Ammar Ihsan Jawad Awadh

Adverse drug reactions reporting : Knowledge and opinion of general public in Penang, Malaysia

Objective: The objective of this study was to explore the knowledge of the general population towards ADR and their reporting system. Methods: An anonymous, self-administered questionnaire (15 items) was designed. The questionnaire was subjected to face validity and content validity. The reliability coefficient was found to be 0.71. This study recruited proportionately large convenience sample of the general public in Penang. Interviews using a structured questionnaire were conducted over a week period in August 2009. The recommended sample size was calculated to be 368. Results: Three hundred thirty-four responses were received. Slightly more than half of the respondents were in the age group of 18-25 years (53.6%; n = 179). When asked about the sources of their medication majority of them reported medical doctor (85.6%), whereas small number (34.7%) reported community pharmacists as sources of medications. Three-quarter of the respondents (77.2%) get their information about the side-effects of drugs from physicians, followed by pharmacist (44.6%). More than half of the respondents (65.6%, n = 219) reported unawareness about the existence of ADR center set up by the Ministry of Health. Conclusion: Respondents reflected inadequate knowledge on ADR reporting. This needs to be corrected as the trend of future pharmacovigilance is toward the patient. Moreover, the new trend seems to be more appropriate as the patient is the group of the people who are directly affected from the ADR of a particular drug and not the health-care providers. Furthermore, the patient will be informed about the economic implications of not reporting ADR. It is recommended that government agencies, like MADRAC needs to find ways to increase patient- reported ADR cases.

The investigation of the skin biophysical measurements focusing on daily activities, skin care habits, and gender differences

Skin, as a protective barrier to exogenous substances, can be modulated by various internal and external factors that can affect its functional state. In order to prevent the early symptoms and signs of diseases of the skin, frequent skin health assessment should be performed. The aims of the study were to evaluate four skin properties of transepidermal water loss (TEWL), hydration, elasticity, and pigmentation using a non‐invasive skin assessment tool, DermaLab Combo®, and also to determine possible factors that may influence skin condition.

Immunization knowledge and practice among Malaysian parents: a questionnaire development and pilot-testing

BackgroundParents are the main decision makers for their children vaccinations. This fact makes parents’ immunization knowledge and practices as predictor factors for immunization uptake and timeliness. The aim of this pilot study was to develop a reliable and valid instrument in Malaysian language to measure immunization knowledge and practice (KP) of Malaysian parents.MethodsA cross-sectional prospective pilot survey was conducted among 88 Malaysian parents who attended public health facilities that provide vaccinations. Translated immunization KP questionnaires (Bahasa Melayu version) were used. Descriptive statistics were applied, face and content validity were assessed, and internal consistency, test-retest reliability, and construct validity were determined.ResultsThe mean ± standard deviation (SD) of the knowledge scores was 7.36 ± 2.29 and for practice scores was 7.13 ± 2.20. Good internal consistency was found for knowledge and practice items (Cronbach’s alpha = 0.757 and 0.743 respectively); the test-retest reliability value was 0.740 (p = 0.014). A panel of three specialist pharmacists who are experts in this field judged the face and content validity of the final questionnaire. Parents with up-to-date immunized children had significantly better knowledge and practice scores than parents who did not (p < 0.001 and p = 0.001 respectively), suggesting a good construct validity. A significant difference was found in knowledge and practice scores among parents’ age (p = 0.006 and p = 0.029 respectively) and place of living (p = 0.037 and p = 0.043). The parents’ knowledge level was positively associated with their practice toward immunization (Spearman’s rank correlation coefficient 0.310, p = 0.003).ConclusionsThe pilot study concluded that the Bahasa Melayu version of the immunization KP questionnaire has good reliability and validity for measuring the knowledge and practices of Malaysian parents and therefore this version can be used in future research.

Does an educational intervention improve parents’ knowledge about immunization? Experience from Malaysia

BackgroundParents’ knowledge about immunization is an important predictor factor for their children’s immunization status. The aims of this study were to assess parents’ knowledge and to evaluate the effect of a short educational intervention on improving parents’ knowledge of childhood immunization.MethodsA cross-sectional study using a pre- and post-test intervention survey of a single group was conducted among Malaysian parents. Changes in total knowledge score before and after the intervention were measured using a validated questionnaire. The intervention consisted of an animated movie and lecture using simple understandable language. Wilcoxon signed ranks test and the McNemar x2 test were applied to compare the differences in knowledge before and after the intervention.ResultsSeventy-three parents were enrolled in this study; the majority were mothers (n = 64, 87.7%). Parents’ knowledge about childhood immunization increased significantly after the intervention compared to the baseline results (p < 0.001). There were significant differences between parents’ knowledge and their educational level and monthly income (p < 0.001 and p = 0.005), respectively.ConclusionsA short educational intervention designed for parents had a positive effect on their knowledge about immunization. Educational interventions targeting parents with low levels of education and income are needed. Further studies investigating the actual effectiveness of such interventions on immunization rates and statuses are required.

