JOURNAL of PHARMACY
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PP12684/8/2008 Vol. 1 Issue 11. Oct 2014 MALAYSIAN JOURNAL of PHARMACY MALAYSIAN JOURNAL OF PHARMACY Vol . 1. Issue MALAYSIAN In this issue: Cost-effectiveness analysis of a behavioral risk factor reduction program at a worksite: Experience from a public university in Malaysia Formulation and Stability of Extemporaneously Prepared Morphine Oral Suspension Supplement Proceedings of the 25th FAPA Congress 2014 A Publication of the Malaysian Pharmaceutical Society 11 Malaysian Journal of Pharmacy Vol.1 Issue 11, October 2014 The Official Journal of the Malaysian Pharmaceutical Society Editor-in-Chief: Assoc Prof Dr Asrul Akmal Shafie Associate Editors: Prof Dr PT Thomas Prof Dr Yuen Kah Hay Assoc Prof Dr Mohamed Azmi Ahmad Hassali Assoc Prof Dr Mohamad Haniki Nik Mohamed Mr Lam Kai Kun Publisher: Malaysian Pharmaceutical Society 16-2 Jalan OP 1/5, 1-Puchong Business Park Off Jalan Puchong 47160 Puchong Malaysia Tel: 6-03-80791861 Fax: 6-03-80700388 Homepage: www.mps.org.my Email: [email protected] The Malaysian Journal of Pharmacy is a publication of the Malaysian Pharmaceutical Society. Enquiries are to be directed to the publisher at the above address. The Publisher reserves copyright and renewal on all published materials, and such material may not be reproduced in any form without the written permission of the Publisher. Table of contents Editorial Working Together for a Robust and Relevant Research iii Research Papers Cost-Effectiveness Analysis of a Behavioral Risk Factor Page? Reduction Program at a Worksite: Experience From a Public University In Malaysia Page ? Formulation and Stability of Extemporaneously Prepared Morphine Oral Suspension th Proceedings of the 25 FAPA Congress 2014 Plenary Lectures Concurrent Symposium Oral Presentations Hospital and Clinical Pharmacy Community Pharmacy Drug Marketing and Socio-Economic Pharmacy Industrial Pharmacy Scientific Phytopharmacy and Pharmacopeia Pharmacy Education and Student Affairs Pharmaceutical Legislations, Ethics and Regulatory Affairs Emergency Medicine and Others Poster Presentations Hospital and Clinical Pharmacy Community Pharmacy Drug Marketing and Socio-Economic Pharmacy Industrial Pharmacy Scientific Phytopharmacy and Pharmacopeia Pharmacy Education and Student Affairs Pharmaceutical Legislations, Ethics and Regulatory Affairs Emergency Medicine and Others Editorial WORKING TOGETHER FOR A ROBUST AND RELEVANT RESEARCH Asrul A Shafie School of Pharmaceutical Science, Universiti Sains Malaysia, 11800 Penang, MALAYSIA Pharmacy research and practice in Malaysia has never been as exciting. The Malaysian Pharmaceutical Society has co-organized the National MPS Scientific Conference since 2001, the National Research & Development Conference for eight years running and various conferences at state level. Each of the conference highlighted hundreds of researches produced throughout the country covering wide range of themes in pharmacy. This reflects the rapid growth of research and interest in scientific endeavour in the country. An interesting observation in the conferences are the increasing researches conducted in pharmacy practice setting by practitioners. Whilst this is an encouraging trend, researchers need to be aware of the technical progress made in the field that has push forward the sophistication in study methods and design. For example, it is no longer sufficient to infer from observational study that did not consider confounding factors and biasness in their analysis. In fact, publication are now required to adhere to reporting guidelines specific to its study design e.g. CONSORT for clinical trial (1), PRISMA for systematic review (2), CHEERS for economic evaluation (3). This reflects greater understanding by scientific community on the methods limitation and potential risk to its internal validity, and the desire to increase generalizability of the results. In spite of the interest shown by Malaysian researchers and practitioners in disseminating their research in conference, the same cannot be said for publishing their research in peer reviewed journal. This is a gross missed opportunity as such publication would allow dissemination of local pharmacy research to both international and local audience. Hence it is not surprising to observe researchers flogging a dead horse in local conference. In contrast to conference that only provides brief and limited exposure of the evidence, journal publication is a time tested archive that allow research to be shared over and over again. Thus, allowing