Pub Date : 2023-11-23DOI: 10.21315/mjps2023.21.2.3
Mohd Shainol Azmar Kassim, Soo Pei Pei
Pharmacists can contribute to the improvement in diabetes management and help patients recognise and manage barriers to optimal medication adherence. Home medication review (HMR) services provided by pharmacists could also assist patients in minimising drugrelated problems. This systematic review aimed to evaluate and summarise evidence from recent literature on the effectiveness of pharmacist-led home medication review interventions to improve medication adherence in adult type-2 diabetes mellitus (T2DM) patients. Primary research articles published in English from 1st January 2012 to 31st May 2022, were retrieved from five online electronic databases (MEDLINE, Embase, Scopus, Cochrane Reviews and the Web of Science). The methodological quality of all included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists. The literature search identified 2,178 publications; only four were included in this review. All four studies found that pharmacist-led HMR was associated with significant positive changes in the patient’s medication adherence. Significant improvements were demonstrated either through self-reported medication adherence assessment questionnaires or the pill counting adherence ratio before and after HMR visits. There was evidence of statistically significant effectiveness of pharmacist-led HMR initiatives to improve patient adherence to medication among adult T2DM patients.
{"title":"SYSTEMATIC REVIEW OF PHARMACIST-LED HOME MEDICATION REVIEWS TO IMPROVE ADHERENCE TO ANTIDIABETIC MEDICATIONS AMONG ADULT TYPE 2 DIABETES PATIENTS","authors":"Mohd Shainol Azmar Kassim, Soo Pei Pei","doi":"10.21315/mjps2023.21.2.3","DOIUrl":"https://doi.org/10.21315/mjps2023.21.2.3","url":null,"abstract":"Pharmacists can contribute to the improvement in diabetes management and help patients recognise and manage barriers to optimal medication adherence. Home medication review (HMR) services provided by pharmacists could also assist patients in minimising drugrelated problems. This systematic review aimed to evaluate and summarise evidence from recent literature on the effectiveness of pharmacist-led home medication review interventions to improve medication adherence in adult type-2 diabetes mellitus (T2DM) patients. Primary research articles published in English from 1st January 2012 to 31st May 2022, were retrieved from five online electronic databases (MEDLINE, Embase, Scopus, Cochrane Reviews and the Web of Science). The methodological quality of all included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists. The literature search identified 2,178 publications; only four were included in this review. All four studies found that pharmacist-led HMR was associated with significant positive changes in the patient’s medication adherence. Significant improvements were demonstrated either through self-reported medication adherence assessment questionnaires or the pill counting adherence ratio before and after HMR visits. There was evidence of statistically significant effectiveness of pharmacist-led HMR initiatives to improve patient adherence to medication among adult T2DM patients.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.21315/mjps2023.21.2.2
Y. Oseni, W. Erhun
A recent baseline study showed that community pharmacists’ involvement in HIV/AIDS services in Oyo State, Nigeria was low while respondents showed willingness to participate in training to improve services. This study assessed the training programme delivered to same respondents with the aim of improving HIV/AIDS services at the pharmacies. A one-day training was developed and delivered to 70 selected community pharmacists in Oyo State, Nigeria. Semi-structured questionnaire on a 5-point Likert scale was administered to the respondents to assess their opinion on the training, evaluate the resource persons and perceive sufficiency of the training to provide services. Data were analysed using IBM SPSS version 21.0 with descriptive statistics while open-ended responses were thematically analysed. Response rate was 71.4%. The mean score of participants’ opinion on the training program based on 10 indicators identified was 45.98 ± 5.177 (range of 10–50; midpoint 30). Lowest (21.21 ± 3.168) and highest (23.46 ± 2.510) scores were obtained (range 5–25; midpoint 15) based on the lecture presentation using 5-item measures for the resource persons. All the respondents agreed that the training will be sufficient to carry out the HIV/ AIDS services in their premises. Community pharmacists were satisfied with the training delivered, the resource persons were competent to deliver the training and that the training will be sufficient to deliver HIV/AIDS services in their pharmacies. Further study will evaluate the effect of the training on the HIV/AIDS services delivered by community pharmacists using the same participants.
