Evaluation of education and economic barriers in implementing essential medicines concept in Malaysia
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Date
2009
Authors
Abdallah Ahmed, Hind Mahjowb
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Abstract
Although the National Essential Medicines List (NEML) in Malaysia was
launched in 2000, there were no studies conducted to measure prescribers,
pharmacists and medical and pharmacy students’ awareness on essential medicines
concept, or to measure affordability of actual prescriptions used for treatment of
chronic conditions. This study consists of three parts. The first part determined
knowledge, attitude and practice of prescribers and pharmacists among government
clinics and hospitals, respectively. Two separate survey questionnaires were used.
Questionnaires were mailed to 113 clinics and 60 hospitals in west Malaysia. Out of
65 clinics (186 prescribers) and 44 hospitals (277 pharmacists) responded to the
survey. Knowledge median scores were 5 for both groups; out of 8 points, attitude
median scores were 17 and 18, out of 25 points, while practice median scores were 8
and 6 out of 10 points for prescribers and pharmacists, respectively. The second part
was conducted to measure knowledge and attitude of medical and pharmacy students
on essential medicines in Malaysian government universities and to check university
curricula if essential medicines concept is taught to undergraduate students. The
survey questionnaires for students’ and the curriculum survey were mailed to 5
universities. A total of 250 medical students and 314 pharmacy students completed
questionnaire for a valid response rate of 60% and 100% for medicine and pharmacy
schools, respectively. Knowledge median scores were 3 and 4 out of 8 points, while
attitude median scores were 8 of the two groups out of 10 points for medical and
pharmacy students, respectively. The third part was conducted to evaluate
affordability of essential medicines used in treatment of hypertension, diabetes type
II, asthma and multiple chronic conditions of the previous diseases in Malaysia. A
case study measured prescriptions contents of USM panel clinics’ claim forms for
year 2006. Affordability of medicines used was calculated using private retail
pharmacies prices. Affordability was expressed as number of days’ salary required
by a USM lowest wage workers to pay for one month treatment. Low affordability
was noted for most brands products, most combined treatments and all multiple
chronic cases treatments. Therefore, efforts are required in Malaysia to focus on
increasing the awareness of health professionals on essential medicines concept. A
commitment by the government is also required to meet the needs of citizens who
suffer from chronic diseases.
Description
Master
Keywords
Pharmaceutical science , Education , Economic , Medicines