DSpace Collection:

A study on the elements that affect digital technology acceptance in enhancing medication therapy adherence among patients with type 2 diabetes mellitus

Wed, 02 Jul 2025 00:00:00 GMT

Title: A study on the elements that affect digital technology acceptance in enhancing medication therapy adherence among patients with type 2 diabetes mellitus Authors: Chong, Cheng Jun (P119143) Abstract: Despite various interventions, medication adherence among type 2 diabetes mellitus (T2DM) patients remains suboptimal, leading to poor glycaemic control, complications, and higher healthcare expenditure. Although digital apps demonstrated possibilities in improving adherence, the adoption rates are low, and the determinants influencing adoption remain unclear. Therefore, this study aimed to assess the acceptability of digital apps for enhancing medication adherence among Malaysian T2DM patients through four projects. Project 1, a systematic review and meta-analysis, evaluated the effects of mobile apps on adherence and glycaemic outcomes. Project 2, a qualitative phenomenological study, explored T2DM patients' perspectives on adopting mobile apps for medication adherence. Project 3, a quantitative cross-sectional survey, examined factors influencing readiness, acceptance, and barriers to app adoption. Project 4, a grounded theory study, explored strategies to enhance app adoption for T2DM medication adherence and self-management. The findings demonstrated that mobile apps improved medication adherence and glycaemic outcomes, reducing glycated haemoglobin (HbA1c MD -0.36%) and fasting plasma glucose (FPG MD - 16.75mg/dL). An extended Technology Readiness and Acceptance Model (TRAM) was proposed. Four readiness themes were identified: optimism as empowerment, embracing innovativeness, discomfort from unfamiliarity, and data insecurity. For acceptance, three perceived usefulness themes (medication, patient, and healthcare professional elements) and three perceived ease of use themes (patient, app, and family elements) emerged. 76% of participants were unready to use medication apps. 72% found them not useful and 74% perceived them as difficult to use. Hence, 75% were unwilling to use them. Only readiness (β = 0.467, p < 0.001) and perceived usefulness (β = 0.547, p < 0.001) significantly influenced adoption intentions. Readiness factors encompassed anticipated convenience (β = 0.492, p < 0.001), perceived benefits (β = 0.254, p = 0.022), openness to new technologies (β = 0.145, p < 0.001), and digital literacy (β = 0.109, p = 0.001). Meanwhile, perceived usefulness factors included age (β = -0.206, p < 0.001), healthcare professionals’ influence (β = 0.313, p < 0.001), and engagement (β = 0.308, p < 0.001). Furthermore, a multidimensional model for enhancing app adoption was developed, comprising technological, economic, social, behavioural, and environmental strategies. Overall, this study highlighted the prominent factors influencing app adoption for medication adherence, offering actionable strategies to improve app uptake. Future studies should focus on the practical implementation of digital interventions in real-world settings to achieve transformative impacts.

Development of a pharmacist -led cancer related pain management module for cancer patients on opioids

Mon, 25 Aug 2025 00:00:00 GMT

Title: Development of a pharmacist -led cancer related pain management module for cancer patients on opioids Authors: Nancy Y. H. Nashwan (P103903) Abstract: Pain is a significant symptom of cancer, profoundly affecting patients' quality of life. This project focuses on optimizing pain management in cancer patients using pharmacist-led interventions, supported by a well-defined, evidence-based module. A scoping review examined the effects of such interventions in adult cancer patients, analyzing studies published between 2000 and 2022. Of the 7042 studies screened, 37 were included. These studies highlighted the positive effects of educational programs on pain management. A cross-sectional study at a Turkish Palestinian Friendship Hospital (TPFH) assessed cancer pain and opioid nonadherence among 270 patients. Pain intensity and interference as well as adherence were evaluated using validated questionnaires. The average pain intensity score was 5.96 suggesting moderate pain intensity. Less than one third of the patients had high adherence score towards the opioid prescribed. Predictors of opioid adherence were educational level, perceived relief with analgesic and presence of side effects. Addressing these factorsoptimize adherence and educating patients are critical for effective pain management. To further explore facilitators and barriers towards opioid adherence, a qualitative study was conducted at TPFH between August and September 2023. This study involved telephone-based semistructured interviews with 15 high-adherence and 15 low-adherence patients based on the previous survey. It investigated their experiences with analgesic use, side effect management, support systems and routines during medication shortages that may have affected their adherence to opioids. Insights from these interviews revealed patient attitudes toward opioids and identified areas for improvement in adherence strategies. These comprehensive findings together with extensive review of the literature informed the development of a pharmacist-led module designed to improve cancer-related pain management outcomes. A Content Validity Index (CVI) was employed to evaluate the module. Three oncologists and three oncology pharmacists assessed the module’s content and usability using a 4-point Likert scale. The CVI measured content relevance through two metrics: the Average (S-CVI/Ave) and Universal Agreement (S-CVI/UA). Usability testing was conducted using the System Usability Scale (SUS) by participating pharmacists, confirming the module’s practical application. Both CVI and SUS showed good validity and usability, respectively. This research underscores the importance of tailored interventions in managing cancer pain, emphasizing patient education, adherence optimization, and collaboration among healthcare professionals. By addressing barriers to opioid use and enhancing pharmacist-led initiatives, the module offers a comprehensive approach to optimizing opioid use for cancer pain management improving the quality of life for cancer patients.

