Community pharmacists' knowledge, attitudes, and practices regarding counselling on vitamins and dietary supplements in Malaysia: A study on complementary medicines

Background

The utilization of vitamins and dietary supplements (DSs) among consumers in Malaysia has seen a notable increase. However, there is limited research available on how pharmacists in Eastern countries manage the provision of these products.

Objective

This study aims to assess the knowledge, attitudes, and practices of community pharmacists in Malaysia regarding the provision of counselling services on vitamins and DSs. The findings will inform education strategies in this area.

Methods

A cross-sectional quantitative study was conducted from February to April 2022 using a validated online-based questionnaire. The survey was distributed to community pharmacists across Malaysia through social media channels. t-test and ANOVA test were used for data analysis.

Results

Among the 260 participants, 73.5% were categorized as having average product knowledge. Key concerns included a lack of knowledge about the indications of new products and when to discontinue their use. Regarding dosing in specific patient groups, 33.5% of pharmacists only occasionally consulted references and primarily relied on product labels. Furthermore, 29% of pharmacists believed it was unnecessary to refer patients to doctors when they experienced ongoing symptoms while taking vitamins or DSs. Interestingly, 44.6% of pharmacists believed there was a correlation between the efficacy of vitamins and their price, often recommending more expensive brands despite similar content.

Conclusion

There is an opportunity to enhance the knowledge of pharmacists in Malaysia regarding vitamins and DSs. Education interventions should focus on areas such as dosing for specific patient groups, when to discontinue products, understanding new products, evidence-based efficacy of products for specific conditions, and providing a framework for appropriate referral to support pharmacists in their practice.

Effectiveness of pharmacogenomics educational interventions on healthcare professionals and health professions students: A systematic review

BACKGROUND

The field of pharmacogenomics is rapidly advancing, but its adoption and implementation remain slow and lacking. Lack of pharmacogenomics knowledge among healthcare professionals is the most frequently cited barrier to adopting and implementing pharmacogenomics in clinical settings.

OBJECTIVES

This study aimed to critically evaluate and determine the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice.

METHODS

Four electronic databases were searched: MEDLINE, EMBASE, CENTRAL, and PsycINFO. Studies on pharmacogenomics educational interventions for health care professionals and students with pre- and post-intervention assessments and results were included. No restrictions were placed on time, language, or educational contexts. The educational outcomes measured include both objective and subjective outcomes. The pharmacogenomics competency domains used to judge educational interventions are based on the competency domains listed by the American Association of Colleges of Pharmacies (AACP). The National Heart, Lung, and Blood Institute of the National Institutes of Health was used for the quality assessment of pre-post studies with no control group and the controlled intervention studies. No meta-analysis was conducted; the data were synthesized qualitatively. The systematic review was reported in accordance with the PRISMA statement.

RESULTS

Fifty studies were included in this review. All included studies integrated the AACP pharmacogenomics competency domains into their educational interventions. Most of the studies had educational interventions that integrated clinical cases (n = 44; 88%). Knowledge was the most frequently evaluated outcome (n = 34; 68%) and demonstrated significant improvement after the educational intervention that integrated AACP pharmacogenomics competency domains and employed active learning with clinical case inclusion.

CONCLUSION

This review provided evidence of the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice. Incorporating pharmacogenomics competency domains into education and training, with patient cases for healthcare professionals and students, dramatically improved their pharmacogenomics knowledge, attitudes, and confidence in practice.

Exploring the quality of life of cosmetic users: A cross-sectional analysis from eight Arab countries in the Middle East

BACKGROUND

The use of cosmetic products is growing in dominance in the Arab population, making it essential to measure its effects on users. The production of cosmetics has been largely driven by consumerism and a bid to keep abreast with the latest trends in the beauty industry with less attention on how the users' quality of life (QoL) is affected.

AIMS

This study aims to investigate the effect of cosmetic products on users' quality of life in eight Arab countries.

METHODS

A cross-sectional study was carried out using an online data collection approach. A validated and specialist instrument tool called BeautyQoL, which consists of five domains and a total of 52 questions, was distributed to a sample of 2219 cosmetic users. Descriptive and inferential statistical analysis was done using SPSS® version 26.0.

RESULTS

The mean age of participants was 34 ± 11.25 years, and more women were represented in the sample (71%) than men. The majority of respondents had oily skin type (39.6%) and tan skin tone (30.4%). QoL through cosmetic use is computed with a mean score of 51 out of 100. The users' mean score satisfaction from cosmetic use is centred on attractiveness (56.1), followed by self-confidence (51.8). Cosmetics have a statistically significant effect on participants who are young adults, women, single, and employed with high income. As the respondents' skin tone deepens from very fair to dark, the mean score for each domain significantly increases, whereas when skin type changes from very oily to dry, the mean score for each domain decreases.

