ORCID Profile
0000-0002-9228-6266
Current Organisations
University of Tasmania
,
University of Nottingham
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Publisher: Springer Science and Business Media LLC
Date: 29-08-2018
DOI: 10.1007/S11096-018-0721-X
Abstract: Background Assessing patient satisfaction regarding a pharmacy ambulatory care service is important as patient satisfaction is a determinant of the viability and sustainability of the service provided. Objective To develop and validate the Ambulatory Care Patient Satisfaction Questionnaire in Malaysia. Setting A public hospital in Malaysia with two outpatient pharmacies. The main outpatient pharmacy has an average waiting time of 1-2 h whilst PharmCARE (which prepares repeat prescriptions in advance) has an average waiting time of 5-15 min. Method Our instrument was developed based on literature review, a theoretical framework and an expert panel. The initial version consisted of 20 Likert-type items (where a higher score indicates higher satisfaction) was administered to patients/carers who were ≥ 21 years, from November 2015 to June 2016 at baseline and 2 weeks later. Main outcome measure The psychometric properties of the instrument. Results A total of 200/220 participants agreed to participate (response rate = 90.9%): main outpatient pharmacy = 114, PharmCARE = 86. Flesch reading ease was 51.9. The final version consists of 17 items with five domains measuring information (4 items), accessibility (4 items), relationship (4 items), outcomes (2 items) and continuity of care (3 items). Participants who collected their medications from PharmCARE [78.0% (72.8-81.3)] were significantly more satisfied than participants from the main outpatient pharmacy [72.0% (68.0-76.0), p < 0.001]. The overall Cronbach's alpha value was 0.839. Kappa values ranged from 0.681 to 0.914. Conclusion Our instrument was found to be a valid and reliable instrument to assess satisfaction of patients towards an ambulatory care pharmacy service in Malaysia.
Publisher: American Chemical Society (ACS)
Date: 28-04-2022
Publisher: Springer Science and Business Media LLC
Date: 25-11-2022
DOI: 10.1007/S11096-022-01493-6
Abstract: Opioids are commonly used for the management of chronic non-malignant pain in Pakistan but there is a lack of literature around precursors or motivators in the use of opioids. The study holistically explored factors contributing towards the unsafe use of opioids and identifies strategies to overcome them. Exploratory qualitative methods using interviews, focus groups and non-participant observational case studies were used. Interviews and focus groups were carried out face-to-face as well as virtually and observations were conducted in community pharmacies in Islamabad and Khyber Pukhtoon Khuwa province, Pakistan. Data were collected from 4 stakeholder groups pharmacy policy makers (n = 11), people with chronic non-malignant pain (n = 14), doctors (n = 31) and community pharmacists (n = 36) by purposive critical case s ling method. Data were analysed inductively using reflexive thematic analysis and then deductively mapped to a social ecological framework. Non-participant observations were analysed using a cross case synthesis using explanation building technique. Data from all three methods were triangulated to develop a logic model. Identified factors at macro (regulation), meso (social perceptions of pain and opioids) and micro levels (uncontrolled pain, self-medication, health literacy) and strategies are presented holistically and were used to develop a logic model for the prevention and mitigation of factors currently causing unsafe use of opioids. The study provides an in-depth view of factors contributing towards ersion of pharmaceutical opioids and can help guide national and international policy makers in their future initiatives to promote safe use of opioids in the management of chronic non-malignant pain in Pakistan.
Publisher: Informa UK Limited
Date: 06-2021
DOI: 10.2147/PPA.S314641
Publisher: Wiley
Date: 09-2022
DOI: 10.1002/HSR2.810
Abstract: Evidence suggests that, while a preference for functional Health Literacy (HL) outcome measurement exists, researchers are converging towards more all‐encompassing instruments. While this claim is present in the HL field, minimal research has comprehensively explored the state of community HL measurement practices at the direct and proxy level. The almost exclusive focus on direct, as opposed to proxy, community HL measurement indicates a review of progress is needed. To identify HL outcome measurement practices for community HL interventions at the direct and proxy level of measurement. Medline, PsycINFO, Web of Science, ERIC, Embase, Scopus, CINAHL, ProQuest Dissertations and Theses, Google Scholar and targeted websites were searched. Studies were s led from the general population, included HL as an outcome of interest, involved an intervention aiming to improve HL, were English‐text publications and were published ≥2010. Study author(s) and publication years, s le characteristics, intervention profiles and direct and proxy instrument and outcome measurement information were extracted. Full‐text review retrieved 25 eligible studies. In total, 21 unique direct and 38 unique proxy instruments were extracted. The majority of interventions assessed functional compared to communicative, critical, and other HL domains, with objective instruments more frequently used than subjective or combined objective‐subjective types, though more unique subjective HL instruments were extracted overall. The Test of Functional HL in Adults was the most popular instrument, and perceived health, knowledge, behaviors and health intentions were the most frequent proxy outcome measures, with only the Healthy Lifestyle Behavior Scale‐II and Patient Activation Measure used across multiple interventions. Direct HL outcome practices endured a unidimensional profile, despite previous suggestions of a convergence towards holistic instruments. This review provides the first overview of proxy HL measurement across community HL interventions, identifying substantial variation in proxy outcome practices. A University‐based senior librarian contributed to the development of the search strategy, and reviewed iterations of the strategy until refinement was complete. No further public or patient contribution was made given the review‐based nature of the research.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Wiley
