpbs.jpbs_3_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/03/2020] [Accepted: 02/10/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction: Methadone maintenance therapy (MMT) program helped to improve access to antiretroviral therapy (ART) among people who inject drugs (PWID) with human immunodeficiency virus (HIV). However, the time to treatment initiation (TTI) and outcomes of ART intervention in this population have scarcely been analyzed. Objectives: The aim of this study was to analyze the TTI and outcomes of ART among MMT clients in primary health-care centers in Kuantan, Pahang. Materials and Methods: This was a retrospective evaluation of MMT clients from 2006 to 2019. The TTI was calculated from the day of MMT enrolment to ART initiation. The trends of CD4 counts and viral loads were descriptively evaluated. Cox proportional hazard model was used to analyze the survival and treatment retention rate. Results: A total of 67 MMT clients from six primary health-care centers were HIV-positive, of which 37 clients were started on ART. The mean TTI of ART was 27 months. The clients who were given ART had a mean CD4 count of 119 cells/mm3 at baseline and increased to 219 cells/mm3 after 6 months of ART. Only two patients (5.4%) in the ART subgroup had an unsuppressed viral load. The initiation of ART had reduced the risk of death by 72.8% (hazard ratio = 0.27, P = 0.024), and they are 13.1 times more likely to remain in treatment (P < 0.01). Conclusion: The TTI of ART was delayed in this population. MMT clients who were given ART have better CD4 and viral load outcomes, helped reduced death risk and showed higher retention rates in MMT program.
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Affiliation(s)
- Aida Roziana Ramlan
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.,Department of Pharmacy, Hospital Tengku Ampuan Afzan, Ministry of Health Malaysia, Kuantan, Pahang, Malaysia
| | | | - Afidalina Tumian
- Kulliyyah of Engineering, International Islamic University Malaysia, Gombak, Selangor, Malaysia
| | | | - Dzawani Mohamad
- Medical Department, Hospital Tengku Ampuan Afzan, Ministry of Health Malaysia, Kuantan, Pahang, Malaysia
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13
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Shirazi OU, Ab Rahman NS, Zin CS. A Narrative Review of Antimicrobial Stewardship Interventions within In-patient Settings and Resultant Patient Outcomes. J Pharm Bioallied Sci 2020; 12:369-380. [PMID: 33679082 PMCID: PMC7909060 DOI: 10.4103/jpbs.jpbs_311_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/18/2020] [Accepted: 06/22/2020] [Indexed: 12/25/2022] Open
Abstract
The overuse of antibiotics has led to various healthcare problems such as the emergence of resistance in infectious microbes and mortality due to antibiotic resistant healthcare associated infections (HAIs). An antimicrobial stewardship (AMS) program is the set of interventions used worldwide to enhance the rational use of antibiotics especially for the hospitalized patients. This review aimed to describe the characteristics of the implemented AMS programs in various hospitals of the world mainly focusing on the interventions and patients outcomes. The literature about AMS program was searched through various databases such as PubMed, Google Scholar, Science Direct, Cochran Library, Ovid (Medline), Web of Science and Scopus. In this review the literature pertaining to the AMS programs for hospitalized patients is sorted on the basis of various interventions that are categorized as formulary restriction (pre-authorization), guideline development, clinical pathway development, educative interventions and prospective audit. Moreover a clear emphasis is laid on the patient outcomes obtained as a result of these interventions namely the infection control, drop in readmission rate, mortality control, resistance control and the control of an overall cost of antibiotic treatment obtained mainly by curbing the overuse of antibiotics within the hospital wards. AMS program is an efficient strategy of pharmacovigilance to rationalize the antimicrobial practice for hospitalized patients as it prevents the misuse of antibiotics, which ultimately retards the health threatening effects of various antibiotics.
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Affiliation(s)
- Ovais Ullah Shirazi
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
| | - Norny Syafinaz Ab Rahman
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia.,Big Data Research in Drug Utilization Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
| | - Che Suraya Zin
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia.,Big Data Research in Drug Utilization Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
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14
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Lim KH, Heng PP, Nik Mohamed MH, Teh CH, Mohd Yusoff MF, Ling JMY, Baharom N, Wee LH, Chan CMH, Ho BK, Robson Z, Draman S, Ab Rahman NS, Kartiwi M, Ab Rahman J. Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia. Asia Pac J Public Health 2020; 31:22S-31S. [PMID: 31802718 DOI: 10.1177/1010539519874944] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Jane Miaw Yn Ling
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nizam Baharom
- Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Klang, Malaysia
| | | | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
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15
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Azmi J, Nurumal MS, Mohamed MHN, Rahman NSA. A Snapshot of Pre- and Post-intervention Changes Among Cardiovascular Disease Patients Participating in the New Smoking Cessation Program. Int J Prev Med 2020; 11:6. [PMID: 32089806 PMCID: PMC7011462 DOI: 10.4103/ijpvm.ijpvm_83_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/08/2019] [Indexed: 11/04/2022] Open
Abstract
Background The study evaluates the changes of pre and post stages of behavioral change, motivation level, and smoking status among cardiovascular disease patients, participating in the new smoking cessation program in Hospital Tengku Ampuan Afzan, Kuantan. Methods A total of 65 adult cardiac patients were randomly distributed into two groups, i.e., intervention and control group, who were baseline smokers and assessed in three phases. Initially, the first, second, and third phase collected the information about their demographic details, their smoking status, and smoking status using cotinine amylase strip, respectively. Results It showed that behavioral change was significant for the control group (P value = 0.031), while motivation level improved for both groups (i.e., control, P value = 0.000 and intervention group, P value = 0.001). The smoke quitting status percentage was higher for intervention group 41.9% and lower for control group 20.6%; however, the P value was insignificant for both control group (1.000) and intervention group (0.250). Conclusions This study suggests a need for more personal testimonial videos to focus on other smoking-related diseases.
