MyMedR

Displaying all 11 publications

Abstract:

Sort:

Professional pharmacist organizations--their role in the development of Australian pharmacists within General Practitioner Super Clinics

Poulsen JH, Kaae S, Mak V

Res Social Adm Pharm, 2014 Sep-Oct;10(5):807-8.
PMID: 24986542 DOI: 10.1016/j.sapharm.2014.05.002
Fulltext Awareness, knowledge and views of off-label prescribing in children: a systematic review

Balan S, Hassali MA, Mak VS

Br J Clin Pharmacol, 2015 Dec;80(6):1269-80.
PMID: 26314841 DOI: 10.1111/bcp.12750

AIM: The aim of this review was to provide an updated overview of awareness, knowledge and views of off-label prescribing in children.
METHOD: A literature search using electronic databases including PubMed, Medline, Scopus, Science Direct, Springer Link, Proquest, Ebsco Host and Google Scholar was conducted. Additional articles were identified by reviewing the bibliography of retrieved articles. The articles were searched with any of the following medical subject headings (MeSH) terms in the title: attitude, awareness, knowledge, experience, view, off-label, pediatric, paediatric and children. The inclusion criteria were full text articles published in English between January 2004 and February 2015 and reported outcome related to awareness, knowledge and views regarding off-label prescribing in children. Editorials, reviews, notes, conference proceedings, letters and studies reporting prevalence of off-label prescribing were excluded. The articles were scrutinized using thematic analysis.
RESULTS: Eleven studies conducted among doctors, community pharmacists, paediatric nurses, parents and children met the inclusion criteria. Nine themes were developed through document analysis which included main domains such as knowledge, awareness and views on off-label drug use in children, choice of information sources, reasons and suggestions to reduce off-label prescribing, concern regarding obtaining consent and participation in clinical trials.
CONCLUSION: The studies reviewed reported that the majority of doctors and community pharmacists were familiar with the term off-label prescribing but knowledge among parents was low. Awareness on off-label prescribing in children remains low among all study participants. There is a mismatch between views on off-label prescribing in children of study participants and the finding of previous studies.
Non-regulatory related factors leading to off-label prescribing in children: A concept map

Balan S, Hassali MA, Mak VSL

Res Social Adm Pharm, 2017 Nov;13(6):1219-1221.
PMID: 28576615 DOI: 10.1016/j.sapharm.2017.05.013
Challenges in pediatric drug use: A pharmacist point of view

Balan S, Hassali MA, Mak VSL

Res Social Adm Pharm, 2017 May-Jun;13(3):653-655.
PMID: 27493130 DOI: 10.1016/j.sapharm.2016.06.014

The pediatric population is an enormously diverse segment of population varying both in size and age. The diversity caused pharmacists face various challenges primarily related to procuring, provision as well as use of drugs in this group of patients. Pediatric dose calculation is particularly a concern for pharmacists. Another challenge faced by pharmacists is unavailability of suitable formulations for pediatric use. This has also led many pharmacists to prepare extemporaneous liquid preparations, even though stability data on such preparations are scarce. Some extemporaneous preparations contain excipients which are potentially harmful in children. Besides that, inadequate labeling and drug information for pediatric drug use had not only challenged pharmacists in recommending and optimizing drug use in children, but also inadvertently caused many drugs used outside the approved terms of the product license (off-label use). Pharmacists are striving to stay connected to overcome the common and comparable challenges faced in their day to day duties and strive to maximize the safe and effective use of medicines for children.
Fulltext Cost-effectiveness analysis of strontium ranelate verse alendronate for management of osteoporosis among post-menopausal women in Malaysia using a Markov modelling approach. [Abstract]

Wu DB, Hussain S, Mak V, Lee KK

Value Health, 2014 Nov;17(7):A382.
PMID: 27200852 DOI: 10.1016/j.jval.2014.08.2625