Date: 02-06-2023
DOI: 10.1111/ANAE.16055
Abstract: This retrospective cohort study on adults undergoing colectomy from 2010 to 2019 used linked primary (Clinical Practice Research Datalink), and secondary (Hospital Episode Statistics) care data to determine the prevalence of persistent postoperative opioid use following colectomy, stratified by pre‐admission opioid exposure, and identify associated predictors. Based on pre‐admission opioid exposure, patients were categorised as opioid‐naïve, currently exposed (opioid prescription 0–6 months before admission) and previously exposed (opioid prescription within 7–12 months before admission). Persistent postoperative opioid use was defined as requiring an opioid prescription within 90 days of discharge, along with one or more opioid prescriptions 91–180 days after hospital discharge. Multivariable logistic regression analyses were conducted to obtain odds ratios for predictors of persistent postoperative opioid use. Among the 93,262 patients, 15,081 (16.2%) were issued at least one opioid prescription within 90 days of discharge. Of these, 6791 (45.0%) were opioid‐naïve, 7528 (49.9%) were currently exposed and 762 (5.0%) were previously exposed. From the whole cohort, 7540 (8.1%) developed persistent postoperative opioid use. Patients with pre‐operative opioid exposure had the highest persistent use: 5317 (40.4%) from the currently exposed group 305 (9.8%) from the previously exposed group and 1918 (2.5%) from the opioid‐naïve group. The odds of developing persistent opioid use were higher among in iduals who used long‐acting opioid formulations in the 180 days before colectomy than those who used short‐acting formulations (odds ratio 3.41 (95%CI 3.07–3.77)). Predictors of persistent opioid use included: previous opioid exposure high deprivation index multiple comorbidities use of long‐acting opioids white race and open surgery. Minimally invasive surgical approaches were associated with lower odds of persistent opioid use and may represent a modifiable risk factor.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY19060
Abstract: This study aims to update and validate quality prescribing indicators (QPIs) for Australian general practice. The study comprised two phases: (1) developing preliminary potential QPIs based on the 2006 National Prescribing Service (NPS) MedicineWise indicators, published literature, international indicators and guidelines, and through qualitative focus group discussions and (2) validating the proposed QPIs through a two-round online survey using the Delphi technique. The Delphi panel included four GPs, four pharmacists and two clinical pharmacologists. The Delphi panel rated the potential QPIs for their validity, importance and feasibility using a 1–10 Likert scale. In round one, all proposed QPIs presented as ‘prescribing rules’ achieved high scores regarding validity, importance and feasibility No rule was eliminated and three new rules were introduced. Rules were reworded into ‘prescribing indicators’ for round two, which resulted in 35 indicators being accepted and two indicators being eliminated. The final QPIs also include seven drug–drug interactions, which received high scores in round one. In conclusion, 42 QPIs were nominated for use in Australian general practice, based on their validity, importance and feasibility. If implemented, these QPIs have the potential to assist in efforts to improve the quality and safety of medicines management.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.SAPHARM.2016.10.004
Abstract: This study describes the perspective of patients, nurses, pharmacists, doctors and policy makers to identify the level of collaboration and the areas for improvement to achieve inter-professional collaboration between doctors, nurses, pharmacists and policy makers in a primary care clinic. Patients (n = 20), Nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) from a primary care were in idually interviewed using a semi-structured topic guide. Purposive s ling was used. Interviews were transcribed verbatim and analysed using thematic analysis informed by constant comparison. Patients, doctors, nurses, pharmacists and policy makers were eager for pharmacists to be more proactive in creating health awareness and conducting osteoporosis screening at the primary care clinic via inter-professional collaboration. These findings were further examined using the D'Amour's structural model of collaboration which encompasses four main themes: shared goals and visions, internalization, formalization and governance. This model supports our data which highlights a lack of understanding of the pharmacists' role among the doctors, nurses, policy makers and pharmacists themselves. There is also a lack of governance and formalization, that fosters consensus, leadership, protocol and information exchange. Nonetheless, the stakeholders trust that pharmacists have sufficient knowledge to contribute to the screening of osteoporosis. Our primary care clinic can be described as developing towards an inter-professional collaboration in managing osteoporosis but is still in its early stages. Inter-professional collaboration in osteoporosis management at the primary care level is beginning to be practised. Efforts extending to awareness and acceptance towards the pharmacists' role will be crucial for a successful change.