CONCLUSION

The effect of cosmetics on the users' QoL is limited, contrary to the narrative commonly portrayed in cosmetics' advertisements. Therefore, the use of cosmetics among the Arab population should be from an informed perspective of their specific needs instead of conforming to the viral trends pedaled by influencers and bloggers on social media, which might be irrelevant for them.

Lockdown Fatigue and University Students: Exploring the Factors That Play Significant Roles in the Level of Lockdown Fatigue Among University Students in the Era of COVID-19

Background

Due to the COVID-19 global pandemic, the educational sector has undergone a series of changes which have affected both learners and students alike. As a result, the distortion of the students’ daily routine, isolation, social distancing and potential exposure to the COVID-19 virus changed almost all of the aspects of student life which has led to exhaustion of students, with both psychological and emotional challenges. Therefore, the main aim of this study is to determine the factors that have a significant impact on the level of lockdown fatigue among university students in the era of COVID-19.

Methods

A cross sectional was undertaken for this study. A questionnaire was designed and then shared electronically with the respondents of this study. The respondents were 819 students from tertiary institutions in Iraq. Some of the scales used in ranking the responses of the participants are the Lockdown Fatigue scale, Brief Resilience Scale and Coping Behaviours questionnaire. Data analysis was.

Results

Overall, the students had a high level of fatigue due to lockdown-measurement. Emptiness was one of the dominant feelings experienced by the students, along with concern for the safety and well-being of their own families. There was general agreement that students take a long time to return to normal routines after stressful events. The students also indicated that they cope with the lockdown through a variety of activities, ranging from making jokes about the situation to putting their faith in a higher power. Male student were less likely to suffer from lockdown-fatigue, however, studying in public university, being from urban areas, and studying in science field are the most significant factors that increase the level of lockdown. However, lower levels of lockdown fatigue were linked to significantly higher levels of personal resilience and coping abilities.

Conclusion

High level of lockdown fatigue among students is noticed, and several factors have been identified. Therefore, it is helpful for students to consistently work on reinforcing positive habits which would help them to build resilience when they are subjected to stressful conditions and scenarios.

Exploring the level of lockdown fatigue and effect of personal resilience and coping behaviours on university students during the covid-19 pandemic: a cross-sectional analysis from Iraq

Governments worldwide have imposed lockdowns in their countries to restrict unnecessary movement and curb the spread and transmission of the Covid-19 as a mitigation measure. The education sector has also implemented rapid changes, and this has transformed the operational procedures for both students and lecturers. As the pandemic has progressed, its emotional and psychological toll is equally bearing on students, leading to lockdown fatigue. This study aimed to investigate the level of lockdown-induced fatigue and its correlation with personal resilience and coping skills among university students in Iraq. This study used quantitative methods of research using a cross-sectional study design. A questionnaire survey was distributed electronically among 819 university students in Iraq. The study used three standardised scales: the lockdown fatigue scale, brief resilience scale, and coping behaviours questionnaire for data collection. Descriptive and inferential statistical analysis were done using SPSS. Overall, students indicated a high level of lockdown fatigue with a mean score of 33.48out of 50. Fear of personal safety and the wellbeing of the family was the most fear expressed by the students. The ability to go through stressful times and unpleasant events was the most common worry among the students. Female, urbanised, and science field students were the most students who suffered from lockdown-induced fatigue. However, positive coping behaviours and personal resilience were significantly correlated with decreasing fatigue levels during the lockdown period. Level of lockdown fatigue accelerated in an alarming stage among university students in Iraq. Hence, students need to build their emotional resilience and learn how to navigate surviving hard times and bounce back after a loss. This could be facilitated by counselling services being availed to educational and social institutions to benefit university students.

Antibiotic use and resistance in a tertiary care hospital: knowledge and attitude among patients of orthopaedic and surgical wards in Malaysia

Objectives

The prevalence of antimicrobial resistance (AMR) is rising globally as well as in Malaysia. AMR can lead to difficulty in the treatment of chronic infection if being neglected. This study aimed to assess the level of knowledge and attitude about antibiotic usage and AMR.

Methods

A cross-sectional study design was carried out at the Hospital Kuala Lumpur (HKL), Malaysia, where participants were recruited by using the non-probability convenience sampling from the six orthopaedic and four surgical wards. A self-administered questionnaire was used to collect the required data which were then analysed by using SPSS.