{"title":"DELIVERY OF TRAINING IN HIV/AIDS SERVICES AMONG COMMUNITY PHARMACISTS IN OYO STATE, NIGERIA: AN INTERVENTIONAL STUDY","authors":"Y. Oseni, W. Erhun","doi":"10.21315/mjps2023.21.2.2","DOIUrl":"https://doi.org/10.21315/mjps2023.21.2.2","url":null,"abstract":"A recent baseline study showed that community pharmacists’ involvement in HIV/AIDS services in Oyo State, Nigeria was low while respondents showed willingness to participate in training to improve services. This study assessed the training programme delivered to same respondents with the aim of improving HIV/AIDS services at the pharmacies. A one-day training was developed and delivered to 70 selected community pharmacists in Oyo State, Nigeria. Semi-structured questionnaire on a 5-point Likert scale was administered to the respondents to assess their opinion on the training, evaluate the resource persons and perceive sufficiency of the training to provide services. Data were analysed using IBM SPSS version 21.0 with descriptive statistics while open-ended responses were thematically analysed. Response rate was 71.4%. The mean score of participants’ opinion on the training program based on 10 indicators identified was 45.98 ± 5.177 (range of 10–50; midpoint 30). Lowest (21.21 ± 3.168) and highest (23.46 ± 2.510) scores were obtained (range 5–25; midpoint 15) based on the lecture presentation using 5-item measures for the resource persons. All the respondents agreed that the training will be sufficient to carry out the HIV/ AIDS services in their premises. Community pharmacists were satisfied with the training delivered, the resource persons were competent to deliver the training and that the training will be sufficient to deliver HIV/AIDS services in their pharmacies. Further study will evaluate the effect of the training on the HIV/AIDS services delivered by community pharmacists using the same participants.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139243967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.21315/mjps2023.21.2.4
Vandana Gupta
Lipids have been extensively used as main ingredients in various drug delivery systems, such as liposomes, solid lipid nanoparticles, nanostructured lipid carriers and lipid-based lyotropic liquid crystals. Over the past few years, lipid-based lyotropic, bicontinuous cubic phase liquid crystals have been investigated for their applicability to controlled delivery of active ingredients. Lipid-based lyotropic liquid crystals have highly ordered, thermodynamically stable internal nanostructure, thereby offering the potential as a sustained drug release matrix. The emulsification of cubic lipid phases in water results in the production of cubosomes that can be defined as nanoparticulate disperse systems characterised by high biocompatibility and bioadhesivity. The unique microstructure of cubosomes have the potentials to control the release of active ingredients, improve drug bioavailability and reduce toxicity, enhance the stability of drugs and to increase the penetrability of drug after topical application. This reflection will provide an overview of the lipids used to prepare cubic phase at physiological temperature, as well as the influencing factors on the phase transition of liquid crystals. In particular, the most current research progresses on cubic phase as drug delivery systems and its applications will be discussed. It might act as smart lipid nanoparticles for drug delivery.
{"title":"AN OVERVIEW ON CUBOSOMES AS REMARKABLE NANOCARRIER FOR DRUG DELIVERY","authors":"Vandana Gupta","doi":"10.21315/mjps2023.21.2.4","DOIUrl":"https://doi.org/10.21315/mjps2023.21.2.4","url":null,"abstract":"Lipids have been extensively used as main ingredients in various drug delivery systems, such as liposomes, solid lipid nanoparticles, nanostructured lipid carriers and lipid-based lyotropic liquid crystals. Over the past few years, lipid-based lyotropic, bicontinuous cubic phase liquid crystals have been investigated for their applicability to controlled delivery of active ingredients. Lipid-based lyotropic liquid crystals have highly ordered, thermodynamically stable internal nanostructure, thereby offering the potential as a sustained drug release matrix. The emulsification of cubic lipid phases in water results in the production of cubosomes that can be defined as nanoparticulate disperse systems characterised by high biocompatibility and bioadhesivity. The unique microstructure of cubosomes have the potentials to control the release of active ingredients, improve drug bioavailability and reduce toxicity, enhance the stability of drugs and to increase the penetrability of drug after topical application. This reflection will provide an overview of the lipids used to prepare cubic phase at physiological temperature, as well as the influencing factors on the phase transition of liquid crystals. In particular, the most current research progresses on cubic phase as drug delivery systems and its applications will be discussed. It might act as smart lipid nanoparticles for drug delivery.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.21315/mjps2023.21.2.1
P. Lim, T. Wong, Yen Li Lim, Shueh Lin Lim, C. Lee
The impact of a pharmacist-managed insulin titration has never been systematically assessed among patients with diabetes. This study aimed to evaluate the impact of pharmacist-managed insulin titration on glycaemic control, total daily insulin dose, hypoglycaemia, hunger and body weight. Data was collected retrospectively from patients treated with insulin under the care of a pharmacist-managed insulin titration programme at the Diabetes and Endocrine Clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia. Patients who followed-up with pharmacists at one month to two months intervals and completed at least eight visits were included. Ninety-one patients (59.3% male) aged 50.82 ± 17.63 years old with 13.38 ± 8.88 years of diabetes were evaluated. Glycaemic control improved significantly from baseline to 4th month (–1.19%, p < 0.001) and 8th month (–1.37%, p < 0.001). Majority of patients were on twice daily premixed insulin (44.0%) followed by basal insulin (28.5%), basal bolus (18.7%) and thrice daily premixed insulin (8.8%). Total daily insulin dose increased significantly from baseline to 8th month among patients on basal insulin (0.24 ± 0.15 versus 0.29 ± 0.18 units/kg/day, p = 0.008) whereas the opposite was seen in patients treated fully on insulin (1.06 ± 0.48 units/kg/day versus 0.96 ± 0.37 units/kg/day, p = 0.005). Total hypoglycaemia and hunger episodes reduced significantly from 160 episodes/month to 30 episodes/month, p = 0.001 and 39 cases/month to 5 cases/ month, p < 0.001, respectively, across all groups. Mean weight increased by 0.66 kg from baseline to 8th month, p = 0.045. Insulin dose had a positive correlation to hypoglycaemia, r = 0.338, p = 0.001. Pharmacist-managed insulin titration programme significantly improved glycaemic control and reduced hypoglycaemia occurrences.