Incorporating an Immunization Course in the Pharmacy Curriculum: Malaysian Experience

To the Editor. The immunization system is a successful systematic program, especially during the last century. However, the immunization system is still imperfect because many countries still have unvaccinated children. The most common reasons for parents not having their child vaccinated are concern about immunization adverse effects, disbelief that the vaccine works, lack of awareness that the immunization is necessary, and lack of healthcare provider recommendation for the immunization.1 Health-care providers play an important role in child immunization because they have positive effects on parental decisions related to immunization.2 As a health care provider, pharmacists have played a role in promoting, maintaining, and improving immunization rates among children because the pharmacist is one of the most accessible healthcare professionals. A pharmacist can be trained to screen children for immunizations and counsel parents on immunization decisions, including providing information on immunizations risks and immunization benefits. In addition, pharmacists are highly regarded by the parents and by most immunization providers as drug information specialists, and often sought by people for medical advice.1,3 In the United States, 49 states have granted authority to pharmacists to immunize people, and pharmacists can play an important role in disease prevention by advocating and administering immunizations.4-6 While pharmacists in Malaysia are not authorized to immunize people, they can promote immunization through several types of activities: history and screening, patient counseling, documentation, administrative measures, and public education and reminders. In Malaysia, there are about 17 pharmacy colleges and schools (public and private) and 10 schools are fully accredited.7 Most of the schools or colleges do not have enough education courses regarding immunization. These deficiencies in immunization education and training in colleges and schools of pharmacy may contribute to low immunization rates in the Malaysia. An immunization course was introduced in Kulliyyah of Pharmacy- International Islamic University Malaysia during the current academic year (2012-2013). The course was offered as a part of the Pharmacotherapeutics I module during the first semester for fourth-year students enrolled in the bachelor of pharmacy degree program. The immunization course consists of 3 hours presented in 3 lectures. The first lecture consists of: immunization and vaccine types in children and adults; schedule and timing; adverse reactions; and contraindications. The topics for the second lecture hour consist of: epidemiology and disease prevention, pharmacist’s role, documentation, record keeping, planning, storage, parents’ education, and reminder. Immunization errors types, pharmacovigilance, and recommendations are presented in the last lecture. At the end of the immunization course, questionnaires will be administered to students to assess their perceptions of the course. As academic pharmacists, we believe that it is time for Malaysian pharmacy schools to help reach the national goals for immunization compliance through educating future generations of pharmacists. Schools of pharmacy have the responsibility to improve immunization education and to develop the practice skills of undergraduate pharmacy students. It can be done by introducing immunization into the undergraduate pharmacy curriculum. Although the initiation of the new course in pharmacy school requires additional resources and takes time to develop and update the curriculum, we strongly advise others Malaysian schools of pharmacy to mandate immunization education course and training as part of their core curriculum. The authors thank Assoc. Prof. Dr. Mohamad Haniki Nik Mohamed (Academic Deputy Dean) and Assistant Professor Dr.Siti Hadijah Shamsudin (Head of Department of Pharmacy Practice) for their support in establishing and approving this immunization course in Kulliyyah of Pharmacy- International Islamic University Malaysia.

