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

Predictors of medication adherence in a hypertensive population of Pakistan

This study is aimed to explore the predictors of medication adherence in a hypertensive population of Pakistan. A questionnaire-based cross sectional analysis was undertaken. A prevalence based sample of 385 hypertensive patients was selected from two tertiary care hospitals. Hypertension Fact Questionnaire (HFQ) and Drug Attitude Inventory (DAI-10) were used for data collection. The socio demographic and disease related data was also taken into account. Statistical Package for Social Sciences (SPSS) v 16.0 was used for data analysis. The factors that were significantly associated with adherence were further assessed by binary logistic regression analysis. The statistical significance was set at 0.05. Three hundred and eight five hypertensive patients were approached. The cohort was dominated by males (68.6 %, n = 265) with mean age of 39.02 ± 6.596 years. Out of 385 patients, 236 (61.3 %) of the patients had average knowledge about hypertension while 249 (64.7 %) were categorized as poor adherent. Mean knowledge score was 8.03 ± 0.42 and mean adherence score was -1.74 ± 2.15. The created model shows a significant goodness of fit as the Omnibus Test of Model Coefficient was highly significant (Chi square = 10.983, p = 0.027, df = 4). Knowledge score had significant association (adjusted OR= 1.159, 95 % CI = 1.004-1.339, P < 0.001) with medication adherence. Knowledge towards hypertension shaped as a significant predictor of drug adherence. Patient education must be formalized and acknowledged as an official part of the health care system.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Smoking cessation intervention: Can diabetic patients’ change their motivation to quit and nicotine dependence?

Introduction: Considering smoking tobacco is a bad habit that drive smokers to nicotine dependence; that argue an urgent need to evaluate factors keep them smoke and how a smoking cessation intervention can affect these factors and minimize their effect. As well as intervention impact on their nicotine dependence and motivation to quit. Methods: This was a randomised controlled trial involving patients with diabetes who smoked tobacco and attended the out-patient diabetes clinic at Hospital Pulau Pinang in Malaysia. Results: Among 126 participants followed over the study period, Malays represent about 41% of the participants. No significant difference between the patients in the two groups with respect to their nicotine dependence. However repeated measures test showed a significant difference over the study period but not with respect to the groups (intervention and control) Fagerström test F (2,220) = 3.663. Significant main effects were found among participants in the different groups with respect to their motivation to quit F (1,110) = 3.975. Conclusion: changing patients behaviour may need consistent and comprehensive intervention for longer time. © 2018, Pharmainfo Publications. All rights reserved

ISPOR Code of Ethics 2017 (4th Edition)

As the leading health economics and outcomes research (HEOR) professional society, ISPOR has a responsibility to establish a uniform, harmonized international code for ethical conduct. ISPOR has updated its 2008 Code of Ethics to reflect the current research environment. This code addresses what is acceptable and unacceptable in research, from inception to the dissemination of its results. There are nine chapters: 1 – Introduction; 2 – Ethical Principles respect, beneficence and justice with reference to a non-exhaustive compilation of international, regional, and country-specific guidelines and standards; 3 – Scope HEOR definitions and how HEOR and the Code relate to other research fields; 4 – Research Design Considerations primary and secondary data related issues, e.g., participant recruitment, population and research setting, sample size/site selection, incentive/honorarium, administration databases, registration of retrospective observational studies and modeling studies; 5 – Data Considerations privacy and data protection, combining, verification and transparency of research data, scientific misconduct, etc.; 6 – Sponsorship and Relationships with Others (roles of researchers, sponsors, key opinion leaders and advisory board members, research participants and institutional review boards (IRBs) / independent ethics committees (IECs) approval and responsibilities); 7 – Patient Centricity and Patient Engagement new addition, with explanation and guidance; 8 – Publication and Dissemination; and 9 – Conclusion and Limitations

Measurement of nicotine withdrawal symptoms: linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) in Malay

<p>Abstract</p> <p>Background</p> <p>The purpose of the linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) was to produce a translated version in Malay language which was "conceptually equivalent" to the original U.S. English version for use in clinical practice and research.</p> <p>Methods</p> <p>A seven-member translation committee conducted the translation process using the following methodology: production of two independent forward translations; comparison and reconciliation of the translations; backward translation of the first reconciled version; comparison of the original WSWS and the backward version leading to the production of the second reconciled version; pilot testing and review of the translation, and finalization.</p> <p>Results</p> <p>Linguistic and conceptual issues arose during the process of translating the instrument, particularly pertaining to the title, instructions, and some of the items of the scale. In addition, the researchers had to find culturally acceptable equivalents for some terms and idiomatic phrases. Notable among these include expressions such as "irritability", "feeling upbeat", and "nibbling on snacks", which had to be replaced by culturally acceptable expressions. During cognitive debriefing and clinician's review processes, the Malay translated version of WSWS was found to be easily comprehensible, clear, and appropriate for the smoking withdrawal symptoms intended to be measured.</p> <p>Conclusions</p> <p>We applied a rigorous translation method to ensure conceptual equivalence and acceptability of WSWS in Malay prior to its utilization in research and clinical practice. However, to complete the cultural adaptation process, future psychometric validation is planned to be conducted among Malay speakers.</p

A qualitative exploration of Malaysian cancer patients' perspectives on cancer and its treatment

<p>Abstract</p> <p>Background</p> <p>Cancer patients' knowledge about cancer and experiences with its treatment play an important role in long-term adherence in their disease management. This study aimed to explore cancer patients' knowledge about cancer, their perceptions of conventional therapies and the factors that contribute to medication adherence in the Malaysian population.</p> <p>Methods</p> <p>A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by cancer patients. Twenty patients were interviewed using a semi-structured interview guide. A saturation point was reached after the 18^thinterview, and no new information emerged with the subsequent 2 interviews. All interviews were transcribed verbatim and analysed by means of a standard content analysis framework.</p> <p>Results</p> <p>The majority of patients related the cause of their cancer to be God's will. Participants perceived conventional therapies as effective due to their scientific methods of preparations. A fear of side effects was main reasons given for delay in seeking treatment; however, perceptions were reported to change after receiving treatment when effective management to reduce the risk of side effects had been experienced.</p> <p>Conclusions</p> <p>This study provides basic information about cancer patients' perceptions towards cancer and its treatment. These findings can help in the design of educational programs to enhance awareness and acceptances of cancer screening. Priorities for future research should focus on patients who refused the conventional therapies at any stage.</p

The role of pharmacists in developing countries: the current scenario in Pakistan

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in Pakistan. The paper draws on the literature related to the socioeconomic and health status of Pakistan's population, along with background on the pharmacy profession in the country in the context of the current directions of health care