{"title":"GLYCAEMIC CONTROL AND HYPOGLYCAEMIA AMONG PATIENTS WITH DIABETES IN A PHARMACIST-MANAGED INSULIN TITRATION PROGRAMME","authors":"P. Lim, T. Wong, Yen Li Lim, Shueh Lin Lim, C. Lee","doi":"10.21315/mjps2023.21.2.1","DOIUrl":"https://doi.org/10.21315/mjps2023.21.2.1","url":null,"abstract":"The impact of a pharmacist-managed insulin titration has never been systematically assessed among patients with diabetes. This study aimed to evaluate the impact of pharmacist-managed insulin titration on glycaemic control, total daily insulin dose, hypoglycaemia, hunger and body weight. Data was collected retrospectively from patients treated with insulin under the care of a pharmacist-managed insulin titration programme at the Diabetes and Endocrine Clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia. Patients who followed-up with pharmacists at one month to two months intervals and completed at least eight visits were included. Ninety-one patients (59.3% male) aged 50.82 ± 17.63 years old with 13.38 ± 8.88 years of diabetes were evaluated. Glycaemic control improved significantly from baseline to 4th month (–1.19%, p < 0.001) and 8th month (–1.37%, p < 0.001). Majority of patients were on twice daily premixed insulin (44.0%) followed by basal insulin (28.5%), basal bolus (18.7%) and thrice daily premixed insulin (8.8%). Total daily insulin dose increased significantly from baseline to 8th month among patients on basal insulin (0.24 ± 0.15 versus 0.29 ± 0.18 units/kg/day, p = 0.008) whereas the opposite was seen in patients treated fully on insulin (1.06 ± 0.48 units/kg/day versus 0.96 ± 0.37 units/kg/day, p = 0.005). Total hypoglycaemia and hunger episodes reduced significantly from 160 episodes/month to 30 episodes/month, p = 0.001 and 39 cases/month to 5 cases/ month, p < 0.001, respectively, across all groups. Mean weight increased by 0.66 kg from baseline to 8th month, p = 0.045. Insulin dose had a positive correlation to hypoglycaemia, r = 0.338, p = 0.001. Pharmacist-managed insulin titration programme significantly improved glycaemic control and reduced hypoglycaemia occurrences.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps2023.21.1.6
C. Chong, Melissa Mohammad Hirman
This study aims to evaluate the Malaysian hospital physicians’ practices of intravenous potassium chloride in the treatment of hypokalaemia and their opinions on using premixed formulation. This was a nationwide online survey using a self-administered questionnaire. The survey link was sent to the practising hospital physicians in Malaysia through email (n = 1,455), Facebook Messenger (n = 2,734) and posted on Facebook as well. A total of 207 responses were received. The physicians were mostly males (63.8%), aged between 30 years old–39 years old (51.2%) and worked in the government sectors (76.8%). The most preferred dosage of potassium chloride for mild, moderate and severe hypokalaemia was 10 mmol (44.4%), 20 mmol (55.1%) and 30 mmol (37.7%), respectively. The mostly chosen infusion rate of potassium chloride for mild hypokalaemia was over 24 h (41.1%) while for both moderate and severe hypokalaemia were over 1 h–2 h (63.8% and 89.9%, respectively). The concentration of intravenous potassium chloride is the main factor (68.1%) which would influence the infusion route choice. Serum potassium monitoring of every 24 h was chosen by 52.7% of the respondents for mild hypokalaemia while every 1 h–2 h was mostly chosen for moderate and severe hypokalaemia (49.3% and 87.4%, respectively). Cardiac monitoring was mostly opted in severe hypokalaemic patients (70.0%). Majority of physicians agreed that a premixed formulation is easier to administer (64.7%) and safer for the patients (51.7%). In conclusion, there were variations in the prescribing practices among Malaysian physicians to treat hypokalaemia. Most physicians were in favour of premixed formulation.
