Reflective writing in pharmacy practice

Pharmacists, being health information gurus and one of the largest groups of healthcare providers, seep into the changing dynamics of the healthcare environment where now the patient is both demanding of, and receptive to, information even on minor illnesses. The profession of pharmacy holds the concept of ‘patient centred care,’ thus shifting the image of a pharmacist from a dispenser to a decision-maker and caregiver. This places an additional burden on the pharmacist, and therefore the practice of professional principles should be more dynamic and action-oriented in the best interest of the patient. Future pharmacy practitioners need to gain better understanding of the professional principles and heterogeneous philosophies of pharmacy practice that initiate from dispensing, counselling, congenial interprofessional and intra-professional working, and later culminate in drug and patient safety, pharmacogenomics and pharmacoinformatics. In order to accomplish this, future pharmacy practitioners could be frequently acclimatized to the concept of reflective learning in different pharmacy modules. It is suggested that the concept of reflective learning could be nurtured by observational writing. The requirement of reflection-imbued observational writing generally, exposes the students to activities related to learning and makes them an insider for a transient epoch facilitating in facing the world being observed

PARACETAMOL DISPENSING PRACTICE OF GOVERNMENT HEALTH CLINICS POST INFANTS’ VACCINATION IN MALAYSIA

Objective: This study obtained information on Paracetamol (PCM) Dispensing Practice of Government Health Clinics (GHC) post infants’ vaccination in Malaysia as well as identify its possible factors. Methods: This descriptive cross-sectional retrospective study (with convenient sampling) using a data collection form (DCF) to collect data. The pharmacist who is the representative of the GHC filled the DCF. Potential risk factors were evaluated by Pearson chi-square tests (expected count<5 is<20%) for an independent sample. Results: A total number of 254 samples were collected all over Malaysia within the period of data collection, but only 248 that met inclusion criteria. The PCM dispensing practice of GHC in Malaysia for a total period of 3 y back (from 2015-2017), tend not to give PCM post immunization with respect to age of the upon vaccination and types of vaccination, conversely for gender. Trends of PCM dispensing practice were increasing for “Not Give PCM” with respect to gender, age of the baby upon vaccination, and types of vaccination from 2015 till 2017. The PCM dispensing practice had no association with no statistically significant value (p=0.804) on genders and a weak positive association with statistically significant value (p<0.05 each) on age of the baby (≤ 1year) upon vaccination and types of vaccination. Conclusion: Future research which may include the actual practice in which practices of prescribers or mother may be conducted in determining more accurate data on the giving PCM post infant’s vaccination

Pharmacy education symposium: a need of time

Pharmacists are important among healthcare professionals because of their role in the identification and treatment of minor illnesses and counsel for major diseases irrespective of age, race, gender, and socioeconomic status and health convictions. Within the last five decades there is colossal entry of medications into the pharmaceutical market, thus accelerating the requirement of the pharmacists. The existing position of the pharmacist in a wider standpoint is that of a “seven star pharmacist” and thus pharmacy institutions are struggling to exercise principal influence in training students into full-fledged seven star pharmacists. Pharmacists being the health information custodian and the third largest group of health care providers seep into the changing dynamics of healthcare environment where now patient is both demanding and receptive for information even on minor illnesses [1]. To be precise the profession of pharmacy embraces the concept of ‘Patient centered Care’ thus changing the image of a pharmacist from a ‘dispenser’ to a ‘decision maker’ and ‘caregiver’. However, more work is needed to be done to establish the true value of this underrated healthcare professional group in the eyes of other stakeholders; be it a doctor, nurse, or a patient. In the backdrop of this, there is an urgent need to continuously revisit the principles of pharmacy education for better competency skills. Therefore, the Council of Deans for the Malaysian Public Pharmacy Schools and Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM)planned to organize a symposium, which was held in September 2013 at Conference Room, Cultural Activity Center (CAC), IIUM, Gombak Campus, Kuala Lumpur, Malaysia. This was attended by 34 delegates from different public universities in Malaysia, including Deans, Deans’ representatives, and pharmacy academics. The key speakers were Deans of the Malaysian Public universities. The five a priori themes on which the speakers embarked upon were Academic, Research, Community Services and Industrial Linkages, Student Activities and Internationalization

Cross sectional retrospective study on paracetamol post infants’ vaccination

Introduction: Practice of dispensing Paracetamol (PCM) post infants’ vaccination remains doubtful in Malaysia, thus requiring appropriate regulation measures. Objectives: This research aims to investigate the prevalence of PCM prescribing groups and its associated factors (i.e. gender, age, types and stages of vaccination, concomitant vaccines and drugs and/ vitamins). Materials and Methods: A retrospective cross-sectional study was done for 2011–2017 where the Adverse Events Following Immunization (AEFI) was extracted from Quest 2, Quest 3 and Quest 3+ System of National Pharmaceutical Regulatory Agency (NPRA). The population of vaccinated babies was extracted from the Ministry of Health (MOH) Malaysia official website. The AEFI data was further categorized into (i)AEFI with possibility for PCM to be prescribed and (ii)AEFI with no possibility for PCM to be prescribed. The data was analysed using Microsoft Excel 2013, Simple and Multiple Logistic Regression Tests, SPSS version 22. Results: 359 infants with various AEFI cases reported in 2011–2017. DTaP/Hib/IPV and MMR showed higher prevalence with value of (2.07 and 2.21 respectively) AEFI cases per 100, 000 population than other types of vaccinations meanwhile, the 2 months DTaP/Hib/IPV vaccination showed the highest (3.00) among other age groups. Simple analysis revealed that no factor associated with PCM prescribing groups. Backward Elimination LR Method presented that 3–4 months DTaP/Hib/IPV (95%CI; 0.231, 0.899%; p=0.023) was the associated factor of PCM prescribing groups. 1–5 months Hepatitis B (91.57%), 3–4 months DTaP/Hib/IPV (97.8%), 5–12 months DTaP/ Hib/IPV (95.64%), concomitant vaccines (10.43%) as well as concomitant drugs and/ vitamins (29.45%) were the identified potential cofounders. Conclusion: 2–4 months DTaP/Hib/IPV and 12 months MMR groups were found as the associated factors of PCM prescribing groups, thus PCM post infants’ vaccination may be confined to these groups. The population data for the potential cofounders identified may be collected and analysed for the next research

