Antonio Mastino, Francesca Pettinau, Piergiorgio Palla, Giuseppina Ozzella, Massimiliano Grosso, Barbara Pittau
{"title":"A quantitative investigation in a territory of Italy on citizens' attitudes towards medicines through the COVID-19 pandemic: the importance of possible indirect effects caused by the pandemic.","authors":"Antonio Mastino, Francesca Pettinau, Piergiorgio Palla, Giuseppina Ozzella, Massimiliano Grosso, Barbara Pittau","doi":"10.1080/20523211.2024.2418366","DOIUrl":"10.1080/20523211.2024.2418366","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has greatly influenced many aspects of everyday life, particularly that of the general population health. In order to better understand the potential impacts of the COVID-19 pandemic on people's attitudes toward medicines use, a quantitative investigation was conducted in a territory of Sardinia region, Italy.</p><p><strong>Methods: </strong>Stratification of the random multilevel population sample was based on gender, age range, and territory. The methodological strategy to verify the potential approach changes towards medicines due to the COVID-19 pandemic consisted of oral interviews with adult citizens and unrecognizability preservation. Investigation, also supported by a study completed before the insurgence of the pandemic about taking medicines, interrupting treatments without consulting, and reading the information leaflet, allowed to explore citizens' attitudes before and during pandemic, and changing.</p><p><strong>Results: </strong>The most relevant findings are the tendency towards a higher occurrence of self-interruption of treatments and an increased interest in the information leaflet (package leaflet), but not an increased self-administration of medicines.</p><p><strong>Conclusions: </strong>These results indicate new indirect effects of the COVID-19 pandemic that could exert an additional impact on the state of citizens' health and health systems. The study, with reference to prophylactic medical treatments and based on some considerations concerning the pandemic from its insurgence to today, also provides solutions for related problems for the present or future periods of health emergencies.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dina Abushanab, Shaban Mohammed, Rania Abdel-Latif, Wadha Al-Muftah, Said I Ismail, Moza Al Hail, Wafa Al-Marridi, Oraib Abdallah, Noriya Al-Khuzaei, Asma Al-Thani, Daoud Al-Badriyeh
{"title":"Cost-effectiveness analysis of genotype-guided optimization of major depression treatment in Qatar.","authors":"Dina Abushanab, Shaban Mohammed, Rania Abdel-Latif, Wadha Al-Muftah, Said I Ismail, Moza Al Hail, Wafa Al-Marridi, Oraib Abdallah, Noriya Al-Khuzaei, Asma Al-Thani, Daoud Al-Badriyeh","doi":"10.1080/20523211.2024.2410197","DOIUrl":"10.1080/20523211.2024.2410197","url":null,"abstract":"<p><strong>Background: </strong>Pharmacogenetic testing improves the efficacy and safety of antidepressant pharmacotherapy for moderate-severe major depressive disorder by identifying genetic variations that influence medication metabolism, and adjusting treatment regimens accordingly. This study aims to assess the cost-effectiveness of implementing a pharmacogenetic testing approach to guide the prescription of antidepressants.</p><p><strong>Methods: </strong>From the public hospital perspective, we developed a two-stage decision tree diagram of a short-term 6-week follow up, and a lifetime Markov model with 3-month cycles. The analysis compared the current standard of care with the alternative strategy of Pharmacogenetic-guided (multi-gene panel) testing in adult patients with moderate-severe major depressive disorder. Clinical outcomes and utilities were obtained from published studies, while healthcare costs were locally available. The short-term incremental cost-effectiveness ratio was against treatment response without side effects and without relapse, and against treatment response with/without side effects and without relapse. The long-term incremental cost-effectiveness ratio was against the quality-adjusted life year gained and years of life saved.</p><p><strong>Results: </strong>Adopting the pharmacogenetic-guided therapy for adult patients with moderate-severe major depressive disorder in Qatar resulted in cost savings of Qatari Riyal 2,289 (95% confidence interval, -22,654-26,340) for the health system. In the short term, the pharmacogenetic-guided testing was associated with higher response rates without side effects and without relapse (mean difference 0.10, 95% confidence interval 0.09-0.15) and higher response rates with or without side effects and without relapse (mean difference 0.05, 95% confidence interval 0.04-0.06). For long term, the pharmacogenetic-guided testing resulted in 0.13 years of life saved and 0.06 quality-adjusted life year gained, per person, along with cost savings of Qatari Riyal 46,215 (95% confidence interval-15,744-101,758). The sensitivity analyses confirmed the robustness of the model results.</p><p><strong>Conclusion: </strong>Implementing pharmacogenetic testing to guide antidepressant use was found to improve population health outcomes, while also significantly reducing health system costs.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weigao Cheng, Jiayi Du, Chen Chen, Jiajing Cao, Xudong Xia, Xi Yang, Wan Zhang, Xuedong Jia, Yuedong Qi
