Shazia Qasim Jamshed

Qualitative research method-interviewing and observation

Address for correspondence: Dr. Shazia Jamshed, Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia. E‐mail: pharmacist1992@live.com Buckley and Chiang define research methodology as “a strategy or architectural design by which the researcher maps out an approach to problem‐finding or problem‐solving.”[1] According to Crotty, research methodology is a comprehensive strategy ‘that silhouettes our choice and use of specific methods relating them to the anticipated outcomes,[2] but the choice of research methodology is based upon the type and features of the research problem.[3] According to Johnson et al. mixed method research is “a class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, theories and or language into a single study.[4] In order to have diverse opinions and views, qualitative findings need to be supplemented with quantitative results.[5] Therefore, these research methodologies are considered to be complementary to each other rather than incompatible to each other.[6]

Understanding of antibiotic use and resistance among final-year pharmacy and medical students: a pilot study.

INTRODUCTION This study is aimed to investigate the understanding of antibiotic use and antibiotic resistance and its correlate factors among final-year medical and pharmacy students at International Islamic University Malaysia (IIUM). METHODOLOGY This was a cross-sectional study. The study instrument was developed by extensive literature search and was subjected to face validity and content validity to medical and pharmacy academics. A pilot study was conducted to ascertain the reliability coefficient. Data was entered to SPSS version 17 and descriptive and inferential statistics were applied. RESULTS A total of 123 questionnaires were included in the study. Out of 123 respondents, 58.5% (n = 72) were final-year medical students, while 41.5% (n = 51) were final-year pharmacy students. The majority of the respondents showed adequate knowledge regarding the course contents related to antibiotics (n = 116; 94.3%). Almost all the respondents correctly reported the difference between bactericidal and bacteriostatic antibiotics. Only 15.4% (n = 19) and 27.6% (n = 34) of students were able to recognize Streptococcus pyogenes as non-pencillin resistant bacterium and Enterococcus as vancomycin-resistant bacterium, respectively. CONCLUSIONS The students showed good understanding regarding antibiotic resistance. In comparison to medical students, pharmacy students showed better understanding and more adequate knowledge, as the mean value for each domain was slightly higher for pharmacy students. Extensively improving the curriculum and educating healthcare professionals, especially physicians and pharmacists, right from the time of their educational training can inculcate a moral responsibility toward the judicious use of antibiotics, which can serve to eradicate antibiotic resistance.

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.

Community pharmacists' attitudes, perceptions, and barriers toward adverse drug reaction reporting in Malaysia: a quantitative insight.

Objectives This study was designed to explore awareness and attitudes of community pharmacists toward the national ADR reporting system activities in the northern states of Malaysia. Methods A cross-sectional survey using a validated self-administered questionnaire was used in this study. The questionnaire was delivered to all community pharmacists (N = 470) practicing in the four northern states of Malaysia (Perlis, Kedah, Pulau Pinang and Perak) during the study period. Results A total of 470 survey forms were sent with one wave of reminders. Only 116 pharmacists responded to the survey (response rate of 25.2%). The total number of usable responses was 104 (24.7%). The survey findings revealed that nearly three-quarters of pharmacists (n = 75; 72.1%) were not aware of the pharmacovigilance activities run by the drug regulatory authority in Malaysia. Although more than half (n = 65, 61.5%) of the surveyed pharmacists emphasized the importance of ADR reporting, only 13 pharmacists (12.9%) claimed that they submitted ADR reports to the Malaysia Adverse Drug Reaction Advisory Committee (MADRAC) before this survey. Barriers which prevent community pharmacists from ADR reporting were identified. These included lack of knowledge on how to report (n = 36; 34.7%), the unavailability of reporting forms (n = 44; 42.6%), and ignorance of where the report should be sent to (n = 46; 44.6%). Conclusions Despite the unfamiliarity and the common misconceptions, the study results show that community pharmacists in the northern states of Malaysia have a very positive attitude toward the ADR reporting system in the country. However, the study findings highlight the urgent need for special education programs to establish continuous efforts to promote ADR reporting among community pharmacists. Further studies at the national level aimed at identifying and removing barriers that prevent community pharmacists from performing ADR reporting are required.

Comparison of the knowledge, attitudes, and perception of barriers regarding adverse drug reaction reporting between pharmacy and medical students in Pakistan

Purpose: The goal of this study was to compare the knowledge and attitudes of pharmacy and medical students regarding adverse drug reactions (ADRs), as well as their perceptions of barriers to ADR reporting, in a Higher Education Commission-recognised Pakistani university. Methods: A cross-sectional study was conducted among final-year pharmacy (n=91) and medical (n=108) students in Pakistan from June 1 to July 31, 2014. A self-administered questionnaire was used to collect the data. The responses of pharmacy students were compared to those of medical students. Results: Pharmacy students had a significantly better knowledge of ADRs than medical students (mean±SD, 5.61±1.78 vs. 3.23±1.60; P<0.001). Gender showed a significant relationship to knowledge about ADRs, and male participants were apparently more knowledgeable than their female counterparts (P<0.001). The attitudes of pharmacy students regarding their capability to handle and report ADRs were significantly more positive than those of medical students (P<0.05). In comparison to pharmacy students, a lack of knowledge of where and how to report ADRs was the main barrier that medical students perceived to ADR reporting (P=0.001). Conclusion: Final-year pharmacy students exhibited more knowledge about ADRs and showed more positive attitudes regarding their capacity to handle and report ADRs than final-year medical students.