本研究旨在评估马来西亚医院医生静脉注射氯化钾治疗低钾血症的做法，以及他们对使用预混制剂的意见。这是一项全国性的在线调查，使用的是一份自我管理的问卷。调查链接通过电子邮件(n = 1,455)和Facebook Messenger (n = 2,734)发送给马来西亚的执业医院医生，并在Facebook上发布。我们共收到207份回应。医生以男性居多(63.8%)，年龄介乎30至39岁(51.2%)，在政府部门工作(76.8%)。轻度、中度和重度低钾血症患者首选氯化钾剂量分别为10 mmol(44.4%)、20 mmol(55.1%)和30 mmol(37.7%)。轻度低钾血症患者首选氯化钾输注时间超过24 h(41.1%)，中度和重度低钾血症患者均选择输注时间超过1 h - 2 h(63.8%和89.9%)。静脉氯化钾浓度是影响输注途径选择的主要因素(68.1%)。对于轻度低钾血症，52.7%的受访者选择每24 h监测一次血钾，而对于中度和重度低钾血症，大多选择每1 h - 2 h监测一次(分别为49.3%和87.4%)。重度低钾血症患者多采用心脏监护(70.0%)。大多数医生认为预混制剂更容易管理(64.7%)，对患者更安全(51.7%)。总之，马来西亚医生在治疗低钾血症的处方实践中存在差异。大多数医生赞成预混配方。
{"title":"A Nationwide Survey on Malaysian Hospital Physicians’ Practices of Intravenous Potassium Chloride Supplementation and Opinions on Premixed Formulation in the Treatment of Hypokalaemia","authors":"C. Chong, Melissa Mohammad Hirman","doi":"10.21315/mjps2023.21.1.6","DOIUrl":"https://doi.org/10.21315/mjps2023.21.1.6","url":null,"abstract":"This study aims to evaluate the Malaysian hospital physicians’ practices of intravenous potassium chloride in the treatment of hypokalaemia and their opinions on using premixed formulation. This was a nationwide online survey using a self-administered questionnaire. The survey link was sent to the practising hospital physicians in Malaysia through email (n = 1,455), Facebook Messenger (n = 2,734) and posted on Facebook as well. A total of 207 responses were received. The physicians were mostly males (63.8%), aged between 30 years old–39 years old (51.2%) and worked in the government sectors (76.8%). The most preferred dosage of potassium chloride for mild, moderate and severe hypokalaemia was 10 mmol (44.4%), 20 mmol (55.1%) and 30 mmol (37.7%), respectively. The mostly chosen infusion rate of potassium chloride for mild hypokalaemia was over 24 h (41.1%) while for both moderate and severe hypokalaemia were over 1 h–2 h (63.8% and 89.9%, respectively). The concentration of intravenous potassium chloride is the main factor (68.1%) which would influence the infusion route choice. Serum potassium monitoring of every 24 h was chosen by 52.7% of the respondents for mild hypokalaemia while every 1 h–2 h was mostly chosen for moderate and severe hypokalaemia (49.3% and 87.4%, respectively). Cardiac monitoring was mostly opted in severe hypokalaemic patients (70.0%). Majority of physicians agreed that a premixed formulation is easier to administer (64.7%) and safer for the patients (51.7%). In conclusion, there were variations in the prescribing practices among Malaysian physicians to treat hypokalaemia. Most physicians were in favour of premixed formulation.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41524122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps2023.21.1.4
Aduke Elizabeth Ipingbem, W. Erhun, R. Adisa
The study aimed at estimating the cost of hospitalisation associated with medication non-adherence (MNA) among hypertensive in-patients in a tertiary healthcare facility in southwestern Nigeria. It involved a cross-sectional retrospective review of 322 medical records of hypertensive in-patients at the University College Hospital between 2013 and 2015. Physician’s documentation of MNA in the patients’ medical records prior to admission determined the eligibility into the study. Direct medical costs mainly consultation, medications, laboratory costs for individual patients during hospitalisation were calculated using out-of-pocket payer’s perspective approach. Data were summarised with descriptive statistics, Pearson’s product moment correlation coefficient was used to determine relationship between length of stay in hospital, cost of management and number of comorbidities at p < 0.05 considered statistically significant. Of the 322 medical records of hypertensive in-patients evaluated within the 3-year study period, 230 (71.4%) had a documentation of MNA. The average age was 55.9 ± 15.7 years old. Artisans/self-employed (n = 82; 35.7%) and petty traders (n = 61; 26.5%) made up the majority of the patients. The total cost of hospitalisation for the period studied was USD100,461.40 for all the patients, with an average of USD52.00 ± 28.10/patient/day, more than a quarter of which was spent on pharmaceuticals. Similarly, the costs of management also increased with increase in length of hospitalisation (Pearson’s product moment correlation r = 0.539, p = 0.000). The number of comorbid diseases increased the length of hospitalisation (r = 0.133, p = 0.044). Cost associated with hospitalisation in relation to MNA is high among the studied participants. There is a need to develop strategies to enhance medication adherence among patients with hypertension.
