Interventions on Improving Medication Adherence in Malaysia: A Mini Review

Medication non-adherence is a global issue. Past review on the interventions to improve medication adherence provided little practical implications for healthcare professionals and policy makers in Malaysia, due to the substantive differences across studies. Hence, this review attempted to evaluate the interventions on improving medication adherence conducted in Malaysia, to generate some insights and recommendations for future interventions. Method: Search of past literatures from Google Scholar, PubMed, MEDLINE, EBSCO, PsycINFO, CINAHL (via EBSCO) with search strategy: “medication adherence or medication compliance” [Mesh] AND “intervention” [Mesh] AND “Malaysia” AND English [lang- Lang] was conducted on September 28, 2016. The framework of judging methodological quality used by Zwikker and colleagues was employed. Results and Discussion: A total of 28 articles were identified. Studies which were not conducted using Malaysia population, not measuring medication adherence, without intervention on medication adherence, non-prospective and non-experimental design were omitted. Hence, 9 articles were retained for further evaluation. Eight out of the nine prospective randomized controlled studies were found to be low-quality studies. Overall, interventions that were pharmacist led, physician led, adoption of automated text messaging reminder and improvised medication labelling were found to be effective. Conclusion: This review provides valuable insights on contemporary interventions to improve medication adherence conducted in Malaysia. It is suggested that multifaceted approach with involvement of different healthcare professionals should be encouraged to synergize the strengths of each profession and to further enhance the effectiveness of interventions

Prevalance Of Health Supplement Products Use And Their Potential Interactions With Drugs Prescribed For The Outpatient Population Of Sarawak District Hospital

Recently, the use of health supplement products is increasing among public in Malaysia. Nevertheless, there is limited research on the prevalence of health supplement products utilization among Malaysian population. Additionally, previous studies in Malaysia did not properly address the prevalence of concomitant use of prescribed medicines and health supplement products, as well as the practices, perceptions, factors which lead to the use of supplement products, and potential interaction between health supplement products and prescribed medicines among the rural population from Sarawak. This study aims to assess the prevalence of health supplement products consumption, and to identify practices, perception, factors affecting the use of such products, and potential interaction between health supplement products and prescribed medicines among patients with chronic diseases in rural area of Sarawak, Malaysia. This was a multicenters cross-sectional study conducted in outpatient pharmacy department of seven non-specialist government districts Hospitals in Sarawak. A data collection form was developed, and pilot tested prior to the data collection. Data was collected from June to August 2018. Binary logistic regression was used to assess the association between patients’ social demographic characteristics and the consumption of supplement products

Compliance of Community Pharmacists and Private General Medical Practitioners With Malaysian Laws on Poisons and Sale of Drugs

Background: Compliance of community pharmacists (CPs) and private general medical practitioners (GPs) with Malaysian Laws on Poisons and Sale of Drugs is crucial in encouraging rational supply of medicine to patients that will subsequently lead to rational use of medicine, especially controlled medicine and psychotropic substances. This study aims to identify the trend of yearly compliance rate of both CPs and GPs with the Malaysian Laws on Poisons and Sale of Drugs, and to quantify the effectiveness of disciplinary actions in improving their compliance level. Methods: This is a retrospective observation study from the Sarawak state Pharmaceutical Enforcement Division (PED) inspection reports on CPs and GPs from January 1, 2012, to December 31, 2014. Descriptive statistics in numbers and percentages are used to present the results. Results: From years 2012 to 2014, the compliance rate of GPs increased from 34% to 51%, while the compliance rate of CPs remained almost constant, with a slight drop from 53% (2012) to 50% (2014). The most common noncompliance found among CPs is with the Poison Acts 1952 Section 26 Condition 2: “Records for the supply of preparations containing Pseudoephedrine, Ephedrine and Dextromethorphan,” and among GPs, it is the Regulation 12 of Poisons Regulation 1952: “labeling of dispensed medicines.” Warning letter is the most effective disciplinary action for both CPs (75% improvement) and GPs (67.8% improvement). Conclusion: This study serves as a baseline that provides valuable insights to policy makers, researchers, and other stakeholders in developing better enforcement strategies. © 2017, ©The Author(s) 2016

Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial

Abstract Background Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely “Know Your Medicine – Take if for Health” (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program. Methods/design This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score <6) were randomly assigned to the treatment group (MEDIHEALTH) or the control group. The primary outcome of this study is medication adherence level at baseline and 1, 3, 6 and 12 months post-intervention. The secondary outcomes are attitude, subjective norms, perceived behavioural control, intention and knowledge related to medication adherence measured at baseline and 1, 6 and 12 months post-intervention. The effectiveness and sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8. Discussion This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program. Trial registration National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706. Registered on 25 July 2017