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Community pharmacists are responsible for providing the appropriate information on the use of medications to patients, which may enhance their medication adherence. The extent of control that patients have on their health care preferences creates many challenges for community pharmacists. This study aimed to determine the impact of pharmacist interventions and patient decisions on health outcomes concerning medication adherence and the quality use of medicines among patients attending community pharmacies. Appropriate studies were identified in a systematic search using the databases of Medline, Scopus, Google Scholar, and PubMed. The search included literature published between 2004 and 2019. The database searches yielded 683 titles, of which 19 studies were included after the full-text analysis with a total of 9313 participants. Metaprop command in Stata software version 14 was used for the analysis. This study was undertaken based on the general principles of the Cochrane Handbook for Systematic Reviews of Interventions and subsequently reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA) extension. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was directly used to rate the quality of evidence (high, moderate, low, or very low). The results revealed the effective interaction between patients and community pharmacists, the importance of pharmacist intervention on medication adherence and quality use of medicine, and the role of community pharmacists in counselling patients. Decision/choice of patients in self-care and self-medication is a factor contributing to health outcomes. Effective interaction of community pharmacists with patients in terms of medication adherence and quality use of medicines provided a better health outcome among patients. The community pharmacists influenced the decision/choice of patients in self-care and self-medications.

Pharmacy students’ knowledge about adverse drug reaction reporting can impact their attitude towards patient care and issues on patient safety. The aim of this study was to investigate the knowledge and perception of pharmacy students about adverse drug reaction reporting and pharmacovigilance and to study their willingness to report. A cross-sectional study using a validated questionnaire was conducted among the university students. The demographic details of the respondents were studied. The number of female respondents was comparatively higher than the male respondents. There were no significant differences by gender regarding the knowledge on adverse drug reaction reporting and pharmacovigilance except with the knowledge of post-marketing surveillance for which male students appeared to be more knowledgeable than female students. The results showed that the pharmacy students had sufficient knowledge and there are significant differences in perception among the students on adverse drug reaction reporting.

This study aimed to explore the use and perceived benefits of mouthwash among Malaysian adults. Method: This is a cross-sectional study which was conducted in public places around the states of Selangor and Penang, Malaysia. It is a questionnaire-based study which was conducted as face-to-face interview. A convenience sample of 792 mouthwash users was recruited in 2013 in an ethically approved study (International Medical University). The study instrument was formulated on the basis of literature search and subjected to 20 experts for validation purpose. A pilot study was conducted to compute Cronbach Alpha (0.78). Data was entered into PASW version 20. Descriptive and inferential statistics were applied. Results: A response rate of 99% was achieved. More than two third of the respondents are female, suggesting women are more likely to use mouthwash (n ¼486; 61.8 %). The major reason to use mouthwash were to mask halitosis (n¼287; 36.5%) and to prevent oral diseases (n¼243; 30.9%). Majority knew that fluoride helps in reducing plaque (n¼599; 76.1%) and tooth decay (n¼631; 80.2%). Respondents were not clear that only tooth brushing alone is insufficient to prevent gum disease (n¼553; 70.3%). More than two thirds perceived that mouthwash is useful in reducing plaque (n¼567; 72.0%) as well as periodontal disease (n¼580; 73.7%). Respondents perceived that mouthwash is more effective in eliminating halitosis (n¼714; 90.7%) and preventing caries (n¼630; 80.1%). The frequency of mouthwash use was statistically significant with age, gender, race and monthly income (p¼0.018. 0.091, 0.010, 0.030) . Conclusion: This study indicates that Malaysian adults have good knowledge on the use and perceived benefits of mouthwash. A nationwide study is advocated to gather more information from general population, targeting the use of mouthwash in a large scale to minimize oral health problems.