该研究旨在估计尼日利亚西南部一家三级医疗机构中高血压住院患者与药物依从性(MNA)相关的住院费用。该研究对2013年至2015年间大学学院医院322例高血压住院患者的病历进行了横断面回顾性分析。医生在患者入院前的医疗记录中记录的MNA决定了是否有资格进入研究。直接医疗费用，主要是个别患者住院期间的咨询、药物、化验费，采用自付视角计算。采用描述性统计对资料进行汇总，采用Pearson积差相关系数确定住院时间、管理费用和合并症数量之间的关系，p < 0.05认为有统计学意义。在3年研究期间评估的322例高血压住院患者的医疗记录中，230例(71.4%)有MNA的记录。平均年龄55.9±15.7岁。工匠/自雇人士(82名;35.7%)和小商贩(n = 61;26.5%)占多数。在研究期间，所有患者的住院总费用为100,461.40美元，平均为52.00±28.10美元/患者/天，其中超过四分之一用于药物。同样，管理费用也随着住院时间的增加而增加(Pearson积差相关r = 0.539, p = 0.000)。合并症的数量增加了住院时间(r = 0.133, p = 0.044)。与MNA相关的住院费用在研究参与者中较高。有必要制定策略，以提高高血压患者的药物依从性。
{"title":"Medication Non-Adherence and Cost Associated with Hospitalisation of Hypertensive In-Patients in a Tertiary Hospital, Southwestern Nigeria","authors":"Aduke Elizabeth Ipingbem, W. Erhun, R. Adisa","doi":"10.21315/mjps2023.21.1.4","DOIUrl":"https://doi.org/10.21315/mjps2023.21.1.4","url":null,"abstract":"The study aimed at estimating the cost of hospitalisation associated with medication non-adherence (MNA) among hypertensive in-patients in a tertiary healthcare facility in southwestern Nigeria. It involved a cross-sectional retrospective review of 322 medical records of hypertensive in-patients at the University College Hospital between 2013 and 2015. Physician’s documentation of MNA in the patients’ medical records prior to admission determined the eligibility into the study. Direct medical costs mainly consultation, medications, laboratory costs for individual patients during hospitalisation were calculated using out-of-pocket payer’s perspective approach. Data were summarised with descriptive statistics, Pearson’s product moment correlation coefficient was used to determine relationship between length of stay in hospital, cost of management and number of comorbidities at p < 0.05 considered statistically significant. Of the 322 medical records of hypertensive in-patients evaluated within the 3-year study period, 230 (71.4%) had a documentation of MNA. The average age was 55.9 ± 15.7 years old. Artisans/self-employed (n = 82; 35.7%) and petty traders (n = 61; 26.5%) made up the majority of the patients. The total cost of hospitalisation for the period studied was USD100,461.40 for all the patients, with an average of USD52.00 ± 28.10/patient/day, more than a quarter of which was spent on pharmaceuticals. Similarly, the costs of management also increased with increase in length of hospitalisation (Pearson’s product moment correlation r = 0.539, p = 0.000). The number of comorbid diseases increased the length of hospitalisation (r = 0.133, p = 0.044). Cost associated with hospitalisation in relation to MNA is high among the studied participants. There is a need to develop strategies to enhance medication adherence among patients with hypertension.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43333113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps20223.21.1.2
Mubarak O. Ameen, Adelaja A. Akinlolu
Moringa oleifera (MO) and Musa sapientum (MS) are ethno-medicinal plants, while cadmium is a carcinogen. SARS-CoV-2 binds to ACE2 for host’s cell invasion and infection. This study evaluated the effects of MO11 (isolated from MO leaves) and MS06 (isolated from MS suckers) on ACE2 levels in cadmium chloride (CdCl)-induced toxicity in rats. Twentyfour adult male Wistar rats were randomly divided into six groups (n = 4). Group 1 was control. Groups 2–4 received single 1.5 mg/kg bodyweight of CdCl (i.p.) (Day 1). Groups 3 and 4 were post-treated with MO11 and MO11 + MS06 doses, respectively (Days 1–17). Groups 5 and 6 received only MO11 and olive oil (vehicle), respectively (Days 1–17). MO leaves and MS suckers were subjected to bioassay-guided fractionation and isolation procedures using chromatography and spectroscopic techniques. ACE2 levels (ELISA) were evaluated in blood, kidney and liver of rats. MO11 and MS06 were the most active antioxidant and antimicrobial compounds isolated from MO leaves and MS suckers, respectively. Liquid chromatography-mass spectrometry showed presence of therapeutic compounds and amino-acids in MO11 and MS06, which are part of 14 shared amino-acids used by SARS-CoV and SARS-CoV-2 for ACE2-binding. Post-treatments of CdCl-exposure with MO11 and MS06 showed decreased ACE2 levels in Group 4 (20.63 ± 4.33 ng/mL and 16.11 ± 0.49 ng/mL in blood and kidney samples, respectively), compared with Group 2 (39.39 ± 3.15 ng/mL and 85.39 ± 3.10 ng/mL in blood and kidney samples, respectively). In conclusion, MO11 and MS06 possess significant ethno-medicinal potentials, may compete with SARS-CoV-2 for ACE2 binding, and are recommended for evaluations as anti-SARS-CoV-2 agents.
