A cross sectional assessment of health related quality of life among patients with Hepatitis-B in Pakistan

OBJECTIVE: The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan. METHODS: A cross sectional study by adopting European Quality of Life scale (EQ-5D) for the assessment of HRQoL was conducted. All registered HB patients attending two public hospitals in Quetta, Pakistan were approached for study. Descriptive statistics were used to describe demographic and disease related characteristics of the patients. HRQoL was scored using values adapted from the United Kingdom general population survey. EQ-5D scale scores were compared with Mann–Whitney and Kruskal-Wallis test. Standard multiple regression analysis was performed to identify predictors of HRQoL. All analyses were performed using SPSS v 16.0. RESULTS: Three hundred and ninety HB patients were enrolled in the study. Majority of the participants (n = 126, 32.3%) were categorized in the age group of 18-27 years (36.07 ± 9.23). HRQoL was measured as poor in the current study patients (0.3498 ± 0.31785). The multivariate analysis revealed a significant model (F(10, 380) = 40.04, P < 0.001, adjusted r(2) = 0.401). Educational level (β = 0.399, p = 0.025) emerged as a positive predictor of HRQoL. Age, gender, occupation, income and locality were not predictive of better quality of life in HB patients. CONCLUSIONS: Hepatitis B has an adverse affect on patients’ well-being and over all HRQoL. The study findings implicate the need of health promotion among HB patients. Improving the educational status and imparting disease related information for the local population can results in better control and management of HB

Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study

Background Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life. Objective To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life. Setting Four primary care general practices in North West England Methods Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically. Results Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines. Conclusion There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life

Prescribing patterns for upper respiratory tract infections : a prescription-review of primary care practice in Kedah, Malaysia and the implications

Introduction and aims: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among ten public primary healthcare centres in Kedah, Malaysia from 1st January to 31st March 2014. Results: A total of 123,524 prescriptions were screened and analysed. Of these, 7129 prescriptions were for URTI, with 31.8% (n=2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic constituting 61% (n=1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p=0•001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ=0•122).. Conclusions: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programmes and further educational initiatives are ongoing in Malaysia to improve antibiotic us

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan

Background In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. Methods A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Conclusion Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan

Current Clinical Practices in Pakistan and Hospital Pharmacist’s Perception towards Their Role: A Qualitative Approach

The professional role of the pharmacist in hospital setting is changing from a focus on preparation of medication to patient oriented approach and now pharmacist assists the patient to get best possible results from medication. The aim of this study was to evaluate the perception of hospital pharmacists towards their role in the healthcare system of Pakistan. A qualitative study design was adopted. Face to face interviews were conducted using a semi structure interview guide. A total of nineteen interviews were conducted and become the part of the study. All the interviews were transcribed verbatim and thematically analyzed for its content. Thematic content analysis yielded five major themes: 1) perception regarding pharmacist-patient interaction, 2) perception towards reducing prescription errors, 3) perception towards pharmacy curriculum, 4) perception towards pharmacist engagement in hospital policies, and 5) perception regarding clinical role of pharmacists.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Knowledge, Perception and Attitude of Community Pharmacists towards Generic Medicines in Karachi, Pakistan: A Qualitative Insight

Purpose: In an era of escalating healthcare costs and ageing population, there is a need for costeffective measures. This study was aimed to investigate the knowledge, perception and attitude of community pharmacists towards generic medicines. Methods: A  qualitative methodology was adopted. Snowball sampling technique was used to identify eight community pharmacists. Semi-structured interviews were conducted with the pharmacists until the point of saturation was obtained. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and further verified by other authors’ analyses. Results: Thematic content analysis identified three major themes: knowledge of generic medicines,perception towards generic medicines, and attitude towards generic medicines. All the pharmacist  showed good understanding and positive perception towards generic medicines. Mixed responses were observed regarding dispensing of locally manufactured medicines. Low cost was cited as the major determinant in dispensing locally manufactured generics. Conclusion: The current study showed good knowledge and perception towards generic medicines among community pharmacists in Karachi, Pakistan. It also highlighted mixed attitudes towards generic medicine dispensing. A 24-hour mandatory presence of professionally qualified pharmacists in community pharmacies can boost the confidence of doctors in pharmacists and enhance generic substitution.Keywords:   Community pharmacist, Generic Medicine, Pakistan, Qualitative methodolog

Evaluation of the Perception of Community Pharmacists Regarding their Role in Pakistan's Healthcare System: A Qualitative Approach

Purpose: To explore the perception of community pharmacists regarding their role in Pakistan's healthcare system.Methods: A qualitative study design was adopted. A semi-structured interview guide was developed and face to face interviews were conducted. The participants were community pharmacists and were recruited through one of the researcher’s personal contacts in two cities of Pakistan (Islamabad and Lahore) from April to June 2008. The interviews were conducted at the pharmacists’ work-place. Arrangements for the time and place of interview were made during initial contacts. Written consent was obtained from the participants prior to the interview.Results: Among the respondents interviewed, seven were male and three female community pharmacists aged between 25 and 50 years. All the participants regularly dispensed &gt; 50 prescriptions daily. Thematic content analysis yielded 5 major themes: (a) provision of pharmacy services to consumers, (b) counseling at pharmacy, (c) application of Good Pharmacy Practice (GPP), (d) Pakistan Pharmacy Association (PPA) contribution towards pharmacy profession, and (e) strategies to improve community pharmacies.Conclusion: Community pharmacies in Pakistan currently face shortage of pharmacists. This has resulted in non-provision of patient counseling; rather services are more focused more on the management of pharmacies than clients. As a result, there is little public awareness of the pharmacist’s role in health care.Keywords: Perception, Community pharmacist, Patient care, Pakistan, Qualitative methodology

Pharmacists’ Perception of the Sale of Non-Clinically Proven Health Supplements in Penang, Malaysia

Purpose: To explore community pharmacists’ perception of the sale of non-clinically proven health supplements and over-the-counter (OTC) products available in Penang, Malaysia.Methods: A cross-sectional survey using a self-completed postal questionnaire was conducted in July 2010 among 200 community pharmacists practicing in Penang Island.Results: Fifty six pharmacists participated in the study (response rate, 28.0 %). A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists believed that non-clinically proven OTC products are effective, while 35.7 % thought that it is not ethical to sell these products. A majority of the respondents (94.7 %) agreed that manufacturers’ advertisement have a huge effect on positive consumers’ behaviour towards such products. Most respondents agreed that manufacturers of these products claim that their products are effective (57.1 %) and have fewor no side effects (60.7 %).Conclusions: Pharmacists who participated in the study have mixed  opinions on the efficacy and effectiveness of non-clinically proven products. There is a need for pharmacists to be well educated on the  evidence-based use of these products in order to be able to offerappropriate advice to those who come to them to purchase the items.Keywords: Perception, Health promotion, Urban poor, Health supplements