Key findings

A total number of 390 adult Malaysians (286 from orthopaedic wards and 104 from surgical wards) were involved in the study. This study showed that the level of knowledge and attitude about antibiotics among the majority of respondents were moderate. However, their knowledge regarding AMR was very low (i.e. lack of knowledge). In contrast, the majority of them (69.8%) showed a positive attitude towards antibiotics. Statistical analysis of data revealed that the level of knowledge of AMR was significantly associated with gender, age, race, marital status, educational level and knowledge about antibiotic resistance terms (P < 0.05) while respondents’ attitude towards antibiotic usage was significantly associated with gender, race, marital status and education level (P < 0.05).

Conclusions

It was necessary to formulate and develop strategies to improve the knowledge and awareness about antibiotics and AMR among health professionals. These might help them to improve their skills in delivering health information to the patients through a proper counselling technique.

Perception and attitude of adults toward cosmetic products amid COVID-19 pandemic in Malaysia

BACKGROUND

The use of cosmetics is growing among both male and female consumers due to the availability of different brands. While there is an increase in the usage of cosmetic products, it is concerning whether the consumers are aware of the safety of the products.

AIMS

This study aimed to widely explore consumers' perceptions and attitudes toward cosmetics within the context of the COVID-19 pandemic.

METHODS

A cross-sectional study was carried out among adults in Selangor, Malaysia. Thirty-three questions divided into three dimensions (socio-demographic parameters, assessment of perception, and assessment of attitude) were developed and validated to be answered by cosmetics consumers. Descriptive and inferential statistical analysis was done using SPSS.

RESULTS

A response rate of 87% was achieved, and the mean age of participants was 33 ± 7.2. The overall perception of consumers indicates low levels of perception and moderate level of attitude toward cosmetic products. There was a positive correlation and high relationship between participants' perception and attitude (p = 0.001, r = 0.72). A significant association was observed between demographic data of respondents and their attitude and perception toward cosmetic products. Participants were unaware that sharing of cosmetic products could lead to bacterial infection and possibly increased the chance of contracting COVID-19.

CONCLUSION

This study displayed a nonchalant perception and attitude of Malaysian adults toward cosmetic products by focusing on aesthetics rather than health safety. Therefore, it is recommended to raise awareness on the composition and effects of cosmetic products, increase the practice of hygiene and dissuade the sharing of cosmetics to reduce transmissions of COVID-19.

Health-related quality of life and its predictors among adults living with HIV/AIDS and receiving antiretroviral therapy in Pakistan

BACKGROUND

Health-related quality of life (HRQoL) is considered to be the fourth 90 of UNAIDS 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART). ART has significantly increased the life expectancy of people living with HIV/AIDS (PLWHA). However, the impact of chronic infection on HRQoL remains unclear, while factors influencing the HRQoL may vary from one country to another. The current study aimed to assess HRQoL and its associated factors among PLWHA receiving ART in Pakistan.

METHODS

A cross-sectional descriptive study was conducted among PLWHA attending an ART centre of a tertiary care hospital in Islamabad, Pakistan. HRQoL was assessed using a validated Urdu version of EuroQol 5 dimensions 3 level (EQ-5D-3L) and its Visual Analogue Scale (EQ-VAS).

RESULTS

Of the 602 patients included in the analyses, 59.5% (n = 358) reported no impairment in self-care, while 63.1% (n = 380) were extremely anxious/depressed. The overall mean EQ-5D utility score and visual analogue scale (EQ-VAS) score were 0.388 (SD: 0.41) and 66.20 (SD: 17.22), respectively. Multivariate linear regression analysis revealed that the factors significantly associated with HRQoL were: female gender; age  > 50 years; having primary and secondary education;  > 1 year since HIV diagnosis; HIV serostatus AIDS-converted; higher CD 4 T lymphocytes count; detectable viral load; and increased time to ART.

CONCLUSIONS

The current findings have shown that PLWHA in Pakistan adherent to ART had a good overall HRQoL, though with significantly higher depression. Some of the factors identified are amenable to institution-based interventions while mitigating depression to enhance the HRQoL of PLWHA in Pakistan. The HRQoL determined in this study could be useful for future economic evaluation studies for ART and in designing future interventions.

Translation and cross-cultural adaptation of WHOQOL-HIV Bref among people living with HIV/AIDS in Pakistan

BACKGROUND

Reliable Health-Related Quality of Life (HRQoL) assessment will be useful in identifying health issues and in identifying health care actions. Due to the lack of a psychometrically valid tool in Urdu, we aim to translate and examine the psychometric and cross-cultural adaptation of WHOQOL HIV Bref among people living with HIV/AIDS (PLWHA) in Pakistan.