{"title":"Exploring the influencing factors of adverse drug reaction reporting among medical personnel: a COM-B model-based study.","authors":"Weigao Cheng, Jiayi Du, Chen Chen, Jiajing Cao, Xudong Xia, Xi Yang, Wan Zhang, Xuedong Jia, Yuedong Qi","doi":"10.1080/20523211.2024.2417410","DOIUrl":"10.1080/20523211.2024.2417410","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify the factors that influence medical workers' enthusiasm for reporting adverse drug reactions (ADRs). Understanding these factors is essential to implement targeted interventions that can improve and refine pharmacovigilance systems.</p><p><strong>Methods: </strong>We adopted the Capability, Opportunity, Motivation, and Behavior model (COM-B) model as the theoretical framework and conducted qualitative research using in-depth interviews with clinicians, nurses, pharmacists, and administrators. 24 one-on-one interviews were conducted and audio-recorded. The interviews were transcribed verbatim, and subjected to thematic analysis to uncover the key factors affecting ADR reporting among medical staff.</p><p><strong>Results: </strong>The participation included 24 healthcare workers from six different healthcare organisations. Analysis revealed that decreased motivation to report ADRs was due to inadequate judgment or inconsistent judgment criteria within the capability domain, poor awareness of ADRs and deficient communication skills within the psychological domain, unclear responsibilities within the motivation domain, and limited or no access to necessary resources within the opportunity domain. Facilitators of ADR reporting included sufficient cognitive and operational abilities, spontaneous and incentivized motivation, clear responsibilities and role expectations, and robust social support.</p><p><strong>Conclusion: </strong>There is a critical need to develop comprehensive interventions that address the identified factors influencing ADR reporting. By improving the motivation of medical staff to report ADRs, the pharmacovigilance system can be significantly improved.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Akhtar Abbas Khan, Tehreem Sara, Zaheer-Ud-Din Babar
{"title":"Pharmacovigilance: the evolution of drug safety monitoring.","authors":"Muhammad Akhtar Abbas Khan, Tehreem Sara, Zaheer-Ud-Din Babar","doi":"10.1080/20523211.2024.2417399","DOIUrl":"https://doi.org/10.1080/20523211.2024.2417399","url":null,"abstract":"<p><p>The Pharmacovigilance system is aimed to promote and protect public health by ensuring the availability of essential medicines in the market and reducing the burden of ADRs. Pharmacovigilance is derived from two words; pharamakon rooted in the Greek word that means medicinal substance and vigilia rooted in the Latin word to keep watch. This concept evolved after Hannah Greener died in 1848 after having a tonsillectomy with chloroform. As a result of the Thalidomide tragedy, drug regulation in Europe has forever changed. From its earliest beginnings to its current state, pharmacovigilance has been shaped by several major milestones. The historical phases of pharmacovigilance can help us understand the value of pharmacovigilance and identify the challenges that lie ahead. Despite advancements in technology, it is imperative that we continue to strive for excellence in pharmacovigilance to ensure all individuals' safety and health. Through collaboration between the Council for International Organizations of Medical Sciences (CIOMS), World Health Organization (WHO), and the International Conference on Harmonization (ICH), Pharmacovigilance has evolved into a regulatory activity.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mas Fazlin Mohamad Jailaini, Jaya Muneswarao, Ching Zhen Hao, Rabia Hussain, Mohamed Faisal Abdul Hamid
