Objectives:To assess the efficacy and costs of a calendar blister packaging intervention used to improve medication adherence.Method:A parallel randomized controlled trial was conducted with 73 hypertensive patients (intervention group = 35, control group = 38) at Hospital Kulim, Malaysia, for 7 months.Results:The intervention group demonstrated a significant improvement in medication possession ratio (p < 0.05) and percentage of on-time refills (p < 0.01) compared to control group. In addition, there was significantly lower blood pressure (p < 0.05) in intervention group. From the provider perspective, the average annual treatment cost per patient in the intervention group was MYR 2178.66 (~USD 526.95) (95% confidence interval = 1786.39–2570.94) compared to MYR 2693.09 (~USD 651.37) (95% confidence interval = 1903.23–3482.95) in the control group.Conclusion:This study provides evidence that calendar blister packaging has a positive impact on medication adherence, blood pressure and also has the potential for considerable cost savings.
A lack of guidance on economic evaluations for oral cancer screening programs forms a challenge for policymakers and researchers to fill the knowledge gap on their cost-effectiveness. This systematic review thus aims to compare the outcomes and design of such evaluations. A search for economic evaluations of oral cancer screening was performed on Medline, CINAHL, Cochrane, PubMed, health technology assessment databases, and EBSCO Open Dissertations. The quality of studies was appraised using QHES and the Philips Checklist. Data abstraction was based on reported outcomes and study design characteristics. Of the 362 studies identified, 28 were evaluated for eligibility. The final six studies reviewed consisted of modeling approaches (n = 4), a randomized controlled trial (n = 1), and a retrospective observational study (n = 1). Screening initiatives were mostly shown to be cost-effective compared to non-screening. However, inter-study comparisons remained ambiguous due to large variations. The observational and randomized controlled trials provided considerably accurate evidence of implementation costs and outcomes. Modeling approaches, conversely, appeared more feasible for the estimation of long-term consequences and the exploration of strategy options. The current evidence of the cost-effectiveness of oral cancer screening remains heterogeneous and inadequate to support its institutionalization. Nevertheless, evaluations incorporating modeling methods may provide a practical and robust solution.
Objective This study aimed to investigate the effect of calendar packaging (CP) on medication adherence among hypertensive patients in Malaysia. Setting Outpatient Pharmacy Department, Kulim Hospital. Methods This was a parallel randomized controlled trial of CP (intervention group) versus normal pack (control group) for patients who were on daily dose antihypertensive drug (amlodipine).The primary outcome was medication adherence to amlodipine, assessed by medication possession ratio (MPR), percentage of on‐time refills and Malay Version Morisky medication adherence scales. Key findings Eighty‐three patients participated. The mean age (standard deviation) was 55.85 (10.25) and 56.55 (10.42) for intervention and control group respectively. This study found that intervention group has better medication adherence score than the control group measured by MPR, Morisky medication adherence score (P < 0.05) and percentage of on‐time refills (P < 0.01). Intervention group showed a significantly lower systolic and diastolic blood pressure (P < 0.05) compared to control group. Intervention group was significantly associated with higher medication adherence measured by MPR (β = 0.006, P < 0.05), Morisky scale (β = 0.365, P < 0.05) and percentage of on‐time refill (β = 0.063, P < 0.01); in addition lower systolic blood pressure (β = −4.4, P < 0.05) after controlling for the study period and patient age. Conclusions This study found that CP could improve adherence to medication among hypertensive patients. The results also suggest possible improvement in blood pressure with the use of CP.
Different attires may bring different perceptions, level of trust, status and transmits social signals towards pharmacist in a community pharmacy setting. The objectives of the study were to explore the public perception of community pharmacist attire and the association of respondents’ sociodemographics with their preferences for community pharmacist attire. This was a cross-sectional, convenience sampling study among 200 general public adults (> 18 years old) in community pharmacies setting in Malaysia. A face validated Likert-type questionnaire was administered to assess the public perceptions and their preferences on community pharmacist attire. Four sets of model photographs with variation in gender, ethnicity and attire formality (i.e., formal wear with lab coat to casual attire) were used to assess respondents’ preferences. The most preferred attire of pharmacists was formal wear with a lab coat compared to other styles of attire (74% versus 36%). The older the respondents were, the more likely they prefer pharmacists in the formal wear with lab coat attire compared to formal (OR: 0.943; 95% CI: 0.899, 0.989; p < 0.05) and semi-formal wear (OR: 0.912; 95% CI: 0.840, 0.989; p < 0.05). Male respondents prefer pharmacists in formal wear without the lab coat (OR: 3.893; 95% CI: 1.449,10.491; p < 0.01) compared to female. A neat and proper attired pharmacist will gain a positive impression from patients. Respondents favour pharmacists in formal attire with a lab coat. Pharmacists in formal wear with a lab coat able to display professionalism and instil feelings of trust, confidence and comfort among the public in a community pharmacy setting.
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