Doctors’ perception and expectations of the role of the pharmacist in Punjab, Pakistan

Purpose: To investigate doctors’ perception and expectations of the role of pharmacists in Pakistan’s healthcare system.Methods: This was a cross-sectional study and the study population consisted of 462 medical doctors from three Pakistani cities in Punjab State, namely, Islamabad, Faisalabad and Lahore. The doctors were selected from government hospitals in these three cities.Results: Three hundred and fifty four questionnaires were returned, giving a response rate of 76.6 %. Sixty eight percent of the doctors appeared comfortable with pharmacists playing patient-centred roles. A majority (84.5 %, n=299; p=0.022) expected pharmacists to take personal responsibility for resolving any drug-related problem. Furthermore, 76 % of them considered pharmacists as knowledgeable drug therapy experts. Only 50 % of the doctors thought that pharmacists apply their drug knowledge in practice while 11 % indicated that pharmacists routinely counselled their patients. Conclusion: The doctors considered pharmacists drug information experts but their expectation of pharmacists as providers of quality clinically-focused pharmacy services was low. The doctors were also uncomfortable with pharmacists providing direct patient care.Keywords: Doctor, Pharmacist, Perception, Expectation, Patient care, Pakistan

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

Health-Related Quality of Life (HRQoL) in Co-Morbid Tuberculosis Relapse Patient: A Case Report from Malaysia

Purpose: To describe changes in HRQoL of pulmonary tuberculosis (PTB) patient and illustrate impact of malnutrition and Type II diabetes on relapse of PTB. Case: A Chinese male patient with complaints of productive cough, and loss of weight and appetite was registered; sputum smear confirmed that patient had PTB. Diagnosis was also supported by routine investigations. Patient had past history of PTB and Type II diabetes mellitus. For management of secondary tuberculosis, he was prescribed WHO recommended therapy. Elevated HbA1c levels and history of drop-off serum albumin concentration at the start of treatment demonstrated inappropriate glycaemic control and malnutrition over the past months. SF-36v2 was used to estimate HRQoL scores at start, after two months and at the end of TB therapy. Although patient’s perception of mental and physical health improved with progress of treatment, vitality (VT), social functioning (SF) and role emotion (RE) scores were still lower than Malaysian norms. Patient was declared ‘cured’ but state of ‘health’ as defined by WHO was not achieved. Conclusion: Relapse of PTB might be a consequence of inappropriate glycaemic control and malnutrition. This case report demonstrates the need for more comprehensive efforts at TB programs to improve HRQoL of TB patients.Keywords: Health-Related Quality of Life, Pulmonary tuberculosis, Malnutrition, Type II diabetes, SF 36v

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