{"title":"Chromatography-Spectroscopic Isolated MO11 (Moringa oleifera) and MS06 (Musa sapientum) Positively Immunomodulated ACE2 Levels in Blood, Kidney and Liver of Rats","authors":"Mubarak O. Ameen, Adelaja A. Akinlolu","doi":"10.21315/mjps20223.21.1.2","DOIUrl":"https://doi.org/10.21315/mjps20223.21.1.2","url":null,"abstract":"Moringa oleifera (MO) and Musa sapientum (MS) are ethno-medicinal plants, while cadmium is a carcinogen. SARS-CoV-2 binds to ACE2 for host’s cell invasion and infection. This study evaluated the effects of MO11 (isolated from MO leaves) and MS06 (isolated from MS suckers) on ACE2 levels in cadmium chloride (CdCl)-induced toxicity in rats. Twentyfour adult male Wistar rats were randomly divided into six groups (n = 4). Group 1 was control. Groups 2–4 received single 1.5 mg/kg bodyweight of CdCl (i.p.) (Day 1). Groups 3 and 4 were post-treated with MO11 and MO11 + MS06 doses, respectively (Days 1–17). Groups 5 and 6 received only MO11 and olive oil (vehicle), respectively (Days 1–17). MO leaves and MS suckers were subjected to bioassay-guided fractionation and isolation procedures using chromatography and spectroscopic techniques. ACE2 levels (ELISA) were evaluated in blood, kidney and liver of rats. MO11 and MS06 were the most active antioxidant and antimicrobial compounds isolated from MO leaves and MS suckers, respectively. Liquid chromatography-mass spectrometry showed presence of therapeutic compounds and amino-acids in MO11 and MS06, which are part of 14 shared amino-acids used by SARS-CoV and SARS-CoV-2 for ACE2-binding. Post-treatments of CdCl-exposure with MO11 and MS06 showed decreased ACE2 levels in Group 4 (20.63 ± 4.33 ng/mL and 16.11 ± 0.49 ng/mL in blood and kidney samples, respectively), compared with Group 2 (39.39 ± 3.15 ng/mL and 85.39 ± 3.10 ng/mL in blood and kidney samples, respectively). In conclusion, MO11 and MS06 possess significant ethno-medicinal potentials, may compete with SARS-CoV-2 for ACE2 binding, and are recommended for evaluations as anti-SARS-CoV-2 agents.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49659689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps2023.21.1.8
A. A. Aje, Taiwo Abiola Adekunle
This study evaluated the impact of an educational intervention on knowledge and counseling on metered-dose inhalers (MDIs) and nebulisers among community pharmacists in Ibadan, Nigeria. A validated semi-structured questionnaire was utilised for data collection on study participants’ baseline knowledge and counseling on the selected asthma medication devices. The community pharmacists were randomised into control and intervention groups. An online educational intervention was carried out among pharmacists in the intervention group. The intervention comprised updates on basic information vis-à-vis knowledge and patient counseling on MDIs and nebulisers. A post-intervention assessment was carried out a month later to evaluate the impact of the intervention. Data was summarised using descriptive and inferential statistics, with level of significance set as p < 0.05. Response rate was 77.2% (112/145). Study findings showed significant improvement on knowledge and counseling among the community pharmacists in the intervention group, postintervention. Pharmacists’ knowledge of MDIs and nebulisers (control versus intervention) was comparable at baseline (5.83 ± 2.46 versus 6.34 ± 2.16) but significantly different postintervention (5.87 ± 2.34 versus 7.10 ± 2.21). Similarly, pharmacists’ counselling on asthma medication devices was comparable at baseline (3.59 ± 2.54 versus 3.63 ± 1.83) but significantly different postintervention (3.35 ± 3.13 versus 7.93 ± 2.58). Work experience as community pharmacists did not influence participants’ knowledge and counseling on MDIs and nebulisers. The educational intervention significantly improved knowledge and counseling on MDIs and nebulisers among community pharmacists in Ibadan, Nigeria. There is need for regular educational updates to improve the quality of care offered by community pharmacists.