Mekanisme neurotoksisiti methiopropamine (MPA) terhadap tingkah laku dan otak pada mencit

Tue, 03 Jun 2025 00:00:00 GMT

Title: Mekanisme neurotoksisiti methiopropamine (MPA) terhadap tingkah laku dan otak pada mencit Authors: Mohd Khairulanwar Bunaim (P112632) Abstract: Methiopropamine (MPA) ialah sebuah bahan psikoaktif baharu (NPS) yang bertindak sebagai perangsang sistem saraf pusat (SSP) dan analog kepada methamphetamine (METH). Penggunaan MPA secara rekreasi telah dikaitkan dengan gejala neurologikal seperti kemerosotan kognitif serta tingkah laku kemurungan dan keresahan, namun bukti saintifiknya masih terhad. Oleh yang demikian, kajian ini dijalankan untuk menyiasat kesan MPA terhadap tingkah laku, fungsi otak, perubahan histologi, dan mekanisme neurotoksisiti yang terlibat. Sebanyak 80 ekor mencit Swiss Albino telah dibahagikan secara rawak kepada dua kelompok, dengan setiap kelompok mengandungi empat kumpulan rawatan (n=10 bagi setiap kumpulan): salina, MPA 1 mg/kg, MPA 3 mg/kg, dan METH 1 mg/kg, yang diberikan secara suntikan intraperitoneal selama tujuh hari. Ujian tingkah laku termasuk ujian pengecaman objek baharu (NORT), ujian renang paksa (FST), ujian lapangan terbuka (OFT), dan ujian 8-arm radial maze (8-ARM) telah dijalankan. Seterusnya, pengukuran neurotransmiter dilakukan menggunakan kromatografi cecair berprestasi tinggi dengan pengesan elektrokimia (HPLC-ECD), ekspresi p-ERK1/2 menggunakan imunohistokimia, dan perubahan histologi menggunakan pewarnaan Nissl dan hematoksilin & eosin (H&E). Manakala, mikrotatasusunan serta reaksi berantai polimerase kuantitatif (qPCR) digunakan untuk menjalankan analisis gen. Dapatan menunjukkan MPA 3 mg/kg menjejaskan memori pengecaman dan memori spatial, serta menunjukkan kesan antiresah tanpa menyebabkan tingkah laku seakan kemurungan. Neurodegenerasi awal dan penurunan aktiviti dopaminergik serta ekspresi p-ERK1/2 di korteks prafrontal turut diperhatikan. Laluan gen berkaitan tekanan oksidatif dan neuroinflamasi didapati meningkat. Kajian ini memberikan pemahaman yang lebih mendalam mengenai risiko neurotoksisiti MPA dan mengenal pasti mekanisme molekular yang terlibat.