OBJECTIVES. Osteoporotic fractures are common in older adults and are often associated with high morbidity and mortality. As the incidence increases with age, it is natural that osteoporotic fractures have become a major health problem worldwide. Increasing number of patients with osteoporotic fracture will have a serious economic impact on the patient themselves and the society. The objective of this study is to study the cost-effectiveness of strontium ranelate compared to alendronate for patients with post-menopausal osteoporotic fractures in Malaysia.
METHODS. A Markov model was developed to project clinical and economic benefits of strontium in a hypothetical cohort of patients (N=1,000) over a 5-year time horizon. This study was conducted from a payer perspective. Model parameters including transition probabilities and costs of treating fracture at various sites were Malaysia-specific. Drug costs were obtained from a public teaching hospital in Kuala Lumpur. Utilities were derived from previous literatures and efficacy data were derived from two pivotal trials, i. e. SOTI and TROPOS trials. Outcomes were presented as cost per quality-adjusted life year (QALY) gained. A discount rate of 3% was applied. Both 1-way and multivariate probabilistic sensitivity analyses were undertaken to evaluate robustness of results.
RESULTS. Compared to alendronate, strontium could prevent 328 wrist, 192 hip, 7 vertebra and 115 multiple fractures respectively over 5 years, which was translated into 27.9 QALYs gained. Using strontium can lead to cost reduction of MYR1,416,595 (USD442,685), MYR478,257 (USD149,455), MYR22,784 (USD7,120) and MYR61,883 (USD113,088) due to reduced episodes of fractures at wrist/hip/vertebra/multiple sites respectively. The total reduction of direct medical costs of MYR2,279,519 (USD712,349) was larger than the extra drug cost, hence making strontium a cost-saving therapy.
CONCLUSIONS. It was shown that strontium appeared to be more cost-effective compared to alendronate and hence should be recommended in the public sector in Malaysia.
Fulltext Health care consumers' perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

Saw PS, Nissen LM, Freeman C, Wong PS, Mak V

Patient Prefer Adherence, 2015;9:467-77.
PMID: 25834411 DOI: 10.2147/PPA.S73953

BACKGROUND: Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists' involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers' views on the integration of pharmacists within private GP clinics in Malaysia.
METHODS: A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10.
RESULTS: A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists' role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs' resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs' reluctance were perceived as barriers to integration.
CONCLUSION: This study provides insights into consumers' perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed.
KEYWORDS: Malaysia; general practitioners; health care consumer; pharmacist integration; private clinic
Fulltext What's been trending with OSCEs in pharmacy education over the last 20 years? A bibliometric review and content analysis

Lim AS, Ling YL, Wilby KJ, Mak V

Curr Pharm Teach Learn, 2024 Mar;16(3):212-220.
PMID: 38171979 DOI: 10.1016/j.cptl.2023.12.028

BACKGROUND: Objective structured clinical examinations (OSCEs) remain an integral part of pharmacy education. This study aimed to characterize key researchers, areas, and themes in pharmacy education OSCEs using a bibliometric review with content analysis.
METHODS: A bibliometric review was conducted on literature from over 23 years from January 2000 to May 2023. Articles focusing on any type of OSCE research in pharmacy education in both undergraduate and postgraduate sectors were included. Articles were excluded if they were not original articles or not published in English. A summative content analysis was also conducted to identify key topics.
RESULTS: A total of 192 articles were included in the analysis. There were 242 institutions that contributed to the OSCE literature in pharmacy education, with the leading country being Canada. Most OSCE research came from developed countries and were descriptive studies based on single institution data. The top themes emerging from content analysis were student perceptions on OSCE station styles (n = 98), staff perception (n = 19), grade assessment of OSCEs (n = 145), interprofessional education (n = 11), standardized patients (n = 12), and rubric development and standard setting (n = 8).
IMPLICATIONS: There has been a growth in virtual OSCEs, interprofessional OSCEs, and artificial intelligence OSCEs. Communication rubrics and minimizing assessor variability are still trending research areas. There is scope to conduct more research on evaluating specific types of OSCEs, when best to hold an OSCE, and comparing OSCEs to other assessments.
A qualitative study on pharmacists' perception on integrating pharmacists into private general practitioner's clinics in Malaysia

Saw PS, Nissen L, Freeman C, Wong PS, Mak V

Pharm Pract (Granada), 2017 Jul-Sep;15(3):971.
PMID: 28943979 DOI: 10.18549/PharmPract.2017.03.971