{"title":"Inhaler personalisation based on peak inspiratory flow (PIF) among dry powder inhaler users: a pilot randomised control trial (RCT) in COPD.","authors":"Mas Fazlin Mohamad Jailaini, Jaya Muneswarao, Ching Zhen Hao, Rabia Hussain, Mohamed Faisal Abdul Hamid","doi":"10.1080/20523211.2024.2415425","DOIUrl":"10.1080/20523211.2024.2415425","url":null,"abstract":"<p><strong>Background: </strong>Dry powder inhalers (DPIs) are commonly used among patients with Chronic Obstructive Pulmonary Disease (COPD). These inhalers are breath-actuated, and require patients to generate sufficient peak inspiratory flow (PIF) to disaggregate the drug powder into respirable fine particles and deliver it to the lower airway tracts. Inhaler personalisation based on PIF among DPI users has not been studied in Malaysia, thus we conducted the present pilot study to determine the feasibility of conducting such research among COPD patients.</p><p><strong>Methods: </strong>This was an open-label pilot randomised control trial, conducted from June 2021-January 2022 at the respiratory clinic of Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia. Measurement of PIF was performed with In-Check DIAL G16 among adult COPD patients treated with DPI and had suboptimal PIF. Eligible subjects were randomised using block randomisation into two groups, either the interventional group or the control group.</p><p><strong>Results: </strong>Twenty-two COPD patients fulfilled the study criteria and were randomised to intervention (n = 11) and control (n = 11) groups. For the interventional group, there were statistically significant improvements between baseline and at 12 weeks for both FEV<sub>1</sub> and CAT scores. The mean (% predicted) FEV<sub>1</sub> were 54.6 ± 20.4% and 56.6 ± 19.8% (<i>p </i>= 0.026), pre-and post-intervention. The mean CAT score at baseline was 24.4 ± 5.8 and reduced to 19.6 ± 4.4 at 12 weeks (<i>p </i>= 0.012). For the control group, the mean (% predicted) FEV<sub>1</sub> at baseline was 58.0 ± 21.9% and 56.5 ± 20.7% at 12 weeks, with no statistical significance difference (<i>p </i>= 0.143). However, there was a statistically significant difference in CAT scores at baseline and 12 weeks, with a mean of 26.5 ± 6.1 and 23.3 ± 5.6, respectively (<i>p</i> = 0.010).</p><p><strong>Conclusion: </strong>The findings from the present pilot RCT highlighted that inhaler personalisation based on PIF among COPD patients was feasible and practical.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muna Barakat, Samar Thiab, Shaymaa B Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini
{"title":"Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication.","authors":"Muna Barakat, Samar Thiab, Shaymaa B Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini","doi":"10.1080/20523211.2024.2410199","DOIUrl":"10.1080/20523211.2024.2410199","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess medication adherence among Jordanian patients with dyslipidemia and evaluate the impact of health literacy, well-being, and doctor-patient communication on adherence in this population. Dyslipidemia is a prevalent condition that significantly increases the risk of cardiovascular diseases, and understanding the factors influencing medication adherence is crucial for improving patient outcomes.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted from March to July 2023. A convenience sample of adult Jordanians diagnosed with dyslipidemia was surveyed in a tertiary hospital using validated scales: the Lebanese Medication Adherence Scale-14 (LMAS-14), the Doctor-Patient Communication Scale (DPC), the WHO well-being index, and the health literacy scale. Bivariate analysis and linear regression models were employed to analyze associations.</p><p><strong>Results: </strong>Among 410 participants (mean age 58.62 ± 12.11 years), the mean scores were LMAS-14 (35.10), DPC (55.77), WHO well-being (47.53), and health literacy (38.96). Higher medication adherence was associated with older age (<i>B</i> = 0.093, <i>p</i> = 0.049), university education (<i>B</i> = 2.872, <i>p</i> = 0.017), prior surgery (<i>B</i> = 2.317, <i>p</i> = 0.021), medium income level (<i>B</i> = 3.605, <i>p</i> = 0.006), and better doctor-patient communication (<i>B</i> = 0.166, <i>p</i> = 0.003). Conversely, cigarette smoking (<i>B</i> = -3.854, <i>p</i> = 0.001) and health insurance (<i>B</i> = -2.146, <i>p</i> = 0.039) were linked to lower adherence.</p><p><strong>Conclusion: </strong>The findings underscore the substantial interplay of socio-demographic and clinical factors affecting medication adherence. Enhanced public health interventions focusing on improving health literacy, communication quality, and addressing socio-economic conditions are vital for better adherence and patient outcomes in Jordan.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Polypharmacy and potentially inappropriate medicine use in older adults with cancer: a multicenter cross-sectional study in Northwest Ethiopia oncologic centers.","authors":"Samuel Agegnew Wondm, Tilaye Arega Moges, Samuel Berihun Dagnew, Fisseha Nigussie Dagnew, Tirsit Ketsela Zeleke, Rahel Belete Abebe, Endalamaw Aschale Mihrete, Fasil Bayafers Tamene","doi":"10.1080/20523211.2024.2397797","DOIUrl":"10.1080/20523211.2024.2397797","url":null,"abstract":"<p><strong>Background: </strong>Most patients with cancer have comorbid conditions that necessitate advanced medical treatment. Polypharmacy (PP) and potentially inappropriate medicine (PIM) use is common among older adult patients with cancer. Not much research has been conducted on PP and PIM use among older adult patients with cancer in Ethiopian oncology centers. Therefore, this study aimed to evaluate the prevalence and determinants of PP and PIM use among older adults with cancer in Northwest Ethiopia oncology centers using the American Geriatrics Society (AGS) 2019 updated Beers criteria.