Background: Limited efforts have been made to evaluate medication adherence among subsidized and self-paying patients. Objective: To investigate medication adherence among patients with and without medication subsidies and to identify factors that may influence patients’ adherence to medication. Setting: Government healthcare institutions in Kuala Lumpur, Selangor, and Negeri Sembilan and private healthcare institutions in Selangor and Negeri Sembilan, Malaysia. Methods: This cross-sectional study sampled patients with and without medication subsidies (self-paying patients). Only one of the patient’s medications was re-packed into Medication Event Monitoring Systems (MEMS) bottles, which were returned after four weeks. Adherence was defined as the dose regimen being executed as prescribed on 80% or more of the days. The factors that may influence patients’ adherence were modelled using binary logistic regression. Main outcome measure: Percentage of medication adherence. Results: A total of 97 patients, 50 subsidized and 47 self-paying, were included in the study. Medication adherence was observed in 50% of the subsidized patients and 63.8% of the self-paying patients (χ²=1.887, df=1, p=0.219). None of the evaluated variables had a significant influence on patients’ medication adherence, with the exception of attending drug counselling. Patients who attended drug counselling were found to be 3.3 times more likely to adhere to medication than those who did not (adjusted odds ratio of 3.29, 95% CI was 1.42 to7.62, p = 0.006). Conclusion: There is no significant difference in terms of medication adherence between subsidized and self-paying patients. Future studies may wish to consider evaluating modifiable risk factors in the examination of non-adherence among subsidized and self-paying patients in Malaysia.

Background: The objective of this study was to compare the performance of cystatin C- and creatinine-based estimated glomerular filtration rate (eGFR) equations in predicting the clearance of vancomycin. Methods: MEDLINE and Embase databases were searched from inception up to September 2019 to identify all studies that compared the predictive performance of cystatin C- and/or creatinine-based eGFR in predicting the clearance of vancomycin. The prediction errors (PEs) (the value of eGFR equations minus vancomycin clearance) were quantified for each equation and were pooled using a random-effects model. The root mean squared errors were also quantified to provide a metric for imprecision. Results: This meta-analysis included evaluations of seven different cystatin C- and creatinine-based eGFR equations in total from 26 studies and 1,234 patients. The mean PE (MPE) for cystatin C-based eGFR was 4.378 mL min −1 (95% confidence interval [CI], −29.425, 38.181), while the creatinine-based eGFR provided an MPE of 27.617 mL min −1 (95% CI, 8.675, 46.560) in predicting clearance of vancomycin. This indicates the presence of unbiased results in vancomycin clearance prediction by the cystatin C-based eGFR equations.Meanwhile, creatinine-based eGFR equations demonstrated a statistically significant positive bias in vancomycin clearance prediction. Conclusion Cystatin C-based eGFR equations are better than creatinine-based eGFR equations in predicting the clearance of vancomycin. This suggests that utilising cystatin C-based eGFR equations could result in better accuracy and precision to predict vancomycin pharmacokinetic parameters.

The use of Internet and social media for health information sharing is expanding among public, pharmacists and other healthcare professionals over the past few years. Research investigating the use of Internet and social media in the practice of pharmacy is growing, however, little is known on the delivery of pharmacy services through these media platforms. Hence, this study aimed to investigate the roles of pharmacist in media in providing healthcare information, to evaluate public perception and acceptance towards pharmacist using media as a platform information sharing and to find out public expectation towards pharmacy services in media. A total of 200 respondents were recruited by random sampling in this cross-sectional study. Study duration was from October until November 2019. The self-administered questionnaire was adapted from previous study investigating the public preferred source of healthcare advices. Majority of the respondents agree that media platforms can be used by pharmacist to improve patient-pharmacist communication with 76.5% expected that social media has the potential to become an established channel for patient-pharmacist communication. 61.0% of the respondents also acknowledged pharmacist to be very knowledgeable on health-related information by providing accurate information. This study provided insights into the public view towards the roles of pharmacist and their expectation towards pharmacist sharing health-related information in media platforms. Participants recognized the potential use of media platforms for healthcare information sharing. To enhance pharmacist presence and impact on public health through digital media platforms, it is important to start incorporating digital medium into their pharmacy services.

Garlic has gained popularity worldwide as a non-pharmacological treatment for hypertension but its use in Malaysia is still moderate. This study was undertaken among Malaysian urban population to assess their knowledge, awareness and attitude towards garlic supplement. This study is a cross sectional study and was carried out from February to May 2015. A total of 202 respondents took part in the study with 45% (n=91) taking garlic supplement. The result demonstrated that there was a significant negative correlation with age and knowledge score (r=-0.15, p=0.03). Majority of the respondents were unaware (n=61/202, 69.8%) that garlic has blood pressure lowering properties. Most preferred conventional medicines (n=119/202, 58.9%) over garlic supplement (n=83/202, 41.1%). However, most of the respondents (n=176/202, 87.1%) were interested to know more about the use of garlic for hypertension. There is no significant correlation between knowledge, awareness and attitude of respondents towards garlic supplement.