This study reports the antibiotic usage at three primary healthcare clinics in Klang Province. The most prescribed antibiotic was amoxicillin in capsules (250mg), which was mainly prescribed for respiratory infections. Although the national antibiotic guidelines state that amoxicillin is a preferred drug for acute bacterial rhinosinusitis, this drug is also being prescribed for other disease conditions, such as acute pharyngitis and acute tonsillitis. This result shows that current practice is not following the current antibiotic guidelines, which state that phenoxypenicillin should be the preferred drug.

ObjectivesTo assess the knowledge of physicians and clinical pharmacists about inappropriate prescribing for elderly patients, their confidence in prescribing for elderly patients, and their perceptions of barriers to appropriate prescribing in this population.MethodsA cross-sectional study using a validated 20-item questionnaire was conducted among physicians (n=78) and clinical pharmacists (n=45) working in the medical wards of two tertiary hospitals in Malaysia. Knowledge was assessed by six clinical vignettes which were developed based on Beers criteria and the STOPP/START criteria. Other domains of the study were investigated using a four-point or five-point Likert scale.ResultsOf the 82 participants who completed the questionnaire, 65% were physicians, 90.2% had never received training in geriatric medicine, and 70.8% estimated that 25% or more of their patients were elderly. Only six participants (7.3%) had ever used STOPP/START or Beers criteria when prescribing for elderly patients, and 60% of the respondents had never heard of either one of those criteria. The mean score (SD) for the knowledge part was 3.65 (1.46) points, and only 27 participants (22.9%) scored more than four out of a possible six points. Overall, 34% of the participants rated themselves as confident in prescribing for elderly patients, and this was significantly associated with their knowledge score (P=0.02). The mean number (SD) of barriers cited per participant was 6.88 (2.84), with polypharmacy being the most cited barrier.ConclusionsThe majority of the participants had inadequate knowledge and low confidence regarding recommending medications for elderly patients. Continuing education on geriatric pharmacotherapy may be of value for the hospital physicians and pharmacists.

Background: Telepharmacy is a relatively recent advancement in healthcare services that enables providing high-quality pharmacy services to rural and remote areas. It gained increased attention during the COVID19 pandemic. Objectives: To assess the knowledge, perceptions, and readiness towards telepharmacy services among senior pharmacy students in a Malaysian public pharmacy school. Materials and Methods: A cross-sectional study was conducted using a self-developed, pre-tested, and validated 35-item questionnaire among penultimate and final year students in a Malaysian public pharmacy school. Ethical approval was obtained before beginning the online data collection between September and December 2020. Descriptive and inferential data analyses were performed using SPSS version 22. A p-value ≤ of 0.05 was considered statistically significant. Results: The study received a total of 178 responses to the questionnaire. The response rates of the third and fourth years were 50.6% and 49.4%, respectively. Overall, 67% had high knowledge, and 68% showed high readiness level. Meanwhile, 61% of the responses had positive perceptions of telepharmacy services. A notably excellent knowledge was demonstrated in items related to the telepharmacy role during the pandemic (93.8%) and the technical competencies required for the service provider (96.1%). The beneficial role of telepharmacy to save patients' resources was perceived positively with a 91% agreement level among study participants. The readiness items related to the lack of incentive and the excessive workload were associated with less agreement levels of 33.7% and 45.5%, respectively. Overall, participants' knowledge of telepharmacy significantly impacted their expressed readiness to implement telepharmacy services in their future practice. Conclusion: Most study participants had adequate knowledge, positive perceptions and demonstrated readiness to implement telepharmacy services in their future pharmacy practice. The potential increase in workload and lack of incentive were the main concerns associated with the widespread adoption of telepharmacy practice models.

Background: Potentially inappropriate prescribing (PIP) is associated with the incidence of adverse drug reactions, drug-related hospitalization and other negative outcomes in older adults. After hospitalization, older adults might be discharged with several types of PIPs. Studies have found that the lack of healthcare professionals' (HCPs) knowledge regarding PIP is one of the major contributing factors in this issue. The purpose of this study is to investigate the impact of a multifaceted intervention on physicians' and clinical pharmacists' behavior regarding potentially inappropriate medication (PIM) and potential prescribing omission (PPO) among hospitalized older adults. Methods: This is a before-and-after study that took place in a tertiary Malaysian hospital. Discharge medications of patients ≥65 years old were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. The prevalence and pattern of PIM/PPO before and after the intervention were compared. The intervention targeted the physicians and clinical pharmacists and it consisted of academic detailing and a newly developed smartphone application (app). Results: The study involved 240 patients before (control group) and 240 patients after the intervention. The prevalence of PIM was 22% and 27% before and after the intervention, respectively (P = 0.213). The prevalence of PPO in the intervention group was significantly lower than that in the control group (42% Vs. 53.3%); P = 0.014. This difference remained statistically significant after controlling for other variables (P = 0.015). The intervention was effective in reducing the two most common PPOs; the omission of vitamin D supplements in patients with a history of falls (P = 0.001) and the omission of angiotensin converting enzyme inhibitor in patients with coronary artery disease (P = 0.03). Conclusions: The smartphone app coupled with academic detailing was effective in reducing the prevalence of PPO at discharge. However, it did not significantly affect the prevalence or pattern of PIM.

To investigate the association between potentially inappropriate medication (PIM)/potential prescribing omission (PPO) and the health-related quality of life (HRQoL) among community-dwelling hospitalized elderly patients. Methods This is a cross-sectional study that took place in a Malaysian tertiary hospital. Patients ≥ 65 years old with at least one medication on admission were recruited. The patients' prehospitalization medications were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. HRQoL was assessed using the EuroQol-5 dimensions (EQ-5D) and EuroQolvisual analog scale (EQ-VAS). The association between the presence of PIM/PPO and the patients' HRQoL was analyzed using Chi-square and Mann-Whitney U tests. Multiple linear regression models were applied to determine the effect of exposure to PIM/PPO on the patients' HRQoL, adjusting for confounders. Results Out of 517 patients who fulfilled the inclusion criteria, 502 patients (97%) accepted to be involved in the study and completed the HRQoL questionnaire. The mean (SD) age was 72.4 (5.9) years. 393 (78.3%) of the patients had problems in at least one EQ-5D dimension with pain/discomfort problem being the most reported complaint. The mean (SD) values of the EQ-5D index and the EQ-VAS were 0.734 (0.214) and 59.6 (14.2), respectively, which are lower than those seen in the general Malaysian population. PIM and PPO were found in 28.5% and 45.6% of the patients, respectively. No significant We use cookies to personalise content and ads, to provide social media features and to analyse our traffic. We also share information about your use of our site with our social media, advertising and analytics partners in accordance with our Privacy Statement. You can manage your preferences in Manage Cookies. ✓ OK Manage Cookies ❯ 3/27/2020 Does inappropriate prescribing affect elderly patients' quality of life? A study from a Malaysian tertiary hospital | SpringerLink