Pharmacy Education in Iraq

To the Editor. We appreciated the letter entitled “Pharmacy Education and Practice in 13 Middle Eastern Countries.”1 The letter provided some information regarding pharmacy education in Iraq. Information was obtained by reviewing the available published literature and individual university Web sites, as well as contacting program or country representatives. In 2008, Iraq had 7 public schools of pharmacy, but no private schools of pharmacy. The bachelors degree remains the first professional degree required to enter pharmacy practice. All schools offer bachelors degree programs and some offer the master’s degree, but no colleges or schools in Iraq offer the PhD degree in pharmaceutical science. Pharmacy schools in Iraq have both male and female students, but there are more female than male students enrolled.1 In this letter, we would like to correct, clarify, and update some important information related to pharmacy education in Iraq. Iraq has 13 public colleges of pharmacy, 9 of which were established in different Iraqi universities before 2008, as follows: Baghdad University in 19362; Mosul University in 19643; Basrah University in 19994; Kufa University in 19995; Mustansiriyah Universityin 20006; Tikrit University in 20027; Sulaimani University in 20048; Kerbala University in 20069; Hawler Medical University in 200610; Duhok University in 200911; Babylon University in 201012; Anbar University in 201113; and Thiqar University in 2012.14 In addition, Iraq has 4 private colleges of pharmacy. Two private colleges were established before 2008 and 2 otherd were established after 2008, as follows: Baghdad Pharmacy College established in 2000 by the Iraqi pharmacists union,15 Al-Yarmouk University College in 2006,16 Al-Rasheed University College in 2010,17 and Al-Rafedin University College in 2011.18 All colleges of pharmacy offered bachelors degree programs, while 3 public colleges of pharmacy offered MSc degree program. In addition, the PhD program was offered in 1 public college of pharmacy. In 1972, Baghdad University offered MSc degree program in 4 areas of pharmaceutical sciences, while the PhD program was offered in 1975 in pharmaceutical chemistry.2 Mosul University and Mustansiriyah University offered MSc program in 1993 and 2011, respectively.3,6 From 1936 to 1994, there was a higher proportion of female students than male students, while from 1994 to 2004, there was a higher proportion of male students than female students due to some regulations related to competition between male and female students. Ministry of Higher Education and Scientific Research in Iraq canceled these competition rules in 2004. Now, the percentage of female students in Iraqi colleges of pharmacy is higher than the percentage of male students.19

The use of sunscreen products among final year medicine and pharmacy students: A cross-sectional study of knowledge, attitude, practice, and perception

Objective: To evaluate the knowledge, attitude, perception, and practice of medical and pharmacy students toward the usage of sunscreen as protection for the skin against ultraviolet (UV) radiation. Methods: This cross-sectional study was conducted among final year medical and pharmacy undergraduates at the International Islamic University Malaysia. Validated questionnaires were distributed to 134 medical students and 100 pharmacy students. Descriptive and inferential statistics were used where appropriate. Findings: One hundred and sixty-one out of 234 participants completed the questionnaires. The participants comprised 101 medical students (75.4%) and sixty pharmacy students (60.0%). The majority of the respondents were females (102; 63.4%), and 59 (36.6%) were males. The median of the knowledge scores of the final year medical students was significantly lower than that of the final year pharmacy students (P < 0.001). The female students showed significantly higher knowledge scores than the male students (P = 0.027). This study reported that 24 (39.3%) pharmacy students were influenced by the media to use sunscreen, whereas 35 (34.7%) medical students were influenced the most by friends to use sunscreen. The final year pharmacy students had a better perception compared to the medical students, with the total perception score of the final year pharmacy students being significantly higher than that of the final year medical students (P = 0.020). Most of the participants were also aware of the harmful effects of UV radiation and had a positive reaction toward the usage of sunscreen to prevent those harmful effects. Conclusion: The knowledge and perception of final year pharmacy students were significantly higher than the knowledge and perception of final year medical students with regard to the usage of sunscreen.

Knowledge and Perception of Medical and Pharmacy Students Toward The Usage of Sunblock

Objectives: To evaluate the knowledge and perception of medical and phar- macy students toward the usage of sunblock as skin protection against ultraviolet (UV). MethOds: This cross-sectional study was conducted among the undergradu- ate final year medical and pharmacy students at the International Islamic University Malaysia (IIUM). Validated questionnaire were used to collect the data. The question- naires were distributed to 134 students from medicine and 100 pharmacy students. Descriptive and inferential statistics are used whenever appropriate. Results: Overall, 161 participants out of a total of 234 completed the questionnaire with 101 medical students (75.4%) and 60 pharmacy students (60.0%). Majority of the respondents were female 64 (63.4%) and 37 (36.6%) were male. The median of knowl- edge scores of the final year medical students was significantly lower than the final year pharmacy students (p<0.01). There is no significant differnce between the knowledge of the female and male students (Mann Whitney U Test value = 0.27, p<0.01). This study reported that 24 (39.3 %) of pharmacy students were influ- enced by the media to use sunblock whereas 35 (34.7%) of medical students had the highest influence from friends to use sunblock. However, this study showed there was no significant difference in the perception of pharmacy and medical studnets p=0.020. cOnclusiOns: In conclusion, the knowledge of pharmacy students is significantly higher than the knowledge of medical students had on the usage of sunblock. Both medical and pharmacy students have the same level of perception towards the usage of sunblock.