future research and policy to be better informed, and equipped. However, local researchers faced many obstacles in publishing their studies. One of the most common is the lack of appeal of the research topic as they are frequently limited to specific pharmacy setting/service. Thus, local researchers need to come out from their silo and expand their research scope to wider audience in health care. Many research problems are also unique to Malaysia setting and might lack appeal to journal based in developed countries. Dispensing separation for example, is a foregone conclusion in many countries with some already moving into empowering prescribing role to pharmacist(4) but the issue remain wanting in Malaysia(5). The issues of Government Sales Taxon drugs, impact of health care reform to pharmacy and continuous point development requirement for pharmacist are some local issues that highly relevant and pharmacist demand their voice to be heard and the issues to be systematically explored. Hence, the Malaysian Pharmacy Journal (MJP) has taken a significant step forward to allow a proper discourse of pertinent issues by introducing letter to editor section that would allow intellectual discussion of recently published studies in the journal or current issue in pharmacy. MJP has also revised the reporting format to conform to international guidelines and is working to list the journal in international indexing service. MJP is committed to foster local pharmacy research and encourage collaborative research between academic and practitioners to improve technical rigor in the researchwhilst at the same time ensuring the research remain relevant to practice. 1. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134(8):663-94 2. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration2009 2009-07-21 10:46:49. 3. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. BMC Medicine. 2013;11(1):80. 4. Nissen L. Pharmacist prescribing: What are the next steps? American Journal of Health-System Pharmacy. 2011;68(24):2357-61. 5. Shafie AA, Hassali MA, Azhar S, See OG. Separation of prescribing and dispensing in Malaysia: A summary of arguments. Research in Social and Administrative Pharmacy. 2012;8(3):258-62. Cost-Effectiveness Analysis of a Behavioral Risk Factor Reduction Program at a Worksite: Experience From a Public University in Malaysia Siow Yen Liau* BPharm, PhD1, Asrul A Shafie BPharm, PhD2, Mohamed Azmi A Hassali BPharm, PhD2, Mohamed Izham Mohamed Ibrahim BPharm, PhD3 1 Pharmacy Department, Hospital Queen Elizabeth 2, Kota Kinabalu, Sabah 2 School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia 3 Social and Administrative Pharmacy, College of Pharmacy, Qatar University, Doha, Qatar * Contact for correspondence, please email: [email protected] ABSTRACT Objectives: The objectives of this study were to determine the cost of a behavioral risk factor reduction program at the worksite and to compare the cost-effectiveness of the program with a control group. Methodology: This was a quasi-experimental study conducted among employees of Universiti Sains Malaysia. The program targeted five primary risk factors (RF). Participants in the intervention program were subjected to schedule individualized counseling and seminars during the 6- month follow-up. Participants in the control group underwent health screening. Cost-effectiveness analysis was conducted from the payer’s perspective to determine the cost of 1% increase in proportion of participants who reach ideal targets for the RF. One-way sensitivity analysis was also conducted. Results: A total 136 participants were recruited in this study. At 6-month follow-up, significantly higher proportion of participants in the intervention group reached target for fruit and vegetable intake (P 0.001) and physical activity (P = 0.017). The costs of the intervention program and control group were estimated to be MYR304.52 (USD92.28) and MYR169.90 (USD51.48) per participant respectively. The incremental cost-effectiveness ratio (ICER) of all the RF were lower than the World Health Organization recommendation based on the CHOICE analyses for relative cost-effectiveness of an intervention. Body mass index and alcohol consumption reported negative ICER which indicated control dominant. Sensitivity analyses showed that ICER was reported to be most sensitive to the change in participants’ salary. Conclusion: The proposed health promotion program was shown to be cost-effective in modifying most of the behavioral RF. Keywords: behavioural, cost-effectiveness analysis, risk factors BACKGROUND Over the years, the