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted among older adult patients with cancer from July 15-December 30, 2023 in Northwest Ethiopian oncology centers. The use of at least one drug included in the 2019 Beers criteria revisions was classified as potentially inappropriate medication use. To identify the factors influencing PP and PIM use, logistic regression analysis was performed.</p><p><strong>Results: </strong>Of the 310 samples aproched, 305(98.4% response rate) participated in the study. The prevalence of PP and PIM use were 70.2% (95% CI 64.9-75.1) and 63.0% (95% CI 57.4-68.8) respectively. Being female AOR:3.6; 95% CI:1.7-7.8; p = 0. 001, advanced age [(70-74 years) AOR:3.9; 95% CI:1.2-6.7; p = 0.046 and ≥75 years AOR:3.8; 95% CI:1.7-8.4; p = 0.0028], abnormal body weight (underweight AOR:5.5; 95% CI:1.5-9.6; p = 0.019, overweight AOR:5.1; 95% CI:1.5-7.3; p = 0.01 and obese AOR:5.6; 95% CI:1.5-9.3; p = 0.021) and comorbidities AOR:3.5; 95% CI:1.7-8.3; p = 0.0032 were statistically significant factors for PP. Advanced age [(70-74 years) AOR:5.5; 95% CI:1.4-9.8; p = 0.015 and ≥75 years AOR:3.3; 95% CI:1.5-7.1; p = 0.002)] and polypharmacy; AOR:7; 95% CI:3.4-9.4; p = 0.001 were statistically significant factors for PIM use.</p><p><strong>Conclusion: </strong>Polypharmacy and potentially inappropriate medicine use were prevalent among older adult patients with cancer. Ensuring safe medicines prescription practices for older patients with cancer requires understanding the issue, stopping unwarranted treatment, and replacing it with less toxic, age-appropriate medicines.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient preferences for the provision of NHS medicines helpline services: a discrete choice experiment.","authors":"Ben Ashby, Matthew D Jones","doi":"10.1080/20523211.2024.2404973","DOIUrl":"10.1080/20523211.2024.2404973","url":null,"abstract":"<p><strong>Introduction: </strong>Patient medicines helpline services (PMHS) can reduce harm and improve medicines adherence and patient satisfaction after hospital discharge. There is little evidence of which PMHS attributes are most important to patients. This would enable PMHS providers to prioritise their limited resources to maximise patient benefit.</p><p><strong>Methods: </strong>Patient preferences for PMHS attributes were measured using a discrete choice experiment. Seven attributes were identified from past research, documentary analysis and stakeholder consultation. These were used to produce a D-efficient design with two blocks of ten choice sets incorporated into an online survey. Adults in the UK who took more than one medicine were eligible to complete the survey and were recruited via the Research for the Future database. Preferences were estimated using conditional logistic regression. Associations between participant characteristics and preferences were investigated with latent class models.</p><p><strong>Results: </strong>460 participants completed the survey. The most valued attributes were weekend opening (willingness-to-pay, WTP: £11.20), evening opening (WTP: £8.89), and receiving an answer on the same day (WTP: £9.27). Alternative contact methods, immediate contact with a pharmacist and helpline location were valued less. Female gender and full-time work were associated with variation in preferences. For one latent class containing 27% of participants, PMHS location at the patient's hospital was the most valued attribute.</p><p><strong>Discussion: </strong>PMHS providers should prioritise extended opening hours and answering questions on the same day. Limitations include a non-representative sample in terms of ethnicity, education and geography, and the exclusion of people without internet access.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Norazida Ab Rahman, Ee Vien Low, Audrey Huili Lim, Azzy Iyzati Ahmad Shanizza, See Wan Ho, Mardhiyah Kamal, Abdul Haniff Mohamad Yahaya, Sheamini Sivasampu
