Background: For the past 10 years, the pharmacist workforce in Malaysia has experienced radical changes in demography, job scope and expectations as well as remuneration due to a drastic surge in the number of pharmacists employed in the public sector. Aim: To investigate the level of job satisfaction amongst pharmacists working in the public sector in Malaysia. Methods: A cross-sectional survey was conducted amongst registered pharmacists working in three of the most populated states in Malaysia. A validated questionnaire consisting of three sections was used to investigate intrinsic and extrinsic factors of job satisfaction and their overall job satisfaction. Results: Analysis of responses from 161 pharmacists revealed significant differences in job satisfaction with age and length of service. Pharmacists within the age group of 35-45 years were more satisfied with their jobs than younger pharmacists. Findings also showed that pharmacists who had been working for more than 7 years tended to be more satisfied with their jobs. Type of institution, position held and gender did not appear to influence job satisfaction. Intrinsic factors such as autonomy, contribution, creativity and challenge had significant impact on job satisfaction; creativity had the strongest impact as compared with other factors. Extrinsic factors such as salary, supervision feedback and job atmosphere also had significant impact on job satisfaction. Conclusion: Only 52% of the pharmacists who responded were satisfied with their current jobs. The study outcomes indicate the major factors that affect pharmacists' job satisfaction. Factors affecting job satisfaction could be used by policy makers and pharmacy managers to design retention strategies.

Background The first Patient-Centered Medical Home (PCMH) demonstration in Singapore was launched in November 2016, which aimed to deliver integrated and patient-centered care for patients with bio-psycho-social needs. Implementation was guided by principles of comprehensiveness, coordinated care, shared decision-making, accessible services, and quality and safety. We aimed to investigate the impact of implementing the PCMH in primary care on quality of life (QoL) and patient activation. Methods The study design was a prospective single-arm pre-post study. We applied the 5-level EuroQol 5-dimension (EQ-5D-5L) and Visual Analog Scale (EQ VAS) instruments to assess health-related QoL. The CASP-19 tool was utilised to examine the degree that needs satisfaction was fulfilled in the domains of Control, Autonomy, Self-realisation, and Pleasure. The 13-item Patient Activation Measure (PAM-13) was used to evaluate knowledge, skills and confidence in management of conditions and ability to self-care. Multivariable linear regression models with random intercepts were applied to examine the impact of the PCMH intervention on outcome measures at 3 months and 6 months post-enrolment, compared to baseline. Results We analysed 165 study participants enrolled into the PCMH from November 2017 to April 2020, with mean age 77 years (SD: 9.9). Within-group pre-post (6 months) EQ-5D-5L Index (β= -0.01, p-value = 0.35) and EQ VAS score (β=-0.03, p-value = 0.99) had no change. Compared to baseline, there were improvements in CASP-19 total score at 3 months (β = 1.34, p-value = 0.05) and 6 months post-enrolment (β = 1.15, p-value = 0.08) that were marginally out of statistical significance. There was also a significant impact of the PCMH on the CASP-19 Pleasure domain (β = 0.62, p = 0.03) at 6 months post-enrolment, compared to baseline. We found improved patient activation from a 15.2 % reduction in the proportion of participants in lower PAM levels, and a 23.4 and 16.7 % rise in proportion for higher PAM levels 3 and 4, respectively, from 3 months to 6 months post-enrolment. Conclusions Preliminary demonstration of the PCMH model shows evidence of improved needs satisfaction and patient activation, with potential to have a greater impact after a longer intervention duration.

To ensure that patients' initial positive experience translates to a long-term relationship with FMC, providers should move beyond providing improved access to care. It is necessary to help patients understand the comparative advantage of community-based care and its contribution to long-term health outcomes. Providers should also elicit patients' desires and expectations when designing future models of care. At a policy level, higher cost of private primary care should be addressed.

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Patient-Centred Medical Home (PCMH) is a strategy to enhance patient-centredness to improve care experience. We aimed to understand patient experience of an integrated PCMH model for complex community-dwelling older adults in Singapore. We used a mixed-method design with a prospective single-group pre-post quantitative component and a concurrent qualitative component. Participants were administered the validated Consumer Assessment of Health Providers and Systems Clinician & Group Survey (CG-CAHPS) at baseline (N = 184) and 6-month (N = 166) post-enrolment. We conducted focus group discussions (FGDs) on a purposive sample of 24 participants. Both methods suggest better care experience in PCMH relative to usual care. There were improvements in the CG-CAHPS measures on patient–provider communication, care coordination, office staff interactions, support for patients in caring for their own health, and provider rating in PCMH relative to usual care. In the FGDs, participants reported benefits of consolidated appointments and positive experience in sustained patient–provider relationship, shared-decision making, and family/caregiver engagement in PCMH. Participants may not fully comprehend the concept of integrated care, hindering both the effective communication of the intended care model and perceived benefits such as the provision of multidisciplinary team-based care.