Penerokaan rawatan penyakit ringan dalam sistem kesihatan Malaysia: potensi pemerkasaan peranan ahli farmasi komuniti

Tue, 03 Jun 2025 00:00:00 GMT

Title: Penerokaan rawatan penyakit ringan dalam sistem kesihatan Malaysia: potensi pemerkasaan peranan ahli farmasi komuniti Authors: Tew, Mei Mei (P97783) Abstract: Tesis ini bertujuan untuk meneroka potensi penggunaan farmasi komuniti dalam menguruskan penyakit ringan dan mengurangkan tekanan kepada jabatan kecemasan. Kajian ini melibatkan empat bahagian. Kajian yang pertama bertujuan untuk menilai beban dan kos rawatan penyakit ringan di jabatan kecemasan di hospital awam. Hasil kajian menunjukkan bahawa jabatan kecemasan mengalami beban yang tinggi di mana sebanyak 82.3% daripada keseluruhan lawatan ke jabatan kecemasan adalah diklasifikasi dalam ketegori Zon Hijau. Sebanyak 82 sampel telah dikumpul untuk pengiraan kos rawatan penyakit ringan di jabatan kecemasan. Hasil kajian mendapati bahawa min rawatan satu penyakit ringan di hospital awam dianggarkan memerlukan kos sebanyak RM 45.88 ± RM 33.56. Projek kedua melibatkan kajian kualitatif temubual separa berstruktur ke atas 25 orang pesakit yang menerima rawatan di jabatan kecemasan untuk rawatan penyakit ringan. Terdapat enam tema utama dikenalpasti mempengaruhi pesakit untuk mendapatkan rawatan di jabatan kecemasan iaitu persepsi keseriusan penyakit, persepsi positif terhadap perkhidmatan jabatan kecemasan, kekurangan penggunaan kemudahan penjagaan kesihatan lain, kemudahan dan kos yang lebih murah, kurang memahami beban kerja jabatan kecemasan seirta kurang keupayaan untuk mengurus penyakit ringan sendiri. Seterusnya kajian soal selidik dijalankan ke atas 562 orang awam bagi menyiasat pengetahuan, persepsi dan amalan dalam memilih farmasi komuniti untuk rawatan penyakit ringan. Majoriti responden (n = 354, 63.0%) mempunyai pengetahuan yang baik (skor 9-10), amalan yang baik (n = 367, 65.3%) (skor 18-30) dan skor persepsi yang baikfn = 305, 54.3%) (skor 41-60). Kajian mendapati bahawa faktor sepera umur (OR 0.956, 95% CI 0.932 to 0.981, p=0.001), individu yang mempunyai tahap pendidikan teitinggi (OR 4.29, 95% CI 1.316 to 13.986, p=0.02), individu yang rnempunyai pengalaman terdahulu (OR 2.17, 95% CI 1.202 to 3.932, 0=0,0 1) serta kekerapan menggunakan farmasi komuniti (OR 2.08, 95% CI 1.271 to 3.402, p=0.004) mempunyai pengaruh yang signifikan terhadap persepsi baik responden, manakala umur (OR 1.039, 95% CI 1.062-1.067, p=0.004) dan kekerapan menggunakan farmasi komuniti (OR 2.527, 95% CI 1.482-4.344, p=0.001) didapati mempunyai pengaruh yang signifikan terhadap amalan baik responden. Kajian keempat dijalankan menggunakan kaedah pemetaan geografi ke atas -7051 klinik pengamal am (GP), 3084 farmasi komuniti (CP), 139 hospital awam (GH) dan 990 klinik kesihatan primer (KK). Kemudahan penjagaan kesihatan didapati sangat padat di kawasan bandar berbanding di luar bandar. Terdapat enam daerah yang tidak mempunyai CP, 2 tidak mempunyai GP, dan 11 tidak mempunyai kedua-duanya. Nisbah keseluruhan GP, CP, GH dan KK kepada populasi ialah 1:4228, 1:10,200, 1:223,619 dan 1:31,397, masing-masing. Secara keseluruhannya kajian ini mendapati terdapat potensi dalam revolusi pengurusan penyakit ringan di fasiliti komuniti farmasi kepada masyarakat. Potensi ini dijangka dapat mengurangkan kesesakan jabatan kecemasan, dan mengoptimumkan penggunaan sumber penjagaan kesihatan. Dapatan kajian boleh digunakan oleh pembuat dasar, pengamal penjagaan kesihatan dan pihak berkepentingan untuk mengoptimumkan sistem kesihatan untuk pengurusan penyakit ringan, dan meningkatkan kecekapan sistem kesihatan dengan penggunaan sumber kesihatan yang berkesan.