Palanisamy Sivanandy,1 Mari Kannan Maharajan,1 Kingston Rajiah,1 Tan Tyng Wei,2 Tan Wee Loon,2 Lim Chong Yee2 1Department of Pharmacy Practice, School of Pharmacy, 2School of Pharmacy, International Medical University, Wilayah Persekutuan Kuala Lumpur, Malaysia Background: Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use.Objective: To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia.Methods: A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted.Results: The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup.Conclusion: The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety. Keywords: patient counseling, medication errors, communication openness, perceptions, attitudes

Summary Objectives This study was done to determine the social factors which influenced the community pharmacists’ values, ethical dilemmas and the predictors which contributed in their ethical decision-making . Study setting This study was conducted in Tirunelveli district, Tamilnadu among the pharmacists working in community pharmacies . Study design A cross-sectional study was done to determine the exposure and outcome simultaneously. Data collection The participants were selected using a multistage sampling technique. Correlation analysis between the independent and dependent variables were done to determine the social factors, which influenced the community pharmacists’ values, ethical dilemmas. Stepwise regression was done to determine the predictors, which contributed in their ethical decision-making. Principal findings The independent variables (age, gender, work experience, education qualification, number of pharmacists per pharmacy, pharmacy location) had correlations with the dependent variable (ethical dilemma). Two variables (age and work experience) have significantly contributed to the ethical decision-making of the community pharmacists. Conclusions In this study, social determinants ‘age’ and ‘work experience’ are the predictors which contributed to the ethical dilemmas of the community pharmacists which in turn impact their values and decision-making. Work experience was the strongest predictor.

This study was conducted to evaluate knowledge of undergraduate pharmacy students about human papillomavirus infection and their attitude towards its prevention. A cross-sectional survey was conducted in 270 undergraduate pharmacy students using a validated questionnaire to assess knowledge about human papillomavirus infection and cervical cancer and their attitudes towards human papillomavirus vaccines. Eighty-one percent of the respondents knew that human papillomavirus is a cause of cervical cancer, and 87.8 % knew that this infection is preventable. The gender of the respondents showed the strongest correlations with human papillomavirus knowledge. There were no significant correlations between the ethnic group of the respondents and their human papillomavirus-related knowledge. Higher perceptions of risk were associated with relationship status, and respondents who were in a relationship showed greater interest in vaccinating themselves; relationship status emerged as a unique predictor. The results indicated a moderately high level of knowledge and positive attitude towards human papillomavirus vaccination with few disagreements. The results of this study will help to develop and plan appropriate education campaigns for pharmacy students that aim to reduce human papillomavirus infection and, consequently, the incidence of and mortality caused by cervical cancer in Malaysia.

The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

The major cause of cervical cancer is human papillomavirus (HPV) for which vaccination is available. The success HPV vaccination programme largely depend on the degree of knowledge of the healthcare providers who can recommend to the public. Health sciences students as future healthcare providers play a major role in HPV vaccination initiatives. The objective of this study was to evaluate the knowledge, attitude, practice and to find out the willingness to pay for HPV vaccination among the health sciences students in a private university. The cross-sectional study was conducted among the university students studying health sciences program using a validated questionnaire to measure their awareness and acceptance of HPV vaccination. The students demonstrated moderate knowledge about HPV infection and vaccination with mean knowledge scores of 9.3 out of 17. Students were showing positive attitude towards HPV vaccination with mean scores of 3.80 out of 5. However, low HPV vaccination uptake rate was reported among the students. Most of the students were willing to recommend HPV vaccine. The participants felt that the cost is the major barrier towards HPV vaccination and they felt the government should cover the cost of vaccination for all. The results of this study may be helpful in establishing educational policies on cervical cancer-related topics in the universities.

The objectives of this study were to determine the knowledge and attitude of adult Malaysians about Traditional Chinese Medicine (TCM), to understand the variation in the knowledge and attitude toward TCM among different demographic groups of adult Malaysian population and to determine the pattern of TCM use among adult Malaysians.: This study was a descriptive, cross-sectional survey using the convenience sampling method. A total of 400 adult Malaysians were recruited for this study. An interview-administered questionnaire was used. Descriptive statistics Mann-Whitney U Test and Kruskal–Wallis H test were used to analyze the data. The reliability of survey data in this study may affect since closed-ended questions are used.: The more commonly utilized therapy was herbal medicine (n=192, 82.1%), acupuncture (n=79, 33.8%) and oriental massage (n=58, 24.8%). The mean knowledge score and mean attitude score for the respondents were 5.00±1.71 and 7.17±2.10 respectively. There was a significant difference in the mean knowledge score between genders, among TCM users and non-TCM users, people of different education levels and ethnicity.: There were more TCM users than non-TCM users and the use of TCM was higher in females than males. The most popularly used TCM modalities were herbal medicines and acupuncture. Gender, education, ethnicity and use of TCM had a significant effect on adults’ knowledge toward TCM.

