The use of complementary medicine (CM) is on the rise worldwide. In Malaysia, CM is available as over-the-counter products in community pharmacies and consumers expect pharmacists to be knowledgeable about CM. However, little is known about Malaysian community pharmacists’ attitude and knowledge of CM. This cross-sectional study aimed to investigate the extent of integration of CM into practice, taking into account community pharmacists’ attitudes towards CM, their role in recommending CM, their knowledge of the evidence-base for commonly used CM, further education and training needs, and knowledge of information sources which can be used by pharmacists for CM information. Ethics approval was obtained and a pilot study was conducted to validate the questionnaire. After amendments were made, community pharmacists were invited to complete a 41-item paper-based or web-based questionnaire. Invitations to complete the survey were sent by either social media, email or face-to-face invitation. A response rate of 27% (453/1662) was achieved providing data from 453 community pharmacists. Most respondents were female (63%), aged 24-72 years. Only 42% of pharmacists always asked their customers presenting with a prescription about concomitant CM use. Forty-two percent (42%) of pharmacists personally recommended CM and slightly more than half (58%) had notified manufacturers of CM products of any suspected adverse drug reactions. On average, pharmacists achieved a score of 54% for knowledge on CM-drug interactions and 71% for knowledge of clinically proven benefits. Most pharmacists (75%) obtained their CM product training through self-directed learning. In addition, most pharmacists (66%) supported CM education at the undergraduate level and almost all (94%) recognised the need for additional CM education for pharmacists. Malaysian registered pharmacists do not routinely ask customers about CM use, or recommend CM products, but have a positive attitude towards their use and were interested in learning more about CM.
complementary medicine ; integrative medicine ; community pharmacists ; pharmacy practice ; quality use of medicines

PURPOSE: The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. METHODS: The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). RESULTS: Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. CONCLUSION: Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students' EBP competence.
Academies and Institutes ; Congresses as Topic ; Delivery of Health Care ; Dentistry ; Education ; Educational Measurement ; Evidence-Based Medicine ; Evidence-Based Practice* ; Health Occupations ; Humans ; Mental Competency ; Nursing ; Pharmacy ; Students, Medical

INTRODUCTIONThe number of patients suffering from chronic kidney disease (CKD) is increasing worldwide. Hyperphosphataemia and high serum calcium (Ca) and phosphorus (P) product contribute to the substantial increase in cardiovascular events in CKD patients. Although reports of CKD complications in Iranian haemodialysis (HD) patients are comparable to data from other developed countries, management of these complications has failed to meet generally accepted targets. This study evaluated the impact of clinical pharmacy services in the management of complications in HD patients.

METHODSDuring a six-month prospective study, clinical pharmacists conducted medical visits in the HD ward and adjusted the patients' medications according to their laboratory findings.

RESULTSSerum Ca concentration was increased in hypocalcaemia patients and decreased in hypercalcaemia patients until it reached the optimal range in both groups. A decline in serum P level was noted in hyperphosphataemia patients, although it did not reach the target range. The Ca × P product decreased in patients with Ca × P > 55 mg2/dL2. Although it did not reach the goal, there was an increase and decrease in serum intact parathyroid hormone (iPTH) concentration in suboptimal and supraoptimal range patients, respectively. Serum Ca, P and iPTH levels did not change in patients with optimal values at the initiation of the study. Haemoglobin concentration increased in anaemic patients and serum ferritin reached target values in all patients. Total cholesterol, low-density lipoprotein cholesterol and triglycerides decreased to near-optimal values in dyslipidaemia patients.

CONCLUSIONThis study showed that clinical pharmacy services at the HD centre can improve the management of complications in CKD patients.

Adult ; Aged ; Aged, 80 and over ; Anemia ; etiology ; prevention & control ; Bone Diseases, Metabolic ; etiology ; prevention & control ; Dyslipidemias ; etiology ; prevention & control ; Female ; Humans ; Iran ; Male ; Medication Adherence ; Middle Aged ; Pharmacy Service, Hospital ; Practice Guidelines as Topic ; Prospective Studies ; Reference Standards ; Renal Dialysis ; adverse effects ; Renal Insufficiency, Chronic ; complications ; therapy