Publisher: Wiley
Date: 30-09-2022
DOI: 10.1002/PDS.5544
Abstract: To investigate whether the rate of Anti‐Osteoporosis Medication (AOM) dispensing was related to prevalence of risk factors and hip fracture incidence in the local population. The Open Prescribing database was used to analyse dispensed AOM at the level of Clinical Commissioning Groups (CCGs) in England. Male Healthy Life Expectancy (MHLE), Female Healthy Life Expectancy (FHLE), the prevalence of smoking and active adults, the incidence of hip fracture and of alcohol related hospital admissions, and local dispensing of a comparator drug (atorvastatin) were considered as predictor variables. Linear and multilinear regression were performed. Using atorvastatin as a comparator, AOM dispensing was compared after the start of the Covid‐19 pandemic with the same quarter the previous year. Rates of AOM per 1000 people aged over 65 years in a CCG area varied between 379.2 and 1129.1, with a mean of 670.3. Population risk factors were in idually related to the amount of AOM dispensed in an area. Collectively, local activity levels in adults (p = 0.042) and local hip fracture incidence (p = 0.003) were significantly negatively correlated with rates of AOM dispensed. Rates of alendronate dispensing fell significantly at the start of the Covid‐19 pandemic (p 0.001), whilst atorvastatin dispensing rates significantly increased (p 0.001). Lower rates of AOM dispensing were seen in areas with a higher proportion of active adults and higher incidence of hip fracture. Multidisciplinary services should be developed to address this care gap with consideration given to local population risk factors. Community pharmacists are ideally placed to play a vital role in osteoporosis management.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.SAPHARM.2022.02.002
Abstract: Human physiology undergoes extensive changes in space potentially leading to alterations in the way a medication functions. Understanding the efficacy behind Pharmacological Countermeasures (PCMs) and deliverable pharmacy services is imperative for the future presence of humans in space. However, while the pharmacist plays an integral role for human health terrestrially, pharmacist input has been minimal for human health in the space sector. Here, we explore the pharmacist's potential role in larger medical teams for future missions. To explore pharmacy and space sector stakeholder perspectives regarding the pharmacist's role in the space sector. Semi-structured interviews and focus groups were conducted with pharmacy (n = 31) and human health-related space sector stakeholders (n = 26) across the globe from governmental, commercial, industry and academic sectors. Purposive and snowball s ling were used to identify stakeholders. Interviews and focus groups were audio recorded, transcribed verbatim and thematically analysed. Three themes - medication management, medication-related research and medication and health information - were generated. The importance of medication optimisation within commercial and federal spaceflight participant medication regimens was cited as necessary for sustainable space exploration. Both groups advocated for pharmacists' involvement with in-situ medication manufacturing and medication-related research, particularly regarding space-based pharmacokinetic and pharmacodynamic drug profiling. Other essential roles included the pharmacist's role in providing medication information to spaceflight participants and other healthcare professionals on their health status and medication use risk in the context of space. With the advancement of accessible, commercial space travel and humans becoming an inter-planetary species, the opportunity to tackle PCM needs via a more extensive and comprehensive collaborative effort between the space, medical and pharmacy sectors is essential for sustainable space exploration.
Publisher: Springer Science and Business Media LLC
Date: 11-06-2022
Publisher: Springer Science and Business Media LLC
Date: 06-02-2023
DOI: 10.1007/S11096-022-01533-1
Abstract: In Thailand, the consumption of herbal medicines has been increasing. Adverse events (AEs) of herbal medicines have been identified through the spontaneous reporting system. However, the number of patients reporting AEs of herbal medicines remains limited. To explore the awareness and perceptions about the patient reporting system and to explore attitudes towards safety of herbal medicines, experiences, and intention to report AEs of herbal medicines. Semi-structured in-depth interviews were conducted with stakeholders (patients, community pharmacists, village health volunteers, and consumers who had experienced submitting a complaint about health products to the Consumers Foundation). Additionally, a focus group discussion was held with stakeholders (academics, herbal medicine manufacturers, healthcare professionals, policy maker who was responsible for promoting the use of herbal medicines, pharmacovigilance staff, patient, and representative from patient organisations). The data were audio recorded, transcribed verbatim and analysed using thematic analysis. Fifty participants were interviewed and the focus group discussion included 12 participants. Patients had positive attitudes towards the safety of herbal medicines. Lack of awareness of the patient reporting system was identified. Nevertheless, all stakeholders acknowledged the importance of the safety monitoring of herbal medicines and indicated a willingness to report AEs via the patient reporting system in the future. A simple reporting system, a variety of reporting channels, the provision of feedback, and providing rewards would motivate patients to report AEs. Although there is a lack of awareness, this provides a great opportunity to improve patient AE reporting system for herbal medicines in Thailand.
Publisher: Springer Science and Business Media LLC
Date: 19-05-2021
Publisher: Public Library of Science (PLoS)
Date: 04-05-2015
Publisher: Informa UK Limited
Date: 09-2014
DOI: 10.2147/PPA.S65718
Publisher: Springer Science and Business Media LLC
Date: 29-01-2018
DOI: 10.1007/S11096-018-0597-9
Abstract: Background Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area. Objective To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management. Setting A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia. Method Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were in idually interviewed using a semi-structured topic guide. Purposive s ling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists. Results All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role. Conclusion Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Publisher: Elsevier BV
Date: 05-2022
Publisher: Springer Science and Business Media LLC
Date: 02-2020
Publisher: Elsevier BV
Date: 09-2019
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Li Shean Toh.