本研究评估了教育干预对尼日利亚伊巴丹社区药剂师对计量吸入器(MDIs)和雾化器的知识和咨询的影响。一份经过验证的半结构化问卷用于收集研究参与者对所选哮喘药物装置的基线知识和咨询的数据。将社区药师随机分为对照组和干预组。对干预组药师进行在线教育干预。干预措施包括更新基本信息，如-à-vis知识和对吸入吸入器和雾化器的患者咨询。一个月后进行干预后评估，以评估干预的影响。数据汇总采用描述性统计和推理统计，显著性水平设置为p < 0.05。有效率为77.2%(112/145)。研究发现，干预组社区药师的知识和咨询在干预后有显著改善。基线时，对照与干预组药师对MDIs和雾化器的了解程度相当(5.83±2.46 vs 6.34±2.16)，但干预后差异显著(5.87±2.34 vs 7.10±2.21)。同样，药师对哮喘药物装置的咨询在基线时具有可比性(3.59±2.54 vs 3.63±1.83)，但干预后差异显著(3.35±3.13 vs 7.93±2.58)。作为社区药剂师的工作经验不影响参与者对MDIs和雾化器的知识和咨询。教育干预显著提高了尼日利亚伊巴丹社区药剂师对计量吸入器和雾化器的了解和咨询。有必要定期更新教育，以提高社区药剂师提供的护理质量。
{"title":"Evaluation of Knowledge and Counseling on Metered-Dose Inhalers and Nebulisers among Community Pharmacists in Ibadan - An Intervention Study","authors":"A. A. Aje, Taiwo Abiola Adekunle","doi":"10.21315/mjps2023.21.1.8","DOIUrl":"https://doi.org/10.21315/mjps2023.21.1.8","url":null,"abstract":"This study evaluated the impact of an educational intervention on knowledge and counseling on metered-dose inhalers (MDIs) and nebulisers among community pharmacists in Ibadan, Nigeria. A validated semi-structured questionnaire was utilised for data collection on study participants’ baseline knowledge and counseling on the selected asthma medication devices. The community pharmacists were randomised into control and intervention groups. An online educational intervention was carried out among pharmacists in the intervention group. The intervention comprised updates on basic information vis-à-vis knowledge and patient counseling on MDIs and nebulisers. A post-intervention assessment was carried out a month later to evaluate the impact of the intervention. Data was summarised using descriptive and inferential statistics, with level of significance set as p < 0.05. Response rate was 77.2% (112/145). Study findings showed significant improvement on knowledge and counseling among the community pharmacists in the intervention group, postintervention. Pharmacists’ knowledge of MDIs and nebulisers (control versus intervention) was comparable at baseline (5.83 ± 2.46 versus 6.34 ± 2.16) but significantly different postintervention (5.87 ± 2.34 versus 7.10 ± 2.21). Similarly, pharmacists’ counselling on asthma medication devices was comparable at baseline (3.59 ± 2.54 versus 3.63 ± 1.83) but significantly different postintervention (3.35 ± 3.13 versus 7.93 ± 2.58). Work experience as community pharmacists did not influence participants’ knowledge and counseling on MDIs and nebulisers. The educational intervention significantly improved knowledge and counseling on MDIs and nebulisers among community pharmacists in Ibadan, Nigeria. There is need for regular educational updates to improve the quality of care offered by community pharmacists.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46548203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps2023.21.1.7
Yohanah Dauda Yerima, A. Isah, A. Oyi, Aliyu Muhammad Musa, Y. Apeji
The aim of this study was to evaluate the direct compression properties of a novel coprocessed excipient (CPE) generated by processing cow bone powder (CBP), maize starch (MS) and Khaya gum (KG) together to form a single composite excipient. Design of experiments (DoE) was employed to optimise the formulation of CPE. CPE was prepared by wet granulation using the optimised formulation of CBP (40%), MS (40%) and KG (20%) as recommended by DoE. Assessment of the organoleptic properties of CPE revealed an odourless, tasteless and coarse texture with a neutral pH of 7.3. CPE was found to be partly crystalline and partly amorphous and demonstrated compatibility between the three components of the formulation. The material in terms of flowability compared well with the flow parameters of StarLac, a reference co-processed excipient. Tablets of diclofenac produced by direct compression using CPE as the directly compressible excipient compared well with the hardness and disintegration time of tablets made using StarLac® as the directly compressible excipient. The study’s outcome shows that CPE can be used as a direct compression excipient in the formulation of tablets by direct compression.