{"title":"Trends in medicine utilisation in public and private healthcare facilities before and during COVID-19: a nationwide analysis of medicine procurement and sales data, 2018-2022.","authors":"Norazida Ab Rahman, Ee Vien Low, Audrey Huili Lim, Azzy Iyzati Ahmad Shanizza, See Wan Ho, Mardhiyah Kamal, Abdul Haniff Mohamad Yahaya, Sheamini Sivasampu","doi":"10.1080/20523211.2024.2401468","DOIUrl":"https://doi.org/10.1080/20523211.2024.2401468","url":null,"abstract":"<p><strong>Background: </strong>There was a fluctuation in medication demand and supply during COVID-19 pandemic. This study aimed to assess the trend of drug utilisation in Malaysia in 2018-2022 and evaluate the impact of COVID-19 on drug utilisation rates.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional study of pharmaceutical sales data from public and private sectors in Malaysia from 2018 to 2022. Drug utilisation rates for the period after the onset of COVID-19 (2020-2022) was compared with the earlier period (2018-2019). Interrupted time-series regression analyses evaluated level and slope changes compared to pre-COVID-19 pandemic level for quarterly rates of drugs utilisation in public and private sectors.</p><p><strong>Results: </strong>There was an immediate reduction in the utilisation rates for all drugs after COVID-19 in public (-20.4%; <i>p</i> = 0.043) and private sectors (-22.4%; <i>p</i> = 0.003). In both sectors, significant level changes were observed for anti-infectives, musculoskeletal, neurological, respiratory, and sensory organs preparations following COVID-19 pandemic, followed by a sustained increase in trend from 2020 to 2022. Public sector had a 22.2% reduction in the utilisation of cardiovascular drugs (<i>p</i> = 0.002), particularly for renin-angiotensin system (RAS) agents (-47.4%, <i>p</i> = 0.019). Private sector had large changes for anti-infectives (-53.6%, <i>p</i> < 0.001) and neurological drugs (-51.4%, <i>p</i> < 0.001), driven by an immediate level reduction in antibacterials (-54.2%, <i>p</i> < 0.001) and cough and cold preparations (-59.2%, <i>p</i> < 0.001). Classes with agents used for COVID-19 treatment, such as systemic corticosteroids, antibiotics, and antivirals had an increasing trend between April 2020 and December 2022, although some slope changes were not statistically significant.</p><p><strong>Conclusion: </strong>A significant reduction in the overall drug utilisation rates was observed in the public and private sectors in Malaysia as an immediate impact of the COVID-19 pandemic in 2020. The impacts varied by therapeutic class and health sector. This finding provides an understanding of the changing patterns of drug utilisation that were affected by disease outbreaks for future planning of pandemic preparedness.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacists' interventions on prescribing errors in Malaysia.","authors":"Zhi Shan Sujata Tan, Siok Yee Chan, Siew Chin Ong","doi":"10.1080/20523211.2024.2404974","DOIUrl":"https://doi.org/10.1080/20523211.2024.2404974","url":null,"abstract":"<p><strong>Background: </strong>Prescribing errors (PEs) cause significant avoidable harm globally. In Malaysia, despite the prevalence of PEs in government healthcare facilities, there is limited research on how pharmacist staffing levels influence intervention frequency and effectiveness. This study aims to address this gap by analysing intervention trends and assessing their association with staffing levels, highlighting the correlation between increased pharmacist presence and the frequency of interventions.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analysed data from the Ministry of Health's Pharmacy Management Form and the Pharmacy Board Registry from 2017 to 2019. Multivariate regression and two-way ANOVA assessed the association between the number of pharmacists, total prescriptions, and interventions on PEs in Health Clinic Outpatient Pharmacy, Hospital Outpatient Pharmacy, and Hospital Inpatient Pharmacy settings.</p><p><strong>Results: </strong>Annually, pharmacists intervened in approximately 1.8% of total prescriptions, with the most common errors being wrong dose, wrong medication, and wrong dosing frequency. These interventions were consistent across all settings, highlighting the uniformity in pharmacists' approach to managing PEs. The regression analysis revealed a significant positive correlation between the number of pharmacists, total prescriptions, and interventions on PEs, with an adjusted R-squared value of 0.899. Both the number of pharmacists and total prescriptions received were positively significant (<i>p</i> < 0.05), indicating that increased pharmacist presence strongly correlates with intervention frequency. No statistically significant differences were observed in intervention rates across different settings and severity levels, suggesting that pharmacists consistently provide effective interventions irrespective of the clinical context.</p><p><strong>Conclusion: </strong>In conclusion, this study confirms that increasing the number of pharmacists and total prescriptions received are critical predictors of interventions on PEs in Malaysia. It underscores the vital role of pharmacists in enhancing patient safety and healthcare quality, demonstrating their effectiveness in diverse settings and their adaptability to various patient needs and challenges.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}