Muhammad Abdul Hadi

Evaluation of breast cancer awareness among female university students in Malaysia

Breast cancer is the most common cancer and the leading cause of cancer death among women of all ethnic and age groups in Malaysia. Objective The objectives of this study were to evaluate the knowledge of breast cancer risk factors, symptoms and methods of screening among female university students and their perception towards the disease treatment outcomes. Methods A cross-sectional survey was conducted from February to March 2008 at Universiti Sains Malaysia. Two hundred participants from 10 randomly selected faculties were interviewed face to face by a trained pharmacist using a validated questionnaire. In addition to their demographic characteristics, participants were required to answer 22 questions concerning knowledge of breast cancer and five questions related to their perception of breast cancer management and treatment outcomes. Data were analyzed using SPSS version 15. Results The mean age of the respondents was 26.7 (SD=1.9) years. The results showed that the vast majority of the female university students had inadequate knowledge of breast cancer. The mean total knowledge score of the students was 60.7%. Indian students had significantly less knowledge of breast cancer compared to their Chinese and Malay counterparts (p<0.05). However, more than two third of the students were aware of breast self examination (BSE) and clinical breast examination (CBE) recommendations. Furthermore, the students had positive perceptions towards the treatment outcomes of breast cancer. Conclusion This study has highlighted the need of a breast cancer awareness campaign, which should also stress the importance of early detection and reporting of breast cancer.

Pharmacy Students’ Knowledge and Perceptions About Pharmacovigilance in Malaysian Public Universities

Objective. To assess senior pharmacy students’ knowledge of and perceptions about pharmacovigilance and reporting of adverse drug reactions (ADRs) at 5 public universities in Malaysia Methods. A cross-sectional study was conducted between December 1, 2010, and January 31, 2010, using a validated self-administered questionnaire delivered to a sample of 510 final-year (fourth-year) pharmacy students at 5 Malaysian public universities. Results. Four hundred twenty-one (84%) students responded to the survey. About 60% (n = 240) indicated that they had taken courses on the concept of pharmacovigilance during their current pharmacy curriculum. The mean score for knowledge about pharmacovigilance and ADR reporting was 6.9 ± 1.4. There was a significant difference in the mean scores for knowledge about pharmacovigilance across the 5 universities. The majority (82.3%) of respondents felt it was necessary to confirm the causal relationship between the drug and the ADR. About 57.8% (n = 241) of the respondents believed that pharmacy students are competent and capable of reporting ADRs during their clerkships. The majority (87.0%) of respondents perceived that pharmacy students should be taught how to report ADRs. Conclusion. The results of this study demonstrate that the majority of final-year pharmacy students in Malaysian public universities have insufficient knowledge about pharmacovigilance and ADR reporting.

Perspectives of heart failure patients in Malaysia towards medications and disease state management: findings from a qualitative study

AimThis study aimed to explore the experiences of readmitted heart failure (HF) patients towards managing their medical problems and to identify factors influencing their adherence to medications.Subject and methodsA qualitative exploratory study was conducted among HF patients who were admitted to Penang General Hospital, Malaysia. A purposive sample of 15 male and 5 female patients of various ethnic groups were interviewed using a semi-structured interview guide. The interviews were audiotaped and transcribed verbatim for thematic content analysis.ResultsThe interviewed patients were generally disturbed by the deterioration in physiological function due to HF. They were aware of the importance of taking HF medications and control of fluid intake but not sodium intake. However, the participants still needed more clarification on ways to reduce sodium intake and improve adherence to lifelong medications and diet. The respondents identified individualized patient self-care, disease, and medication counseling that empower patients to monitor their own body condition to enhance adherence. Barriers identified were limited communication with health care practitioners, lack of correct information about medications and HF, difficulty in remembering, complexity of regimens, and lack of compelling HF symptoms.ConclusionThe present study has identified empowerment of patients in decision making as the main facilitator to improve adherence. These findings suggest that there is a need for doctors and pharmacists to broaden their involvement in exploring and shaping individual patient’s beliefs regarding HF and its management in order to achieve successful treatment outcomes.

Knowledge and Perception of Breast Cancer among Women of Various Ethnic Groups in the State of Penang: A Cross-Sectional Survey

Objective: The objective of this study was to assess and compare the knowledge and perception of breast cancer among women of various ethnic groups in the state of Penang. Subjects and Methods: A cross-sectional survey was conducted from February 5 to March 15, 2008. 384 participants were conveniently selected and interviewed face to face by a trained researcher (M.A.H.) using a validated questionnaire. Participants were required to answer 22 questions concerning knowledge of breast cancer and 5 questions on the perception of breast cancer management and treatment outcomes. Results: The mean total score of knowledge was 59.1%, with Indian women having significantly less knowledge than the Chinese and Malay women (p < 0.001). Only 117 (32.3%) and 120 (33.0%) women were aware of the recommended breast self-examination (BSE) and clinical breast examination (CBE) guidelines, respectively. Multiple regression analysis showed that ethnicity, age, level of education and employment status were major determinants of breast cancer knowledge. Conclusion: The current study has demonstrated that women in the state of Penang have serious knowledge deficits about breast cancer and poor awareness of BSE and CBE guidelines. This study has highlighted the need of an intensive breast cancer awareness campaign which should also stress the importance of early detection and reporting of breast cancer.

