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

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

The experiences of implementing generic medicine policy in eight countries: A review and recommendations for a successful promotion of generic medicine use

Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price. Thus, while providing the same therapeutic outcomes, generic medicines lead to substantial savings for healthcare systems. Therefore, the quality use of generic medicines is promoted in many countries. In this paper, we reviewed the role of generic medicines in healthcare systems and the experiences of promoting the use of generic medicines in eight selected countries, namely the United States (US), the United Kingdom (UK), Sweden, Finland, Australia, Japan, Malaysia and Thailand. The review showed that there are different main policies adopted to promote generic medicines such as generic substitution in the US, generic prescribing in the UK and mandatory generic substitution in Sweden and Finland. To effectively and successfully implement the main policy, different complementary policies and initiatives were necessarily introduced. Barriers to generic medicine use varied between countries from negative perceptions about generic medicines to lack of a coherent generic medicine policy, while facilitators included availability of information about generic medicines to both healthcare professionals and patients, brand interchangeability guidelines, regulations that support generic substitution by pharmacists, and incentives to both healthcare professionals and patients.Scopu

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

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

Influences on interactions between physicians in the public and private sectors and medical representatives in Yemen

Objective This study aims to assess the relative importance of attitude and subjective norms as well as physicians' characteristics and practice-setting factors in predicting the outcome of physicians' interactions with MRs. Methods A cross-sectional survey was conducted among a convenience sample of 602 physicians in Sana'a, Yemen. The data were analysed using descriptive and inferential analyses. The t-test/Mann–Whitney test and ANOVA/Kruskal–Wallis test with post hoc analysis, principal component analysis, correlation analysis and regression analysis were applied at an a priori significance level of 0.05. Key findings The response rate was 76.5%. Results showed that physicians who see a greater number of MRs per week or have academic affiliations were significantly more likely to have received high/low-value promotional items than were those who saw fewer MRs or have no academic affiliations (P values < 0.001 and 0.021, respectively). Also male physicians and physicians who have private clinics were significantly more likely to have received high-value promotional items (P value < 0.001). Three out of five hypotheses were supported (physicians' belief in the appropriateness of accepting high/low-value pharmaceutical companies' promotional techniques relate positively and significantly to their behaviour of interactions with MRs, and physicians' attitudes towards pharmaceutical companies relates positively and significantly to their interactions with MRs). Conclusion Physicians in Yemen consider most of the promotional techniques as normal practice. The article provides empirical evidence for policymakers in developing countries in general, and Yemen specifically, to develop suitable policies and regulations for drug promotion.This work was supported by Yemeni Ministry of Health and Population. The authors acknowledge Dr Michael Steinman, Assistant Professor of Medicine in Geriatrics, San Francisco VA Medical Center and UCSF and Dr Douglas Ball, Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, for providing background support in terms of developing the questionnaire. We also thank all the physicians for their involvement in and cooperation during the study.Scopu

Knowledge, perceived barriers and facilitators of medication error reporting: a quantitative survey in Malaysian primary care clinics

Background Medication errors are the most common types of medical errors that occur in health care organisations; however, these errors are largely underreported. Objective This study assessed knowledge on medication error reporting, perceived barriers to reporting medication errors, motivations for reporting medication errors and medication error reporting practices among various health care practitioners working at primary care clinics. Setting This study was conducted in 27 primary care clinics in Malaysia. Methods A self-administered survey was distributed to family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. Main outcome measures Health care practitioners' knowledge, perceived barriers and motivations for reporting medication errors. Results Of all respondents (N = 376), nurses represented 31.9% (n = 120), followed by doctors (n = 87, 23.1%), pharmacists (n = 63, 16.8%), assistant medical officers (n = 53, 14.1%), pharmacist assistants (n = 46, 12.2%) and family medicine specialists (n = 7, 1.9%). Of the survey respondents who had experience reporting medication errors, 56% (n = 62) had submitted medication error reports in the preceding 12 months. Results showed that 41.2% (n = 155) of respondents were classified as having good knowledge on medication error and medication error reporting. The mean score of knowledge was significantly higher among prescribers and pharmacists than nurses, pharmacist assistants and assistant medical officers (p < 0.05). A heavy workload was the key barrier for both nurses and assistant medical officers, while time constraints prevented pharmacists from reporting medication errors. Family medicine specialists were mainly unsure about the reporting process. On the other hand, doctors and pharmacist assistants did not report primarily because they were unaware medication errors had occurred. Both family medicine specialists and pharmacist assistants identified patient harm as a motivation to report an error. Doctors and nurses indicated that they would report if they thought reporting could improve the current practices. Assistant medical officers reported that anonymous reporting would encourage them to submit a report. Pharmacists would report if they have enough time to do so. Conclusion Policy makers should consider using the information on identified barriers and facilitators to reporting medication errors in this study to improve the reporting system to reduce under-reported medication errors in primary car

Mothers beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal

Background: In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers beliefs and barriers about diarrhea and its management. Methods. Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Results: Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers. Conclusions: There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.Scopu