METHODS

The standard forward-backwards translation technique was used to convert English version of the WHOQOL HIV Bref into Urdu. After cognitive debriefing, final Urdu version of instrument was developed. Based on the principle of at least 5 subjects for each item, a sample of 182 patients was used using a universal random sampling technique from the Pakistan Institute of Medical Sciences, Islamabad. The Cronbach's alpha and intra-class correlation coefficients (ICC) were estimated to assess internal validity and reliability of the translated version. Exploratory factor analysis was carried out to determine the factor structure and independent associations between the instrument domains and CD-4T-cell count were assessed using multivariable linear regression RESULTS: High Cronbach alpha 0.93 was found for all WHOQOL HIV Bref facets. The test-retest reliability demonstrated a statistically significant ICC ranged from 0.88 to 0.98 (p < 0.001). In known group validity, lower CD-4 lymphocytes count was significantly related to poor scores for all six domains (p < 0.001). Similarly, symptomatic subjects had significantly lower scores compared to asymptomatic subjects on the physical, psychological, social relationship and independence domains (p < 0.05). Statistically significant positive correlation of all six domains of instrument with CD4 cells count (p < 0.001), exhibiting patients with higher CD-4 cells will have higher mean scores of all domains. Factor analysis revealed 5 domains, including physical health, psychological health, social relationship, environmental, and spiritual health. Multivariable linear regression analysis reported; only physical, psychological health and environment health domains were found significantly associated with higher CD-4 lymphocytes count (Beta = 0.121, p < 0.001, Beta = 0.103, p = 0.002, and Beta = 0.032, p = 0.032).

CONCLUSION

Findings suggested that the Urdu version of WHOQOL HIV Bref is a psychometrically valid and culturally well-adapted HRQoL measurement tool for PLWHA in Pakistan.

The Types and Pattern of Use of Mobile Health Applications Among the General Population: A Cross-Sectional Study from Selangor, Malaysia

PURPOSE

The aims of this study are to explore the types and patterns of use of health mobile apps among pharmacy clients in Selangor, Malaysia, and to explore the users' experiences and views regarding the benefits of and issues with the use of the health apps.

PATIENTS AND METHODS

A cross-sectional survey was conducted with 278 pharmacy clients who were using health apps on their smartphones. A survey was developed, piloted, and rolled out, comprised of socio-demographic characteristics, information regarding the common types and the pattern of health app use, the benefits of health apps, and issues that users faced while using these apps. Statistical analysis was performed using IBM SPSS version 21.

RESULTS

The mean (±SD) age of health app users was 29.8 (±11.74) years old, and over half of them (51.8%) were male, while less than half were female (48.2%). There were 48 different types of mobile health apps used by the participants in this study. The two most common were multi-purpose general health apps (53.6%) and fitness apps (38.1%). In terms of pattern of use, 33.5% of the participants reported using their health apps daily, 36.7% at least once weekly, and 25.2% monthly. The main benefits reported by the users were tracking of health status (47%), motivation (41%), and knowledge about health and fitness (9%). The main issues reported by the participants included inaccuracy of the app (24%), inconvenience (20.7%), and not being user-friendly (18.5%).

CONCLUSION

The study showed that the participants used many different types of mobile health apps for several purposes, including general health, wellness, fitness, and self-management of diseases. These apps helped the participants to track their health-related activities and motivated them to maintain their wellness and fitness. Further areas of improvement were identified to ensure evidence-based and effective utilization of apps to achieve required health outcomes.

Retrospective assessment of the reporting of adverse drug reactions in a Malaysian clinical training center: A short communication

Objectives:

This study aimed to assess the completeness and quality of adverse drug reaction (ADR) reports that were submitted to the Pharmacovigilance Unit (PVU) in clinical training center (CTC), Faculty of Medicine, UiTM Sungai Buloh Campus.

Materials and Methods:

A retrospective study was conducted using all ADR reports that were submitted to the PVU in CTC from December 31, 2000, to December 31, 2018. The completeness was assessed by reviewing all the required elements to be filled in the ADR reports. The quality was assessed by investigating the required information in the ADR reporting form. Descriptive statistics have been used to present the findings.