Effectiveness of pharmacist-led medication review in chronic pain management: systematic review and meta-analysis

Objective:To evaluate the effectiveness of pharmacist-led medication review in chronic pain management. Materials and Methods:Six electronic databases (Medline, Embase, PsycInfo, CINHAL, CENTRAL, International Pharmaceutical Abstracts) reference lists of retrieved articles and relevant websites were searched for randomized controlled trials published in the English language involving adults with chronic pain. Studies were included if one of the intervention arms had received pharmacist-led medication review independently or as part of a multidisciplinary intervention. Risk of bias was assessed for all the included studies. Results:The search strategy yielded 583 unique articles including 5 randomized controlled trials. Compared with control, meta-analysis showed that participants in the intervention group had: a 0.8-point reduction in pain intensity on a 0 to 10 numerical rating scale at 3 months [95% confidence interval (CI), −1.28 to −0.36] and a 0.7-point reduction (95% CI, −1.19 to −0.20) at 6 months; a 4.84 point (95% CI, −7.38 to −2.29) and −3.82 point (95% CI, −6.49 to −1.14) improvement in physical functioning on a 0- to 68-point function subscale of Western Ontario and McMaster Universities Osteoarthritis Index at 3 and 6 months, respectively; and a significant improvement in patient satisfaction equivalent to a “small to moderate effect.” Discussion:Pharmacist-led medication review reduces pain intensity and improves physical functioning and patient satisfaction. However, the clinical significance of these findings remain uncertain due to small effect size and nature of reported data within clinical trials that limits recommendation of wider clinical role of pharmacist in chronic pain management.

A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors

Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public–private partnership in healthcare.

Community pharmacists’ knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): a cross-sectional survey in Makkah Province, Saudi Arabia

OBJECTIVES To evaluate knowledge, attitude, and practices of community pharmacists towards dispensing antibiotics without prescription (DAwP) in Makkah Province, Saudi Arabia. METHODS A cross-sectional survey was conducted between January and February 2016 using a structured, validated, and pilot-tested questionnaire. A four-step systematic approach was used to recruit community pharmacists who completed a 28-item questionnaire either in English or Arabic language based on their personal preference. RESULTS Of the 200 community pharmacists approached, 189 completed the questionnaire. More than two-thirds (70.5%) of the pharmacists were not aware that DAwP is illegal practice. Lack of patient willingness to consult a physician for a non-serious infection (69.9%) and an inability to afford a consultation with a physician (65.3%) were the most common reasons cited for DAwP. A statistically significant association was found between the number of antibiotics dispensed and educating patients about the importance of adherence and completion of the full course of antibiotics (p=0.007). CONCLUSIONS In general, community pharmacists have a poor understanding of the regulations prohibiting the over-the-counter sale of antibiotics in Saudi Arabia, explaining the high rate of DAwP in the country. A multifaceted approach consisting of educational interventions and improving the access to and affordability of healthcare facilities for the general public is required to effectively reduce DAwP and its negative consequences on public health.

Facilitators and barriers towards adverse drug reaction reporting: perspective of Malaysian hospital pharmacists

To evaluate knowledge, facilitators and barriers towards adverse drug reaction (ADR) reporting among hospital pharmacists in Malaysia.

Mixed-methods research in pharmacy practice: basics and beyond (part 1).

This is the first of two papers which explore the use of mixed‐methods research in pharmacy practice. In an era of evidence‐based medicine and policy, high‐quality research evidence is essential for the development of effective pharmacist‐led services. Over the past decade, the use of mixed‐methods research has become increasingly common in healthcare, although to date its use has been relatively limited in pharmacy practice research. In this article, the basic concepts of mixed‐methods research including its definition, typologies and advantages in relation to pharmacy practice research are discussed. Mixed‐methods research brings together qualitative and quantitative methodologies within a single study to answer or understand a research problem. There are a number of mixed‐methods designs available, but the selection of an appropriate design must always be dictated by the research question. Importantly, mixed‐methods research should not be seen as a ‘tool’ to collect qualitative and quantitative data, rather there should be some degree of ‘integration’ between the two data sets. If conducted appropriately, mixed‐methods research has the potential to generate quality research evidence by combining strengths and overcoming the respective limitations of qualitative and quantitative methodologies.

Mixed-methods research in pharmacy practice: recommendations for quality reporting (part 2)

This is the second of two papers that explore the use of mixed‐methods research in pharmacy practice. This paper discusses the rationale, applications, limitations and challenges of conducting mixed‐methods research. As with other research methods, the choice of mixed‐methods should always be justified because not all research questions require a mixed‐methods approach. Mixed‐methods research is particularly suitable when one dataset may be inadequate in answering the research question, an explanation of initial results is required, generalizability of qualitative findings is desired or broader and deeper understanding of a research problem is necessary. Mixed‐methods research has its own challenges and limitations, which should be considered carefully while designing the study. There is a need to improve the quality of reporting of mixed‐methods research. A framework for reporting mixed‐methods research is proposed, for researchers and reviewers, with the intention of improving its quality. Pharmacy practice research can benefit from research that uses both ‘numbers’ (quantitative) and ‘words’ (qualitative) to develop a strong evidence base to support pharmacy‐led services.