Motivations and Obstacles for Adverse Drug Reactions Reporting amongHealthcare Professionals from the Perspective of LewinâÂÂs Force Field AnalysisTheory: Analytic Approach

Spontaneous Adverse Drug Reactions (ADRs) reporting system is considered the back-bone for any pharmacovigilance system. Within this context, active Involvement of healthcare professionals is very crucial to improve the rate and quality of ADRs reporting. Despite the various techniques that have been adopted in order to improve the rate and quality of ADR reporting, there is a decline in the rate of ADRs notification. Under-reporting of ADRs is well-recognized phenomena associated with the almost all of pharmacovigilance systems around the world. Many logistic and personal barriers to ADRs reporting among healthcare professionals including resistance to change have been reported. This commentary focuses on the problem of resistance to change towards ADR reporting and the possibility of applying theory of Force Field Analysis (FFA) to overcome the problem of underreporting among these professionals.

Reflective writing in pharmacy practice

Pharmacists, being health information gurus and one of the largest groups of healthcare providers, seep into the changing dynamics of the healthcare environment where now the patient is both demanding of, and receptive to, information even on minor illnesses. The profession of pharmacy holds the concept of ‘patient centred care,’ thus shifting the image of a pharmacist from a dispenser to a decision-maker and caregiver. This places an additional burden on the pharmacist, and therefore the practice of professional principles should be more dynamic and action-oriented in the best interest of the patient. Future pharmacy practitioners need to gain better understanding of the professional principles and heterogeneous philosophies of pharmacy practice that initiate from dispensing, counselling, congenial interprofessional and intra-professional working, and later culminate in drug and patient safety, pharmacogenomics and pharmacoinformatics. In order to accomplish this, future pharmacy practitioners could be frequently acclimatized to the concept of reflective learning in different pharmacy modules. It is suggested that the concept of reflective learning could be nurtured by observational writing. The requirement of reflection-imbued observational writing generally, exposes the students to activities related to learning and makes them an insider for a transient epoch facilitating in facing the world being observed.

The Teaching of Subjects Related to Pharmacovigilance in MalaysianPharmacy Undergraduate Programs

Objectives: To evaluate the extent to which subjects related to pharmacovigilance are taught in the pharmacy programs within Malaysian universities. Methods: Self-completed questionnaires were sent (via surface mail) to all heads of schools and faculties of pharmacy and medicine that offer pharmacy programs in Malaysia. The questionnaires were intended for department heads or the person responsible for the teaching of the subject in the respective institutions. Results: Thirteen out of fourteen (n=13, 92.8%) medical and pharmacy schools responded to the survey. The vast majority (n=11, N=13, 84.6%) of the pharmacy programs within the studied Malaysian universities feature pharmacovigilance-related topics in their undergraduate syllabi. About two-thirds (n=8, 72.7%) of the pharmacy programs taught issues related to pharmacovigilance within epidemiology and/or pharmacoepidemiology courses. Pharmacovigilance-related topics are core/required in almost all (n=9, 81.8%) of the pharmacy programs. None of the pharmacy programs had a specific stand-alone course on pharmacovigilance. Conclusion: Subjects related to pharmacovigilance were widely taught in the majority of the universities surveyed. As the field of pharmacovigilance is very important for future pharmacy practitioners, this course should be made a core course within the local pharmacy curriculum in order to enhance medication safety for the population. To ensure effective practice in the area of drug safety, there is an urgent and necessary need for Malaysian pharmacy students to be adequately educated and exposed to the contemporary issues and challenges of pharmacovigilance implementation.

Evaluation of the understanding of antibiotic resistance among Malaysian pharmacy students at public universities: An exploratory study

BACKGROUND Infectious diseases are a great threat to humankind, and antibiotics are a viable proposition to numerous pathologies. However, antibiotic resistance is a global concern. Therefore, the aims of this survey were to explore the understanding and attitudes of pharmacy students regarding antibiotic use and resistance. METHODS This is a cross-sectional study conducted on final-year undergraduate pharmacy students from 5 public universities. A validated, self-administered questionnaire written in English was used to collect data. It was made up of six domains and forty-five questions. Raosoft software was used to determine the minimum required sample size. Descriptive and inferential data analyses were carried out using SPSS version 20 software. RESULTS Out of 346 students, only 59.5% showed a strong understanding of antibiotic usage, while 84.4% of students demonstrated a good level of understanding regarding the issue of antibiotic resistance. However, only 34.1% of students demonstrated a positive attitude toward this issue. CONCLUSION This survey reveals that final-year pharmacy students at Malaysian public universities have a relatively good understanding of antibiotic resistance. However, their attitudes did not strongly correlate to their knowledge.

Role of complementary and alternative medicine in geriatric care: A mini review

Since time immemorial homo sapiens are subjected to both health and diseases states and seek treatment for succor and assuagement in compromised health states. Since last two decades the progressive rise in the alternative form of treatment cannot be ignored and population seems to be dissatisfied with the conventional treatment modalities and therefore, resort to other forms of treatment, mainly complementary and alternative medicine (CAM). The use of CAM is predominantly more popular in older adults and therefore, numerous research studies and clinical trials have been carried out to investigate the effectiveness of CAM in the management of both communicable and non-communicable disease. In this current mini review, we attempt to encompass the use of CAM in chronic non-communicable diseases that are most likely seen in geriatrics. The current review focuses not only on the reassurance of good health practices, emphasizing on the holistic development and strengthening the bodys defense mechanisms, but also attempts to construct a pattern of self-care and patient empowerment in geriatrics. The issues of safety with CAM use cannot be sidelined and consultation with a health care professional is always advocated to the patient. Likewise, responsibility of the health care professional is to inform the patient about the safety and efficacy issues. In order to substantiate the efficacy and safety of CAMs, evidence-based studies and practices with consolidated standards should be planned and executed.