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Affiliation(s)
- Junainah Azmi
- Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia (IIUM), Selangor, Malaysia
| | - Mohd Said Nurumal
- Department of Critical Care Nursing, Kulliyyah of Nursing, IIUM, 25200 Kuantan, Pahang, Malaysia
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16
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Chan CMH, Ab Rahman J, Tee GH, Wee LH, Ho BK, Robson NZMH, Draman S, Ling Miaw Yn J, Kuang Hock L, Yusoff MF, Kartiwi M, Ab Rahman NS, Nik Mohamed MH. Perception of Harms and Benefits of Electronic Cigarettes Among Adult Malaysian Men: A Comparison by Electronic Cigarette Use and Smoking Status. Asia Pac J Public Health 2019; 31:32S-43S. [PMID: 31328531 DOI: 10.1177/1010539519860730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little is known about the perceptions of harm and benefit associated with the use of e-cigarettes in Malaysia. This was a cross-sectional analysis of a nationally representative sample comprising 1987 males (≥18 years of age). Current, former, and never users of conventional cigarettes and/or e-cigarettes participated in a questionnaire study conducted via face-to-face interviews. The relationship between participant characteristics and perceptions of harm and benefit of e-cigarettes were determined with multivariable logistic regression. There were 950 current, 377 former, and 660 never users of e-cigarettes. Government employees (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.29-2.66, P = .001), private sector employees (OR = 1.67, 95% CI = 1.27-2.18, P = .001), and the self-employed people (OR = 1.68, 95% CI = 1.31-2.17, P = .001) were more likely to perceive e-cigarettes as more harmful than conventional cigarettes compared with respondents who were not wage earners. All current users in the form of e-cigarette users (OR = 7.87, 95% CI = 3.23-19.18), conventional cigarette smokers (OR = 1.80, 95% CI = 1.39-2.33), and dual users (OR = 8.59, 95% CI = 4.76-15.52) were more likely to perceive e-cigarettes as useful in quitting conventional cigarette smoking compared with former and never users. Our findings constitute an important snapshot into the perceptions of e-cigarette harms and benefits, which could inform targeted public health messaging strategies.
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Affiliation(s)
| | | | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- National University Malaysia, Kuala Lumpur, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | | | - Shamsul Draman
- International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuala Lumpur, Malaysia
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17
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Ab Rahman J, Mohd Yusoff MF, Nik Mohamed MH, Mahadir Naidu B, Lim KH, Tee GH, Mohamad MS, Kartiwi M, Draman S, Ab Rahman NS, Aris T. The Prevalence of E-Cigarette Use Among Adults in Malaysia. Asia Pac J Public Health 2019; 31:9S-21S. [DOI: 10.1177/1010539519834735] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Electronic cigarettes (e-cigarettes) are a new method for the consumption of nicotine. A nationwide survey among 4288 Malaysian adults was conducted in 2016 to measure the prevalence and to describe the population characteristics of e-cigarette users. A complex sampling design was used, and data were collected using a face-to-face questionnaire. The overall prevalence of current, ever, former, and dual users of e-cigarettes in Malaysia were 3.2% (95% confidence interval [CI] = 2.5-4.1), 11.9% (95% CI = 10.5-13.5), 8.6% (95% CI = 7.5-9.8), and 2.3% (95% CI = 1.8-3.1), respectively. The prevalence of all type of e-cigarette use was higher in urban than in rural areas. Current e-cigarette users were likely to be younger, males, and with higher education level. Among current e-cigarette users, 74% (95% CI = 64-82) also smoked conventional cigarettes (dual user). E-cigarette use is prevalent in Malaysia. It is common among younger adults, males, and cigarette smokers.
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Affiliation(s)
| | | | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
| | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Tahir Aris
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
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18
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Ab Rahman J, Nik Mohamed MH, Mohd Yusoff MF, Ab Rahman NS, Draman S, Kartiwi M, Mahadir B, Aris T. Prevalence and characteristics of e-cigarette use among adults in Malaysia. Tob Induc Dis 2018. [DOI: 10.18332/tid/83854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Elnaem MH, Nazar NIM, Rahman NSA, Jamshed S. Analysis of Drug-Related Problems Identified by Future Pharmacists in Medical Wards of Tertiary Hospitals in the State of Pahang, Malaysia. J Young Pharm 2018. [DOI: 10.5530/jyp.2019.11.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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