Muneer Gohar Babar

Understanding, perceptions and self-use of complementary and alternative medicine (CAM) among Malaysian pharmacy students.

BackgroundIn recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia.MethodsThis cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSS® version 18.ResultsOverall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional.ConclusionsThis study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit.

Patient-reported adverse drug reactions and drug-drug interactions: a cross-sectional study on Malaysian HIV/AIDS patients

Objective: This study aimed to explore the adverse drug reactions (ADRs) reported by patients and to identify drug-drug interactions (DDIs) among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Subjects and Methods: This cross-sectional study was conducted at the Medication Therapy Adherence Clinic, Hospital Sungai Buloh, an HIV/AIDS referral centre. The patients were randomly selected and were encouraged to describe ADRs caused specifically by any of the prescribed antiretroviral drugs (ARDs). Sociodemographic characteristics were recorded from the patients’ medical records. In addition data on antiretroviral treatment (ART), DDIs and other conventional medication were also documented. Results: A total of 325 randomly selected HIV/AIDS patients with a mean age of 22.94 years participated in the study. The most frequently prescribed ARDs were lamivudine (64.6%), zidovudine (40.6%) and efavirenz (42.5%). Commonly reported ADRs were fatigue (54.8%), allergic reactions (41.5%), weight loss (41.5%), dry mouth (35.1%) and memory loss (35.1%). Female (87.8%), non-complementary and alternative medicine (CAM) users (87.3%) and participants below 50 years old (81.1%) were identified as having a higher prevalence of ADRs compared to males (79.6%), CAM users (78.7%) and participants aged 50 years or more (77.5%). Patient age was found to be significantly associated (p = 0.048) with the ADRs. In addition, a total of 44 cases of DDIs belonging to category D were also found in this study. Conclusions: This study enabled us to identify the most common ADRs and DDIs associated with the use of ART. Safe and effective treatment depends on the healthcare providers’ knowledge of the same.

An assessment of dental students' empathy levels in Malaysia

Objectives To examine the validity and reliability of the Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS) in a sample of dental students in Malaysia, with the secondary aim of assessing empathy levels in first to final year dental students in public and private universities in Malaysia. Methods The JSE-HPS was administered to 582 first to fifth (final) year dental students; 441 were enrolled at two public universities and 141 at a private university in Malaysia. Both descriptive and inferential statistics were performed using SPSS® version 18. Results The JSE-HPS demonstrated good internal consistency (Cronbach’s α = 0.70). A three-factor solution emerged and included ‘perspective taking’, ‘compassionate care’ and ‘standing in patient’s shoes’ factors, accounting for 27.7%, 13.9%, and 6.3% of the variance, respectively. The total mean empathy score was 84.11±9.80, where the actual scores ranged from a low of 22.05 to a high of 133.35. Overall, male students (84.97±11.12) were more empathic than female students (83.78±9.24). Fourth-year students were more empathic than students in other undergraduate years, and public university students had significantly higher mean empathy score compared to those enrolled at a private university (84.74 versus 82.13, p=0.001). Conclusions This study confirms the construct validity and internal consistency of the JSE-HPS for measuring empathy in dental students. Empathy scores among students vary depending on type of university and year of study. Future studies, preferably longitudinal in design should explore changes in empathy among dental students during progression through undergraduate courses.

Patients’ involvement in the care process: time to value nontraditional indicators in HIV care

It is widely accepted that modern medicine has never witnessed any other illness like HIV infection and AIDS, perceptions of which are heavily influenced by moral, religious, social and existential values [1]. Despite commendable global success in preventing and treating HIV infection [2], significant challenges are being faced by the developing world in controlling HIV epidemics due to the lack of and suboptimal use of resources, societal issues and the cultural context, where patients’ belief and understanding play an important role [1]. Therefore, retaining HIV-infected individuals in the continuum of care is vital from both clinical and epidemiological points of view, and requires patient engagement in the care process [3]. One possible way to improve patient engagement is to leverage patient-reported outcomes (PROs) to improve overall patient care [4], thus increasing focus on gaining better understanding of the patient experience, not only from the disease and treatment perspectives, but in terms of the care, services and support they receive. Measuring PROs should be an integral part of a broader approach to patient engagement in the care process, whereby patients’ perspectives can supplement traditional measures such as survival outcomes and process of care [5]. Incorporation of PROs in daily practice by health care providers can allow them not only to receive key information, but to gauge patients’ experiences, including barriers affecting shared decision making [6]. As engagement in the care process is generally greatly welcomed by the patient [7], both quantitative and qualitative approaches should be used in the most effective way possible to understand the extent and reasons behind the issues involved. While various tools and measures have been developed for the purpose, their routine utilization at any point of care has remained fairly low [8]. Thus, it is time to take full advantage of PROs, to ensure effective and holistic patient care, while improving patient satisfaction and empowerment, which will benefit ongoing strategies to end the HIV epidemic by 2030 [9].

Use and Perceived Benefits of Mouthwash among Malaysian Adults: An Exploratory Insight

This study aimed to explore the use and perceived benefits of mouthwash among Malaysian adults. Method: This is a cross-sectional study which was conducted in public places around the states of Selangor and Penang, Malaysia. It is a questionnaire-based study which was conducted as face-to-face interview. A convenience sample of 792 mouthwash users was recruited in 2013 in an ethically approved study (International Medical University). The study instrument was formulated on the basis of literature search and subjected to 20 experts for validation purpose. A pilot study was conducted to compute Cronbach Alpha (0.78). Data was entered into PASW version 20. Descriptive and inferential statistics were applied. Results: A response rate of 99% was achieved. More than two third of the respondents are female, suggesting women are more likely to use mouthwash (n ¼486; 61.8 %). The major reason to use mouthwash were to mask halitosis (n¼287; 36.5%) and to prevent oral diseases (n¼243; 30.9%). Majority knew that fluoride helps in reducing plaque (n¼599; 76.1%) and tooth decay (n¼631; 80.2%). Respondents were not clear that only tooth brushing alone is insufficient to prevent gum disease (n¼553; 70.3%). More than two thirds perceived that mouthwash is useful in reducing plaque (n¼567; 72.0%) as well as periodontal disease (n¼580; 73.7%). Respondents perceived that mouthwash is more effective in eliminating halitosis (n¼714; 90.7%) and preventing caries (n¼630; 80.1%). The frequency of mouthwash use was statistically significant with age, gender, race and monthly income (p¼0.018. 0.091, 0.010, 0.030) . Conclusion: This study indicates that Malaysian adults have good knowledge on the use and perceived benefits of mouthwash. A nationwide study is advocated to gather more information from general population, targeting the use of mouthwash in a large scale to minimize oral health problems.