BACKGROUND: Private general practitioners in Malaysia largely operates as solo practices - prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists.
OBJECTIVE: To explore pharmacists' views in integrating pharmacists into private GP clinics in Malaysia.
METHODS: A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10.
RESULTS: Four major themes were identified: (1) Limited potential to expand pharmacists' roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs' responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists' in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines.
CONCLUSION: Findings from the study provided a better understanding to help ascertain pharmacists' views on their readiness and acceptance in a potential new model of practice.
Fulltext Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

Wu DB, Roberts C, Lee VW, Hong LW, Tan KK, Mak V, et al.

Hum Vaccin Immunother, 2016;12(2):403-16.
PMID: 26451658 DOI: 10.1080/21645515.2015.1067351

Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10- or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted life year (QALY) was calculated to compare PCV10 or PCV13 against no vaccination and PCV13 against PCV10 over a 10-year birth cohort's vaccination. Both payer and societal perspectives were used. PCV13 had better public health and economic outcomes than a PCV10 program across all scenarios considered. For example, in the base case scenario in Malaysia, PCV13 would reduce more cases of IPD (+2,296), pneumonia (+705,281), and acute otitis media (+376,967) and save more lives (+6,122) than PCV10. Similarly, in Hong Kong, PCV13 would reduce more cases of IPD cases (+529), pneumonia (+172,185), and acute otitis media (+37,727) and save more lives (+2,688) than PCV10. During the same time horizon, PCV13 would gain over 74,000 and 21,600 additional QALYs than PCV10 in Malaysia and Hong Kong, respectively. PCV13 would be cost saving when compared against similar program with PCV10, under both payer and societal perspective in both countries. PCV13 remained a better choice over PCV10 in multiple sensitivity, scenario, and probabilistic analyses. PCV13s broader serotype coverage in its formulation and herd effect compared against PCV10 were important drivers of differences in outcomes.
Association of Deprescribing With Reduction in Mortality and Hospitalization: A Pragmatic Stepped-Wedge Cluster-Randomized Controlled Trial

Kua CH, Yeo CYY, Tan PC, Char CWT, Tan CWY, Mak V, et al.

J Am Med Dir Assoc, 2021 01;22(1):82-89.e3.
PMID: 32423694 DOI: 10.1016/j.jamda.2020.03.012

OBJECTIVES: Deprescribing has gained awareness recently, but the clinical benefits observed from randomized trials are limited. The aim of this study was to examine the effectiveness of a pharmacist-led 5-step team-care deprescribing intervention in nursing homes to reduce falls (fall risks and fall rates). Secondary aims include reducing mortality, number of hospitalized residents, pill burden, medication cost, and assessing the deprescribing acceptance rate.
DESIGN: Pragmatic multicenter stepped-wedge cluster randomized controlled trial.
SETTING AND PARTICIPANTS: Residents across 4 nursing homes in Singapore were included if they were aged 65 years and above, and taking 5 or more medications.
METHODS: The intervention involved a 5-step deprescribing intervention, which involved a multidisciplinary team-care medication review with pharmacists, physicians, and nurses (in which pharmacists discussed with other team members the feasibility of deprescribing and implementation using the Beers and STOPP criteria) or to an active waitlist control for the first 3 months.
RESULTS: Two hundred ninety-five residents from 4 nursing homes participated in the study from February 2017 to March 2018. At 6 months, the deprescribing intervention did not reduce falls. Subgroup analysis showed that intervention reduced fall risk scores within the deprescribing-naïve group by 0.18 (P = .04). Intervention was associated with a reduction in mortality [hazard ratio (HR) 0.16, 95% confidence interval 0.07, 0.41; P
How to make Asthma Right Care 'easy' in primary care: learnings from the 2023 Asthma Right Care Summit

Williams S, Correia de Sousa J, Khoo EM, Ghedira H, Mak V, Martínez Vázquez M, et al.

NPJ Prim Care Respir Med, 2024 Apr 26;34(1):4.
PMID: 38670970 DOI: 10.1038/s41533-024-00366-x

Filters

Please provide feedback to Administrator ([email protected])

External Links