This commentary shares the experience of a hospital pharmacy department in providing healthcare services during the COVID-19 outbreak in Malaysia. During this pandemic, the medication delivery system is redesigned to minimize contact among patients and the health care providers. Also, the remote medication monitoring system was implemented to deliver pharmaceutical care for inpatients. Communication technology was used to assist the pharmacist in medication counseling. QR codes to access videos demonstrating the use of devices were made available for patients. Pharmacists were also tasked with the procurement of personal protective equipment and medications needed requiring special approval from the Ministry of Health.

BackgroundThe use of multi-drug regimens in tuberculosis (TB) treatment has been associated with undesirable adverse drug reactions (ADRs). This study aims to assess the incidence and impact of ADRs on TB treatment in Hospital Pulau Pinang.MethodsThis cross-sectional study was conducted via retrospective review of outpatients’ medical records. Details regarding ADRs were identified by a pharmacist and verified by a consultant respiratory physician.ResultsA total of 91 cases, out of 210 patients enrolled in this study, were detected with 75 patients (35.7%) experienced at least one ADR. The three most common ADRs detected were cutaneous adverse drug reactions (CADRs) (21.0%), drug-induced hepatitis (DIH) (7.1%) and gastrointestinal disturbance (4.8%). Pyrazinamide was the most common causative agent and 15.7% of all TB patients required treatment modification due to ADRs. Females were shown to have a higher tendency to develop ADRs than the males in this study (P = 0.009). The development of ADRs was shown not to affect the TB treatment outcomes (P = 0.955).ConclusionThe incidence of ADRs in this study was high so it is important to identify the risk factors for ADRs and the individuals who have those risk factors when initiating anti-TB drugs. These individuals require special attention when anti-TB drugs are initiated.

Pharmacists play an important role in healthcare delivery. Over the years, their role has shifted from product-oriented to patient-oriented. This study aimed to assess the perceptions of the public towards the role of pharmacists and the willingness of the public to pay for pharmacist-provided dispensing services in Sabah. This was a questionnairebased, cross-sectional study conducted from September 2014 to June 2015 in three major cities in Sabah, namely, Kota Kinabalu, Sandakan and Tawau. The respondents were conveniently selected and interviewed based on a questionnaire to assess their perceptions of the role of pharmacists. A contingent valuation interview was then conducted to assess the respondents' willingness to pay. A total of 647 respondents were interviewed. Of the respondents, 61.4% agreed that pharmacists knew more about their medications and side effects and how to use the medications than their doctors. However, more than half of the respondents (54.4%) perceived that the pharmacists' role was only to supply medications and 66.6% of the respondents perceived that the pharmacist's role was to follow doctors' directions. Of the respondents, 89.0% appreciated and adhered to the counselling points provided by their pharmacists; 85.0% of the respondents hoped that pharmacists could play a greater role in healthcare in the future. Forty percent of the respondents agreed that community pharmacists were simply business people who sold products in their pharmacies. Finally, 55.3% of the respondents were willing to pay for pharmacist-provided dispensing services. The median (interquartile ranges [IQR]) amount that they were willing to pay was RM5.00 (IQR RM5.00). Respondents in this study showed variations in their views of the pharmacy profession. Nevertheless, more than half of the respondents valued pharmacist-provided dispensing services and were willing to pay RM5.00 for the services. To improve pharmacy practice, efforts should be undertaken to address the respondents' misunderstandings about the pharmacy profession and to promote the roles of pharmacists to the general public.

Pain management with analgaesics employs a multidisciplinary approach of clinicians towards patients.  Nevertheless, preventing drug abuse and misuse in pain management is also an important goal. Understanding patients’ behaviour in the usage of painkillers may facilitate more effective communication and to educate them on the appropriate choice of painkillers. This study aimed to assess patients’ knowledge, attitude and practice towards painkillers. This was a questionnaire-based cross-sectional study conducted from February to May 2016 among patients in Tawau Hospital. Respondents were selected via convenience sampling and interviewed based on a questionnaire to assess their knowledge, attitude and practice towards painkillers. A total of 193 questionnaires with complete responses were analysed. Most of the respondents(60.1%) obtained their painkillers from public facilities. Generally, they were very satisfied with the painkillers that they had used (36.7%). However, most of them (75.0%) did not know the name of the ingredient of the painkillers that they had taken before. They were also not aware of the side effects (73.1%) and allergicreactions (64.8%) caused by painkillers. Most of the respondents (58.5%) had not been informed regarding the side effects of the painkillers by healthcare professionals. Only 25.0% of the respondents had been asked regarding their past medical history, past medication history and allergic history by healthcare professionals before a painkiller was recommended to them. This study highlights the need of continuous efforts by healthcare professionals to inform patients of the proper use and risks associated with painkillers to improve the quality use of painkillers.