{"title":"Direct Compression Properties of Co-Processed Excipient Containing Cow Bone Powder, Khaya Gum and Maize Starch","authors":"Yohanah Dauda Yerima, A. Isah, A. Oyi, Aliyu Muhammad Musa, Y. Apeji","doi":"10.21315/mjps2023.21.1.7","DOIUrl":"https://doi.org/10.21315/mjps2023.21.1.7","url":null,"abstract":"The aim of this study was to evaluate the direct compression properties of a novel coprocessed excipient (CPE) generated by processing cow bone powder (CBP), maize starch (MS) and Khaya gum (KG) together to form a single composite excipient. Design of experiments (DoE) was employed to optimise the formulation of CPE. CPE was prepared by wet granulation using the optimised formulation of CBP (40%), MS (40%) and KG (20%) as recommended by DoE. Assessment of the organoleptic properties of CPE revealed an odourless, tasteless and coarse texture with a neutral pH of 7.3. CPE was found to be partly crystalline and partly amorphous and demonstrated compatibility between the three components of the formulation. The material in terms of flowability compared well with the flow parameters of StarLac, a reference co-processed excipient. Tablets of diclofenac produced by direct compression using CPE as the directly compressible excipient compared well with the hardness and disintegration time of tablets made using StarLac® as the directly compressible excipient. The study’s outcome shows that CPE can be used as a direct compression excipient in the formulation of tablets by direct compression.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45888825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.21315/mjps2023.21.1.3
Azrina Abdul Aziz, C. Chong, Najihah Idris, Wan Alifah Wan Ismail, Hamimah Saidin
Antimicrobial stewardship programme (ASP) was introduced as one of the strategies to curb the rise of multi-drug resistant (MDR) organism. The findings on the programme establishment are important in strengthening ASP measures. This study aimed to assess the impact of ASP implementation on the antimicrobial utilisation, antimicrobial cost and the MDR bacterial resistant rate before and after the programme initiation. A retrospective cohort study involving adult inpatient in a public tertiary hospital was conducted between pre-ASP implementation in year 2015 and post-ASP implementation from year 2016 to 2019. The statistical analysis of Student t-test or Mann-Whitney U test was used depending on the data distribution. The mean defined daily dose (DDD) per 1,000 patient days for ASP targeted antibiotics was significantly decreased by 17% from 161.52 DDD per 1,000 patient days in pre-ASP period to 134.49 DDD per 1,000 patient days in post-ASP period mainly from the usage of third generation cephalosporin, carbapenem and colistin. The annual expenditure for ASP targeted antibiotics had significant monetary reduction from RM30,580.50 in pre-ASP period to RM20,590.60 during post-ASP period. Significant reduction in the mean MDR bacterial resistant rate were notable for extended spectrum beta-lactamase E. coli (27.48%–17.85%), methicillin-resistant Staphylococcus aureus (22.25%–15.73%) and MDR Acinetobacter spp. (71.46%–49.34%). The implementation of ASP leads to significant reduction on the ASP targeted antibiotics utilisation, antimicrobial cost and MDR bacterial resistance rate. These outcomes are beneficial in justification and expansion of ASP activities in Malaysia.
{"title":"Impact of Antimicrobial Stewardship Programme on Antimicrobial Utilisation, Cost and Bacterial Resistance in a Malaysian Public Tertiary Hospital","authors":"Azrina Abdul Aziz, C. Chong, Najihah Idris, Wan Alifah Wan Ismail, Hamimah Saidin","doi":"10.21315/mjps2023.21.1.3","DOIUrl":"https://doi.org/10.21315/mjps2023.21.1.3","url":null,"abstract":"Antimicrobial stewardship programme (ASP) was introduced as one of the strategies to curb the rise of multi-drug resistant (MDR) organism. The findings on the programme establishment are important in strengthening ASP measures. This study aimed to assess the impact of ASP implementation on the antimicrobial utilisation, antimicrobial cost and the MDR bacterial resistant rate before and after the programme initiation. A retrospective cohort study involving adult inpatient in a public tertiary hospital was conducted between pre-ASP implementation in year 2015 and post-ASP implementation from year 2016 to 2019. The statistical analysis of Student t-test or Mann-Whitney U test was used depending on the data distribution. The mean defined daily dose (DDD) per 1,000 patient days for ASP targeted antibiotics was significantly decreased by 17% from 161.52 DDD per 1,000 patient days in pre-ASP period to 134.49 DDD per 1,000 patient days in post-ASP period mainly from the usage of third generation cephalosporin, carbapenem and colistin. The annual expenditure for ASP targeted antibiotics had significant monetary reduction from RM30,580.50 in pre-ASP period to RM20,590.60 during post-ASP period. Significant reduction in the mean MDR bacterial resistant rate were notable for extended spectrum beta-lactamase E. coli (27.48%–17.85%), methicillin-resistant Staphylococcus aureus (22.25%–15.73%) and MDR Acinetobacter spp. (71.46%–49.34%). The implementation of ASP leads to significant reduction on the ASP targeted antibiotics utilisation, antimicrobial cost and MDR bacterial resistance rate. These outcomes are beneficial in justification and expansion of ASP activities in Malaysia.","PeriodicalId":53358,"journal":{"name":"Malaysian Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42792611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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