The relevancy of paracetamol and breastfeeding post infant vaccination: A systematic review

Paracetamol may be used as an antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain post-vaccination in infants. The use of paracetamol during fever may be or may not be recommended since it may alter the natural human body immune response, although it may reduce pain

The use of antidepressants for physical and psychological symptoms in cancer

Cancer patients are commonly associated with various physical and psychological symptoms. In palliative setting, the aims are to relieve those symptoms, improve quality of life, and increase medication adherence among cancer patients. Antidepressants are generally accepted for the treatment of depression among patients with or without cancer. Some other potential benefits of the antidepressants have been reported in cancer patients. Objective: This study aims to review the use of antidepressants for physical and psychological symptoms in cancer patients. Results: Our findings showed the mixed result of positive and negative findings in various symptoms associated with cancer patients. These studies are categorised according to the hierarchy of evidence from high to low level, namely randomised controlled trials, cohort studies, case-control studies, case series, case reports, as well as other type of publications. The majority of antidepressants used in cancer patients seem to be beneficial for the treatment of depression, anxiety, hot flashes and other symptoms such as sexual dysfunction, fatigue, nicotine dependence, vasomotor symptoms, executive functions, sleep problems, pruritus, as well as for hypochondriasis. While fluoxetine was found to be associated with the reduction of antiemetic property in ondansetron, mirtazapine was identified to be a good alternative in treating nausea and cachexia among cancer patients. Conclusion: More research studies with adequate statistical power are warranted to validate the use of antidepressants among cancer patients in treating these physical and psychological symptoms

Orthogonal partial least squares model for rapid prediction of antioxidant activity of Pereskia bleo by fourier transform infrared spectroscopy

Pereskia bleo is a species of primitive cactus. In the present study, infrared spectroscopy was used to characterize the antioxidant activity of P. bleo leaves by multivariate analysis. A total of twenty-four extracts were prepared in different solvents. Antioxidant activities were measured by 1,1-diphenyl-2-picrylhydrazyl assay and fingerprinted by infrared spectroscopy between 4000 and 400 cm−1 at a resolution of 2 cm−1. A three component multivariate orthogonal partial least squares model with R2Y of 0.88 and Q2 of 0.86 was developed to correlate infrared spectra with antioxidant activity and evaluated by internal cross-validation and a true external test. For external validation, bioactivity of new extracts of P. bleo was predicted using the model, and -OH, -NH, and -CH were identified as functional groups responsible for the activity. In summary, a successful orthogonal partial least squares model was developed using infrared spectroscopy as a rapid method to predict antioxidant activity

Human resource planning and development of pharmaceutical sector in Malaysia related to Malaysian National Medicines Policy: a pilot study

The objective of this study is to investigate the internal consistency of the scale and the test reliability of the questionnaire to create a better understanding on the expectations of pharmaceutical companies and educational institutions with Malaysian government in planning human resource development in the pharmaceutical sector. The study was carried out in one week interval by experts in the field. 28 out of 30 self administered questionnaire were completed (96.7%-responds rates). Cronbach's x coefficients computed to measure the internal consistency and reliability of all questions gave values of more than 0.7(0.746, 0.774, 0.894), which show the questionnaires are reliable. The questionnaire provides a reliable, valid and easy-to-administer tool for assessing personal perspective on the human resource planning and development of pharmaceutical sector in Malaysia. The analysis of the survey results showed gaps between what the government agencies are doing and what the industrial pharmacists and academicians expert from them with regard to developing s successful knowledge-based economy. In summary, the research team hopes that the findings of this study will create a better understanding of the expectations of industrial pharmacists and academicians from government agencies to lead to the knowledge-based economy

Malaysian pharmacy students’ intention to provide smoking cessation counseling

Background and purpose Malaysian National Quit Smoking Program had proposed to integrate smoking cessation counseling skills into all relevant healthcare curricula as one of its strategies to increase the number of Malaysians giving up smoking. More effective implementation of the curricula can be facilitated by further understanding the factors influencing students’ intention in terms of providing smoking cessation counseling. This study, guided by Integrated Behavior Model (IBM), aimed to explore the factors which influenced pharmacy undergraduates in providing smoking cessation counseling. Educational activity and setting Following the elicitation study, the IBM-guided questionnaire was developed and distributed to students from two pharmacy schools which agreed to participate, each representing public and private institutions. Findings A total of 387 pharmacy students participated yielding a 83% response rate. Multiple regression analysis revealed that all three, namely, attitude (23%), perceived norm (16%), and personal agency (16%) were significant predictors of students’ intention. Further analysis revealed ‘experiential attitude’ a component of attitude as the strongest predictor. In other words, students who felt more comfortable had higher intention to provide smoking cessation counseling. Summary An implication of this study is that tobacco-related curricula with an emphasis to enhance students’ comfort level in providing counseling would be of value for these future pharmacists in terms of their intention as well as actual provision of smoking cessation counseling through the mediation of “experiential attitude” and personal agency