Summary: Background: Infectious diseases are a great threat to humankind, and antibiotics are a viable proposition to numerous pathologies. However, antibiotic resistance is a global concern. Therefore, the aims of this survey were to explore the understanding and attitudes of pharmacy students regarding antibiotic use and resistance. Methods: This is a cross-sectional study conducted on final-year undergraduate pharmacy students from 5 public universities. A validated, self-administered questionnaire written in English was used to collect data. It was made up of six domains and forty-five questions. Raosoft software was used to determine the minimum required sample size. Descriptive and inferential data analyses were carried out using SPSS version 20 software. Results: Out of 346 students, only 59.5% showed a strong understanding of antibiotic usage, while 84.4% of students demonstrated a good level of understanding regarding the issue of antibiotic resistance. However, only 34.1% of students demonstrated a positive attitude toward this issue. Conclusion: This survey reveals that final-year pharmacy students at Malaysian public universities have a relatively good understanding of antibiotic resistance. However, their attitudes did not strongly correlate to their knowledge. Keywords: Antibiotic resistance, Pharmacy students, Malaysian public universities

Introduction: The ability of physicians to recognize non-adherence is poor and interventions to improve adherence have had mixed results. Furthermore, successful interventions generally are substantially complex and costly. Poor adherence to medication regimens accounts for substantial worsening of disease; death and increased health care costs. The aim of this study is to assess the medication adherence in type-2 diabetes patients who are on polypharmacy and the effect of counseling provided for them in a multispecialty hospital. Materials and Methods: The study was carried out at Kovai Medical Center and Hospital; Coimbatore Tamil Nadu, India. This is a 500-bedded modernized, multi-specialty tertiary care hospital with full-fledged diabetic department. It caters to the needs of both out-patients and in-patients. An assessment was made on type-2 diabetic patients who are receiving more than 5 drugs for their co-morbidities were included in this study. A medication adherence questionnaire was prepared based on the literatures. The study was approved by the Kovai Medical Center and Hospital ethics committee. Results: Among 240 patients, 124 patients were adherent to medication whereas 116 patients were non-adherent. The non-adherent patients were giving verbal counseling in a private counseling room regarding medication adherence. Conclusions: Best way health professionals can tackle the adherence problem is through quality patient counseling as done in this study. With limited time most professionals have with a patient today this can be easier said than done. However, techniques such as the ask-educate-ask approach, the teach-back method and motivational interviewing can help ensure patient understanding of the counseling provided.

Introduction: This study is aimed to investigate the understanding of antibiotic use and antibiotic resistance and its correlate factors among final-year medical and pharmacy students at International Islamic University Malaysia (IIUM). Methodology: This was a cross-sectional study. The study instrument was developed by extensive literature search and was subjected to face validity and content validity to medical and pharmacy academics. A pilot study was conducted to ascertain the reliability coefficient. Data was entered to SPSS version 17 and descriptive and inferential statistics were applied. Results: A total of 123 questionnaires were included in the study. Out of 123 respondents, 58.5% (n = 72) were final-year medical students, while 41.5% (n = 51) were final-year pharmacy students. The majority of the respondents showed adequate knowledge regarding the course contents related to antibiotics (n = 116; 94.3%). Almost all the respondents correctly reported the difference between bactericidal and bacteriostatic antibiotics. Only 15.4% (n = 19) and 27.6% (n = 34) of students were able to recognize Streptococcus pyogenes as non-pencillin resistant bacterium and Enterococcus as vancomycin-resistant bacterium, respectively. Conclusions: The students showed good understanding regarding antibiotic resistance. In comparison to medical students, pharmacy students showed better understanding and more adequate knowledge, as the mean value for each domain was slightly higher for pharmacy students. Extensively improving the curriculum and educating healthcare professionals, especially physicians and pharmacists, right from the time of their educational training can inculcate a moral responsibility toward the judicious use of antibiotics, which can serve to eradicate antibiotic resistance.