Key Findings:

In a total of 31 reports that were submitted to the PVU in CTC, 98.9% of patient's information and 100% of ADR descriptions were completed. Suspected drug information and the reporter's details were completed by 52.2% and 79.6%, respectively. Of 58.0% of the information about seriousness recorded, 38.9% (n = 7) is mild, 44.4% (n = 8) is moderate, and 16.7% (n = 3) is severe. Among all the suspected medicines, drug class of antibiotics (32.4%, n = 12) is the most reported suspected drugs that caused ADR, followed by opioid analgesic (8.1%, n = 3) and nonsteroidal anti-inflammatory drugs (8.1%, n = 3).

Conclusion:

Further efforts and relevant interventions should be considered to increase the reporting frequency and to enhance the completeness and the quality of the ADR reports in the study setting.

The Risk and Impact of COVID-19 Pandemic on Immunosuppressed Patients: Cancer, HIV, and Solid Organ Transplant Recipients

Toward the end of the year 2019, there was the eruption of an acute respiratory syndrome, which is widely referred as coronavirus disease (COVID-19) from Wuhan, Hubei Province. The disease causes a range of respiratory illnesses, which are fatal. The COVID-19 disease has spread globally and has significantly impacted the health delivery systems, travel regulations, and economic activities and has posed and upsurge of responsibilities for the frontline healthcare workers. Due to the nature of the COVID-19 disease, it has typically caused complications which include pneumonia, multiple organ dysfunction together with renal failure, and acute respiratory distress syndrome. As of date, there is no approved vaccine or treatment for COVID-19 though there are ongoing research studies to formulate a treatment. COVID-19 is highly contagious, and the risk of infection is higher for patients with immunesuppressed patients than regular patients. The immunesuppressed conditions include cancer, HIV, and patients with solid organ transplants (SOT). This paper aims to review the risk and impact of COVID-19 on immunesuppressed patients, with a focus on cancer, HIV, and patients with SOT and the essence of special parameters for their care and management. Despite the fatal effects of this global pandemic, the findings of this study indicate the high risk which immunosuppressed patients have to contract the disease; thus, the governments and health delivery systems have to offer them extra support and treatment.

Factors associated with the level of knowledge about hypertension in Malaysia: A short communication

Objective

The aim of this study was to identify factors that have a correlation with hypertensive patients’ knowledge in Malaysia.

Methods

A cross-sectional survey and face-to-face interview methods were applied, and 1000 Malaysian adults were recruited to be involved in this study. The study was carried out in Hospital Kuala Lumpur, and self-administered questionnaire was adopted from previous literature study.

Key findings

Most respondents were female, and the mean age was 48 years old. Analytical test showed that there is an association between gender, age, race, location, education level, and source of information and their knowledge about hypertension. The odds of knowledge were higher among female, urban, higher level of education, young (≤50 years old), and Chinese and Malay respondents and those who got their information from health professionals.

Conclusions

There are several factors have a great impact on hypertension knowledge in Malaysia; hence, understanding them makes it possible for the community to change public policies and educational programmes for the population that need it the most.

Community Pharmacist's Role in Providing Oral Health-care Services: Findings from Malaysia

Introduction

Pharmacists have been well recognized as an active and have a more integrated role in the preventive services within the National Health Services. This study assessed the community pharmacists' attitudes, beliefs, and practices toward oral health in the Malaysian setting.

Materials and Methods

A cross-sectional survey-based study was used to conduct this project. An anonymous self-administered questionnaire was developed and distributed among community pharmacists within Kuala Lumpur and Selangor states areas, Malaysia. The data collection was carried out from the beginning of November to the end of December 2018.

Results

Of the 255 pharmacists, 206 agreed to participate in the study, yielding a response rate of 80.8%. Overall, approximately half of the pharmacists provided two to five oral health consultations per week and two to five over the counter (OTC) oral health products recommendations per week. The main services provided by community pharmacists in were the provision of OTC treatments (93.7%), referral of consumers to dental or medical practitioners when appropriate (82.5%), and identify signs and symptoms of oral health problems in patients (77.2%). In addition, more than 80% of the pharmacists viewed positively and supported integrating oral health promotion and preventive measures into their practices. The most commonly reported barriers to extending the roles of pharmacists in oral health care include lack of knowledge or training in this field, lack of training resources, and lack of oral health educational promotion materials.

Conclusion

The study shows that community pharmacists had been providing a certain level of oral health services and play an important role in oral health. The findings highlighted the need of an interprofessional partnership between the pharmacy professional bodies with Malaysian dental associations to develop, and evaluate evidence-based resources, guidelines, the scope of oral health in pharmacy curricula and services to deliver improved oral health care within Malaysian communities.